The adrenal glands are associated with the kidneys; one gland is located on top of each kidney as illustrated in Figure 1. The adrenal glands consist of an outer adrenal cortex and an inner adrenal medulla. These regions secrete different hormones.

Adrenal Cortex

Figure 1. The location of the adrenal glands on top of the kidneys is shown. (credit: modification of work by NCI)

The adrenal cortex is made up of layers of epithelial cells and associated capillary networks. These layers form three distinct regions: an outer zona glomerulosa that produces mineralocorticoids, a middle zona fasciculata that produces glucocorticoids, and an inner zona reticularis that produces androgens.

The main mineralocorticoid is aldosterone, which regulates the concentration of Na⁺ ions in urine, sweat, pancreas, and saliva. Aldosterone release from the adrenal cortex is stimulated by a decrease in blood concentrations of sodium ions, blood volume, or blood pressure, or by an increase in blood potassium levels.

The three main glucocorticoids are cortisol, corticosterone, and cortisone. The glucocorticoids stimulate the synthesis of glucose and gluconeogenesis (converting a non-carbohydrate to glucose) by liver cells and they promote the release of fatty acids from adipose tissue. These hormones increase blood glucose levels to maintain levels within a normal range between meals. These hormones are secreted in response to ACTH and levels are regulated by negative feedback.

Androgens are sex hormones that promote masculinity. They are produced in small amounts by the adrenal cortex in both males and females. They do not affect sexual characteristics and may supplement sex hormones released from the gonads.

Adrenal Medulla

The adrenal medulla contains large, irregularly shaped cells that are closely associated with blood vessels. These cells are innervated by preganglionic autonomic nerve fibers from the central nervous system.

The adrenal medulla contains two types of secretory cells: one that produces epinephrine (adrenaline) and another that produces norepinephrine (noradrenaline). Epinephrine is the primary adrenal medulla hormone accounting for 75 to 80 percent of its secretions. Epinephrine and norepinephrine increase heart rate, breathing rate, cardiac muscle contractions, blood pressure, and blood glucose levels. They also accelerate the breakdown of glucose in skeletal muscles and stored fats in adipose tissue.

The release of epinephrine and norepinephrine is stimulated by neural impulses from the sympathetic nervous system. Secretion of these hormones is stimulated by acetylcholine release from preganglionic sympathetic fibers innervating the adrenal medulla. These neural impulses originate from the hypothalamus in response to stress to prepare the body for the fight-or-flight response.

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