PHYSIOLOGY OF ADRENAL MEDULLA Dr Eman El Eter

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PHYSIOLOGY OF ADRENAL MEDULLA Dr. Eman El Eter

PHYSIOLOGY OF ADRENAL MEDULLA Dr. Eman El Eter

A case study? “Rollie Hendrix, ” a 35 -year-old husband father of three children,

A case study? “Rollie Hendrix, ” a 35 -year-old husband father of three children, has been experiencing headaches and palpitations of increasing frequency and severity over the past six months. In addition, he has had periods of intense anxiety and panic attacks.

Hormones of the Adrenal Medulla • Adrenaline (epinephrine) • Noradrenaline (norepinephrine) • 80% of

Hormones of the Adrenal Medulla • Adrenaline (epinephrine) • Noradrenaline (norepinephrine) • 80% of released catecholamines are epinephrine. • Hormones are secreted and stored in the adrenal medulla and released in response to appropriate stimuli.

Catecholamine Synthesis tyrosine hydroxylase dihydroxyphenylalanine L-aromatic amino acid decarboxylase dopamine-B-hydroxylase norepinephrine phenylethanolamine-N-methyltransferase epinephrine

Catecholamine Synthesis tyrosine hydroxylase dihydroxyphenylalanine L-aromatic amino acid decarboxylase dopamine-B-hydroxylase norepinephrine phenylethanolamine-N-methyltransferase epinephrine

Mechanism of Action • Receptor mediated – adrenergic receptors • Peripheral effects are dependent

Mechanism of Action • Receptor mediated – adrenergic receptors • Peripheral effects are dependent upon the type and ratio of receptors in target tissues Receptor Norepinephrin +++++ e Epinephrine ++++ ++ ++++ Relative effects of epinephrine and norepinephrine on and adrenergic receptors. Guyton

Differences between Epinephrine and Norepinephrine Epinephrine >> norepinephrine – in terms of cardiac stimulation

Differences between Epinephrine and Norepinephrine Epinephrine >> norepinephrine – in terms of cardiac stimulation leading to greater cardiac output ( stimulation). Epinephrine < norepinephrine – in terms of constriction of blood vessels – leading to increased peripheral resistance – increased arterial pressure. Epinephrine >> norepinephrine –in terms of increasing metabolism.

Effects of Epinephrine • Metabolism - Glycogenolysis in liver and skeletal muscle: • can

Effects of Epinephrine • Metabolism - Glycogenolysis in liver and skeletal muscle: • can lead to hyperglycemia - Mobilization of free fatty acids - Increase metabolic rate -Increases O 2 consumption.

Effects of Epinephrine • Cardiovascular - Heart rate & cardiac contractility - BP Respiration:

Effects of Epinephrine • Cardiovascular - Heart rate & cardiac contractility - BP Respiration: Oxygen consumption & respiratory rate

Pheochromocytoma • A catecholamine-secreting tumor of chromaffin cells of the adrenal medulla adrenal pheochromocytoma

Pheochromocytoma • A catecholamine-secreting tumor of chromaffin cells of the adrenal medulla adrenal pheochromocytoma (90%) Extra-adrenal pheochromocytoma

Signs and Symptoms of Pheochromocytoma • resistant hypertension (95%) classic triad • headache •

Signs and Symptoms of Pheochromocytoma • resistant hypertension (95%) classic triad • headache • sweating • palpitations • chest pain • anxiety • glucose intolerance • increased metabolic rate

Diagnosis and Treatment • High plasma catecholamine. • Increased metabolites [VMA] in urine •

Diagnosis and Treatment • High plasma catecholamine. • Increased metabolites [VMA] in urine • Treatment is surgical resection Imaging

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Adrenal Androgens Dr Eman El Eter Androgens areAdrenal Androgens Dr Eman El Eter Androgens are
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Dr Eman El Eter PHYSIOLOGY OF SLEEP ANDDr Eman El Eter PHYSIOLOGY OF SLEEP AND
PHYSIOLOGY OF MICTURITION Dr Eman El Eter MicturitionPHYSIOLOGY OF MICTURITION Dr Eman El Eter Micturition