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Adrenal Medulla

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Transcript

  • 1. DR. LAXMIKANTA SAY
  • 2. EPINEPHRINE NOREPINEPHRINE DOPAMINE
  • 3. Mechanism of Secretion Nervous Control Physiological & Psychological
  • 4. Sympathetic Activation Nerve Impulse travel across Preganglionic sympathetic fiber Activation Ach receptor Na + Ca 2+ Chromaffin Cell •Epinephrine •NE •ATP •β – hydroxylase •Chromogranin
  • 5. Anxiety - Perception or anticipation of Danger  Pain, trauma  Hypovolaemia  Anoxia  Exposure to extremes of temp.  Hypoglycemia  Severe exercise 
  • 6.  1. Negative feedback mechanism by Dopamine and Norephrine  2. During sleep secretion decreases  3. Increases during fight or flight reaction  4. Increases during cold
  • 7. HYPOTHALAMUS SYMPATHETIC PATHWAY ADRENALINE STRESS RESPONSE FIGHT-or-FLIGHT
  • 8. RECEPTORS α β D
  • 9.  α 1- Post junctional  α 2- Pre junctional on effector organ  Location on nv. Ending  Location - Blood vessel, Nonpregnant Uterus, Glands - Pre-synaptic nerve Terminal  Functions - Excitatory - Vasoconstriction - Inhibit intestinal Motility  Functions - Inhibitory
  • 10.        Vasoconstriction Iris dilation Intestinal relaxation Intestinal sphincter contraction Pilomotor contraction Bladder sphincter contraction Inhibition of neurotransmitter release
  • 11. β1  Location – Heart, JG Cell, Renal  β2  Location – Heart, Bronchi, BV, Uterus, Liver, GIT, Urinary Tract,, Eye, Skeletal Muscle    β3 Location – Adipose Tissue
  • 12.            Vasodilation (β2) Cardioacceleration (β1) Increased myocardial strength (β1) Intestinal relaxation (β2) Uterus relaxatation (β2) Broncho dilation (β2) Calorigenesis (β2) Glycogenolysis (β2) Lypolysis (β1) Bladder wall relaxatation (β2) Thermogenesis (β2)
  • 13. Cardiovascular  Alertness  Blood glucose  Metabolic rate  Lipolysis  K+ 
  • 14. Generalised vasoconstriction – release of NE  (+)ve ionotropic action  SBP  Kidney 1. Vasodilatation – specific dopaminergic receptors 2. Natriuresis – inhibiting Na+-K+ATPase  (Treatment of shock)
  • 15. ADRENAL ADRENAL CORTEX MINERALOCORTIC OIDS ADRENAL MEDULLA GLUCOCORTIC OIDS CATECHOLAMINES
  • 16. HYPERSECRETION Primary Hyperaldosteronism (CONN’S SYNDROME)  Cause - adenoma, tumor of zona glomerulosa   ( - Clinical Features Sodium absorption Sodium content in Sweat, Saliva, GIT secretions) Extracellular volume Hypokalemic Nephropathy Hypertension Metabolic alkalosis
  • 17. Acute – Adrenalectomy, abrupt withdrawal, Sudden stress or Infection Chronic – Auto-immune diorders, TB, Carcinoma, Water – house Friderichensen syndrome) Clinical Features - Cutaneous & Mucocutaneous pigmentation - Hypotension - Hypoglycemia - Fatigability - Weakness - Weight Loss - Anorexia 
  • 18.  ACTH – dependent Cushing’s (80%) Cause - 1. Hyperactivity of Pituitary - 2. Ectopic ACTH production – Ca. Lungs, viscera - 3. Hypothalamic disorders - 4. Excessive ACTH therapy 
  • 19.  Cause - adrenal adenoma, carcinoma, Iatrogenic Clinical Features -1. Trunkal Obesity or centripetal Obesity - 2. Buffallo Hump - 3. Moon Face - 4. Purple stria - 4. Muscle weakness - 5. Sodium & water retention - 6. Hyperglycemia - 7. Hirsuitism 
  • 20.  Cause – Benign tumor of Chromaffin cells of adrenal medulla Clinical Features - 1. Episodic or non-episodic Hypertension - 2. Attacks of Tachycardia, Palpitation, Sweating, Pallor, Head ache - 3. Weight Loss & Waekness - 4. Abdominal pain, Vomiting, constipation & Glucose intolerance 