The adrenal glands sit above the kidneys and are composed of an inner medulla and outer cortex. The cortex secretes corticosteroids like mineralocorticoids and glucocorticoids, and androgenic hormones. Mineralocorticoids regulate sodium and potassium levels while glucocorticoids increase blood glucose and promote fat mobilization. The medulla secretes epinephrine and norepinephrine to stimulate the sympathetic nervous system. Adrenal insufficiency can cause severe renal disorders and electrolyte imbalances due to lack of mineralocorticoid production. Dental management of patients with adrenal insufficiency requires consideration of their corticosteroid needs and risk of stress.
3. INTRODUCTION
• The two adrenal glands, each of which weighs about 4
grams, lie at the superior poles of the two kidneys.
• Each gland is composed two distinct parts: the inner
medulla and the outer cortex.
4. ADRENAL CORTEX:
• Secretes corticosteroids- mineralo-corticosteroids,
gluco-corticosteroids and androgenic hormones.
• Mineralo-corticosteroids- affect electrolytes of
extracellular fluids: sodium and potassium.
• Gluco-corticosteroids- increase the blood glucose level.
• Androgenic hormones- exhibit the same effects as the
male sex hormones.
5. ADRENAL MEDULLA:
• Functionally related to the sympathetic nervous system.
• Secretes Epinephrine and Nor-epinephrine
• These hormones cause almost the same effects as
direct stimulation of the sympathetic nerves in all parts
of the body.
6.
7.
8. FUNCTIONS OF MINERALO-CORTICOIDS
(ALDOSTERONE) :
• Mineralocorticoid Deficiency Causes Severe Renal
disorders like Sodium Chloride Wasting and
Hyperkalemia.
• Aldosterone Increases Renal Tubular Reabsorption
of Sodium and Secretion of Potassium.
• Aldosterone Stimulates Sodium and Potassium
Transport in Sweat Glands, Salivary Glands, and
Intestinal Epithelial Cells.
9. FUNCTIONS OF GLUCO-CORTICOIDS
(CORTISOL):
• Stimulate gluconeogenesis (formation of carbohydrate
from proteins and some other substances) by the liver.
• Cortisol also causes a moderate decrease in the rate of
glucose utilization by most cells in the body.
• Decreased protein synthesis and increased catabolism
of protein already in the cells.
• It promotes mobilization of fatty acids from adipose
tissue.
10. • The cortisol has two basic anti-inflammatory effects:
(1) It can block the early stages of the inflammation
process before inflammation even begins.
(2) If inflammation has already begun, it causes rapid
resolution of the inflammation and increased rapidity of healing.
• Cortisol reduces lymphocyte production and hence, suppresses
immunity.
• Cortisol Blocks the Inflammatory Response to Allergic
Reactions.