Adrenal medulla

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Overview
The adrenal medulla is part of the adrenal gland. It is located at the center of the gland, being surrounded by the adrenal cortex.

Function
Composed mainly of hormone-producing chromaffin cells, the adrenal medulla is the principal site of the conversion of the amino acid tyrosine into the catecholamines adrenaline (epinephrine), noradrenaline (norepinephrine), and dopamine.

In response to stressors such as exercise or imminent danger, medullary cells release catecholamines into the blood in an 85:15 ratio of adrenaline to noradrenaline.

Notable effects of adrenaline and noradrenaline include increased heart rate and blood pressure, blood vessel constriction, bronchiole dilation, and increased metabolism, all of which are characteristic of the fight-or-flight response. Release of catecholamines is stimulated by nerve impulses, and receptors for catecholamines are widely distributed throughout the body.

Origin
Medullary cells are derived from the embryonic neural crest and, as such, are simply modified neurons.

In particular, they are modified postganglionic cells of the sympathetic nervous system that have lost their axons and dendrites, receiving innervation from corresponding preganglionic fibers.

Moreover, as the synapses between pre- and postganglionic fibers are called ganglia, the adrenal medulla is actually a ganglion of the sympathetic nervous system.

Pathology
Neoplasms including:
 * Pheochromocytoma (most common) a catecholamine-secreting tumor of the adrenal medulla
 * Neuroblastoma a neuroendocrine tumor of any neural crest tissue of the sympathetic nervous system
 * Ganglioneuroma a tumor in the nerve cells of the peripheral nervous system