Cardiac Output

HR,  SV , BP
CVS
Blood Re-distribution
 Coronary, Muscle,  GIT
GIT Motility
Skin  Sweating
Skeletal
 Tension Generated
Muscle
Nervous  Brain Arousal, Reflex Speed,
Tissue Aggression, Anxiety
Metabolic Effects of Adrenal
Medulla Hormones
►Rare catecholamine producing tumour
►Arises from chromaffin cells of adrenal medulla or from
sympathetic ganglia

►Symptoms (5Ps)
 Pressure - sudden major increase in blood pressure
 Pain - abrupt throbbing headache, chest, abdominal pain
 Perspiration - generalized diffuse diaphoresis
 Palpitations usually with true tachycardia often with feelings of
panic or anxiety
 Pallor of the skin from vasoconstriction
Steroid Hormones
 Mineralocorticoids ►Derived From
Cholesterol
Aldosterone
 Not Stored
 Synthesised on Demand
 Glucocorticoids
►Bound to Plasma
Cortisol
►Intra Cellular
 Weak Androgens Receptors
 Cytoplasmic or
Weak Sex Steroids Nuclear

►Alter Gene Activity

Secreted By Zona Fasiculata and
Reticularis

Cortisol, Corticosterone,
Cortisone
Cortisol Blood Concentration ≈
5-25g/100mls
Major glucocorticoid in humans
Mainly produced by zona fasciculata
Contains enzymes for synthesis
Smaller amts by zona reticularis

Release controlled by HPA axis

Dexamethasone suppression test
Based on negative feedback
Test cause of hypercortisolemia
Mainly Bound in Plasma ►Free Cortisol
Controlled
 Cortisol Binding  Increased Transcortin
Globulin  Oestrogens
• Transcortin • Pregnancy
• Oral
 Synthesised by the contraceptives
Liver
 Transcortin
 Reservoir of Hormone  Free hormone
 Negative Feedback
Equilibrium  Cortisol secretion
 Free and Bound  Free Hormone
Hormone
Cardiovascular
 Potentiates Effects of Adrenaline -  β-adrenergic Sensitivity

Inhibition of bone formation

 ↓ osteoblast production and ↓ Ca2+ production

Tissue Repair
  Amino Acid Uptake by Liver -  Plasma Hepatic Proteins

Mineralocorticoid Like Effects of Cortisol

 Only Significant At Prolonged High Levels
  Sodium and Water Re-absorption,  Potassium Excretion
►Maintain Blood Volume in Dehydration, Hemorrhagic Stress
21β
Congenital abnormality –
adrenogenital syndrome or congential adrenal hyperplasia
Unable to produce mineralocorticoids or glucocorticoids
Produce adrenal androgens – virilisation of females
In utero – cause masculinisation of external genitalia
In children – increase growth, suppression of gonadal fct

17α
Less common. No glucocorticoids or adrenal androgens
Overproduction of corticosterone but inhibits aldosterone levels
(inhibitory feedback)