Stress can be either physical or psychological or both. One of the major functions of the adrenal gland is to respond to stress. The medulla is stimulated to secrete the amine hormones epinephrine and norepinephrine. The sympathomedullary (SAM) pathway involves the stimulation of the medulla by impulses from the hypothalamus via neurons from the thoracic spinal cord. It is really an extension of the autonomic nervous system, which regulates homeostasis in the body. The adrenal medulla is neuroendocrine tissue composed of postganglionic sympathetic nervous system (SNS) neurons. This pathway will be discussed in more detail below. ACTH then stimulates the adrenal cortex to produce the hormone cortisol. The HPA axis involves the stimulation of hormone release of adrenocorticotropic hormone (ACTH) from the pituitary by the hypothalamus. The adrenal cortex, as a component of the hypothalamic-pituitary-adrenal (HPA) axis, secretes steroid hormones important for the regulation of the long-term stress response, blood pressure and blood volume, nutrient uptake and storage, fluid and electrolyte balance, and inflammation. Each region secretes its own set of hormones. The cortex itself is divided into three zones: the zona glomerulosa, the zona fasciculata, and the zona reticularis.

The adrenal gland consists of an outer cortex of glandular tissue and an inner medulla of nervous tissue.

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Medulla of adrenal gland