Anatomy & Embryology
Manit Arya, Taimur T. Shah, Jas S. Kalsi, Herman S. Fernando, Iqbal S. Shergill, Asif Muneer, Hashim U. Ahmed in MCQs for the FRCS(Urol) and Postgraduate Urology Examinations, 2020
Which one of the following is TRUE regarding the adrenal glands?The right gland is round in shape and lies lower than the left.The zona fasciculata produces sex hormones.The cortex contains chromaffin cells, which produce catecholamines.The blood supply to the adrenal gland includes the inferior phrenic artery.Postganglionic sympathetic fibres directly innervate the adrenal glands.
Adrenal Tumors
Dongyou Liu in Tumors and Cancers, 2017
The zona glomerulosa (outer layer, 15% of cortex volume) is composed of small clusters and short trabeculae of relatively small, well-defined cells; it is involved in the production of mineralocorticoids such as aldosterone for regulation of blood pressure and electrolyte balance. The zona fasciculata (middle layer, 80% of cortex volume) is composed of large cells with distinct membranes arranged in cords two cells wide and cytoplasm containing small lipid vacuoles; it is involved in the production of glucocorticoids such as 11-deoxycorticosterone, corticosterone, and cortisol, for regulation of metabolism and immune system suppression. The zona reticularis (inner layer, 5% of cortex volume) is composed of haphazardly arranged small cells with granular and eosinophilic cytoplasm; it is involved in the production of androgens such as dehydroepiandrosterone (DHEA), DHEA sulfate (DHEA-S), and androstenedione (testosterone precursor) for sexual development and functions.
Endocrine system
Aida Lai in Essential Concepts in Anatomy and Pathology for Undergraduate Revision, 2018
Adrenal gland– lies on U. pole of kidneys– cortex (derived from mesoderm) and medulla (derived from ectoderm)– cortex has three layers: zona glomerulosa (aldosterone)zona fasciculata (androgens and cortisol)zona reticularis (oestrogen, androgens and cortisol)
Neuroprotective and tumoricidal activities of cardiac glycosides. Could oleandrin be a new weapon against stroke and glioblastoma?
Published in International Journal of Neuroscience, 2018
İlhan Elmaci, Ebru Emekli Alturfan, Salih Cengiz, Aysel Ozpinar, Meric A. Altinoz
Hamlyn et al. discovered that an endogenous inhibitor of the Na+ pump circulates in human blood plasma which level correlates with the blood pressure [8]. Following this discovery, a number of endogenous CTS as a new type of steroid hormone were defined belonging to the group of cardenolides and bufadienolides. The Na+ pump, which exists in all cells, acts as a hormone receptor for these substances [7]. Zona glomerulosa and zona fasciculata of the adrenal cortex are proposed to store and/or synthesize endogenous ouabain and the adrenal cortex contains more ouabain than the medulla [9]. Pregnenolone and progesterone are endogenous ouabain precursors and blockage of the conversion of pregnenolone to progesterone by trilostane, an inhibitor of 3β-hydroxysteroid dehydrogenase, inhibits ouabain synthesis [10]. Mammalian cells synthesize digoxin as well; it was isolated from human urine and identified with mass spectrometry, proton NMR, and different HPLC systems [11]. Marinobufagenin (3β,5β-dihydroxy-14,14-epoxybufadienolide), discovered first in amphibians, was determined from the urine of patients with myocardial infarction [3]. Telocinobufagin, the reduced form of marinobufagenin, was also determined as an ingredient of human blood plasma by high-resolution mass spectrometry and its plasma concentration is higher than that of marinobufagenin [4]. The compound is synthesized from cholesterol in the adrenal cortex independent of the cholesterol side-chain cleavage [12].
Enlargement of the human adrenal zona fasciculata and chronic psychiatric illness – an autopsy-based study
Published in Stress, 2020
Johannes Rødbro Busch, Sissel Banner Lundemose, Niels Lynnerup, Christina Jacobsen, Martin Balslev Jørgensen, Jytte Banner
Biochemical measurements show endocrine dynamics, but long-term dysregulation of the HPA-axis in chronic mental illness may also be investigated by looking at the regulatory or effector organs themselves. Animal studies correlate a stressful environment to an increased size of the adrenal zona fasciculata (ZF), where the majority of endogenous corticosteroids are produced (Ulrich-Lai et al., 2006). In humans, most research has been limited to radiological studies, with CT and MRI studies demonstrating an increased volume of the adrenal glands in patients with major depressive disorder (Kahl et al., 2015; Nemeroff et al., 1992; Rubin, Phillips, Sadow, & McCracken, 1995; Rubin, Phillips, McCracken, & Sadow, 1996), while others have found no difference (Amsterdam, Marinelli, Arger, & Winokur, 1987; Ludescher et al., 2008). In one study, Szigethy, Conwell, Forbes, Cox, and Caine (1994) investigated adrenal glands removed at autopsies of suicide victims and matched controls, and found an increased weight and an association between larger gland weight and increased thickness of the cortex. This finding is contrasted by Stein, McCrank, Schaefer, & Goyer (1993) who, in a prospective sample of 118 various forensic autopsy cases, found that adrenal gland weight in individuals where the manner of death was ruled suicide was no different than in individuals who died from natural causes or by accident.
Insufficiency of the zona glomerulosa of the adrenal cortex and progressive kidney insufficiency following unilateral adrenalectomy – case report and discussion
Published in Blood Pressure, 2018
Joanna Kanarek-Kucner, Adrian Stefański, Rufus Barraclough, Tomasz Gorycki, Jacek Wolf, Krzysztof Narkiewicz, Michał Hoffmann
In our patient zona fasciculata function was checked before and after UA and additional examination did not reveal any abnormalities. On supplemental fludrocortisone the patient’s aldosterone was 5.3 ng/dl which is in normal range (2.52-39.2ng/dl), with strikingly high renin level 71.5 ulU/ml (despite the fludrocoritosone administration). Specimen for testing was sampled after 1 hour of upright position. Physical activity should stimulate renin and as a consequence aldosterone secretion. In this case we observed abnormal high renin level with poor aldosterone response. Obtained laboratory results suggest subclinical insufficiency of zona glomerulosa. Taking into consideration laboratory results and evident clinical symptoms such as hyperkaliemia, hyponatremia, metabolic acidosis together, proper function of zona fasciculata and no other hormonal causes of hyperkaliemia, insufficiency of the zona glomerulosa of the remaining adrenal gland with residual secretion is suspected. Moreover, in some studies aldosterone level lower than 3.5ng/dl was considered as undetectable [6]. Directly after UA hyperkaliemia coexisted with deterioration in renal function, but further observation did not reveal any relation between creatinine levels (or eGFR) and potassium levels. Moreover in the 12 months follow up any attempt to stop fludrocortisone administration ended up with hyperkaliemia and hyponatremia. It seems unlikely that postoperative hyperkalemia is due only (and directly) to a reduction in renal function.
Related Knowledge Centers
- Adrenal Cortex
- Adrenocorticotropic Hormone
- Anterior Pituitary
- Cortisol
- Dehydroepiandrosterone
- Glucocorticoid
- Zona Glomerulosa
- Zona Reticularis
- Androgen
- Fight-Or-Flight Response