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Adrenal Gland (Glucocorticoids (cortisol (regulation (stimulated by ACTH,…

- - - - mobilizes fat and sugar stores
    - - stimulated by ACTH
      - neg feedback loop to anterior pituitary and hypothalamus
  - - - chronic high blood cortisol
      - spontaneous (making too much cortisol)
        
        primary adrenal defect: often caused by an adrenal tumor (15% of spontaneous)
        
        pituitary gland defect: excessive ACTH secretion due to tumor (85% of spontaneous cases)
      - iatrogenic
        
        prolonged administration of exogenous glucocorticoids
- - - - stimulatory
        
        increased K conc in blood
        
        increased angiotension II (activated renin-angiotension sys)
        
        low bp
        
        ACTH
        
        Na deficiency
      - inhibitory
        
        K deficiency
        
        high Na conc
        
        atrial natriuretic hormone secretion
        
        elevated bp/vol
    - - Addison's disease (primary adrenocorticoid insufficiency)
        
        idiopathic adrenocorticoid atrophy
        
        autoimmune
        
        low aldosterone, cortisol and androgens
      - iatrogenic
        
        mitotane therapy
- - - - produces mineralocorticoids
    - - produces glucocorticoids
    - - produces androgens
  - - - secrete epi (80%)
      - secrete norepi (20%)
      - induce similar effects as direct sympathetic nerve stimulation (fight or flight)
    - - tyrosine taken up by chromaffin cells
      - converted to dopamine, then norepi, then epi