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Physiology

Endocrine

Question 11 of 180

Selective destruction of the zona glomerulosa of the adrenal cortex would produce deficiency of which of the following hormones:

Answer:

The adrenal cortex is functionally and anatomically divided into three zones of tissue which each secrete different steroid hormones:
  • The outer zona glomerulosa secretes mineralocorticoid (aldosterone) which regulates salt and water homeostasis.
  • The zona fasciculata secretes glucocorticoid (cortisol and its analogues) which regulates carbohydrate metabolism and the response to stress.
  • The inner zona reticularis secretes the androgen dehydroepiandrosterone (DHEA) which has effects on the maintenance of secondary sexual characteristics.

Adrenal Function

The adrenal glands are located on the superior pole of each kidney. The glands are retroperitoneal, covered in perinephric fat and enclosed in renal fascia. The adrenal gland is divided into two functionally distinct regions; the larger outer region (comprising about 90% of the gland) called the adrenal cortex and the inner, much smaller region called the adrenal medulla.

By OpenStax College [CC BY 3.0 , via Wikimedia Commons

Adrenal Gland. (Image by OpenStax College [CC BY 3.0 , via Wikimedia Commons)

Adrenal Cortex

The adrenal cortex is functionally and anatomically divided into three zones of tissue which each secrete different steroid hormones:

  • The outer zona glomerulosa secretes mineralocorticoid (aldosterone) which regulates salt and water homeostasis.
  • The zona fasciculata secretes glucocorticoid (cortisol and its analogues) which regulates carbohydrate metabolism and the response to stress.
  • The inner zona reticularis secretes the androgen dehydroepiandrosterone (DHEA) which has effects on the maintenance of secondary sexual characteristics.

The release of cortisol and DHEA is stimulated by adrenocorticotropic (ACTH) hormone from the anterior pituitary, which in turn is released in response to corticotropin-releasing hormone (CRH) from the hypothalamus.

The secretion of aldosterone, in contrast, is mainly regulated by the renin-angiotensin system, in response to low circulating blood volume, hyponatraemia or hyperkalemia.

Adrenal Medulla

The adrenal medulla produces catecholamines, and is controlled by and functions in concert with the sympathetic nervous system.

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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