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    Suprarenal (Adrenal) Gland: Dr. R. Santhakumar

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    drsuban
    The suprarenal (adrenal) gland is a paired endocrine organ located above the kidneys. It has an outer cortex and inner medulla. The cortex secretes mineralocorticoids, glucocorticoids, and sex hormones to regulate electrolyte balance, carbohydrate metabolism, and sex hormones. The medulla secretes catecholamines like adrenaline and noradrenaline. The glands receive a rich blood supply and drain via the suprarenal veins. Developmental anomalies can include agenesis, fusion, or accessory glands. Diseases involve hypo- or hyperfunction of the cortex or tumors of the medulla.

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    Suprarenal (Adrenal) Gland: Dr. R. Santhakumar

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    drsuban
    134 views33 pages
    The suprarenal (adrenal) gland is a paired endocrine organ located above the kidneys. It has an outer cortex and inner medulla. The cortex secretes mineralocorticoids, glucocorticoids, and sex hormones to regulate electrolyte balance, carbohydrate metabolism, and sex hormones. The medulla secretes catecholamines like adrenaline and noradrenaline. The glands receive a rich blood supply and drain via the suprarenal veins. Developmental anomalies can include agenesis, fusion, or accessory glands. Diseases involve hypo- or hyperfunction of the cortex or tumors of the medulla.

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    The suprarenal (adrenal) gland is a paired endocrine organ located above the kidneys. It has an outer cortex and inner medulla. The cortex secretes mineralocorticoids, glucocorticoids, and sex hormones to regulate electrolyte balance, carbohydrate metabolism, and sex hormones. The medulla secretes catecholamines like adrenaline and noradrenaline. The glands receive a rich blood supply and drain via the suprarenal veins. Developmental anomalies can include agenesis, fusion, or accessory glands. Diseases involve hypo- or hyperfunction of the cortex or tumors of the medulla.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    134 views33 pages

    Suprarenal (Adrenal) Gland: Dr. R. Santhakumar

    Uploaded by

    drsuban
    The suprarenal (adrenal) gland is a paired endocrine organ located above the kidneys. It has an outer cortex and inner medulla. The cortex secretes mineralocorticoids, glucocorticoids, and sex hormones to regulate electrolyte balance, carbohydrate metabolism, and sex hormones. The medulla secretes catecholamines like adrenaline and noradrenaline. The glands receive a rich blood supply and drain via the suprarenal veins. Developmental anomalies can include agenesis, fusion, or accessory glands. Diseases involve hypo- or hyperfunction of the cortex or tumors of the medulla.

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    of 33

    SUPRARENAL(ADRENAL) GLAND

    DR. R. SANTHAKUMAR P.G STUDENT DEPT OF ANATOMY RMMC, AU

    SUPRARENAL GLANDS INDRODUCTION


    A pair of endocrine glands situated on the posterior abdominal wall over the upper pole of kidneys behind the peritoneum Golden yellow in color

    HISTORY
    Discovered by Eustachius in 1522 Winslow (1752) gave detailed & accurate description Ecker (1842) microscopic anatomy Brown-Sequard (1856) established adrenal glands were essential for life

    DIMENSIONS
    50 mm in height 30 mm in breadth 10 mm in thickness Average weight of 2 glands 7-12 gms Size 1/3 of kidney at birth (0.2% of body weight) Size 1/30 of kidney in adults Larger in females

    DEVELOPMENT
    Suprarenal gland develops from 2 components Mesodermal portion - which forms the cortex Ectodermal portion (neural crest cells)which forms the medulla

    DEVELOPMENTAL CHANGES IN THE FOETUS


    2nd month suprarenal glands are larger than kidneys 4-6 months kidneys are twice as large as suprarenals 9th month suprarenals are 1/3rd the size of kidney

    GROWTH CHANGES
    At birth - glands are larger & 1/3rd the size of kidney of same side Immediately after birth - cortex decreases in size & medulla grows little in size End of 2nd month - size decreased up to 50% End of 2nd year-glands begin to grow again By puberty - regain the weight at birth No further weight increase in adult life

    COVERINGS
    Suprarenal glands are surrounded by connective tissue containing perinephric fat Each suprarenal gland together with kidney is enclosed within the renal fascia Suprarenal glands are separated from kidneys by small amount of fibrous tissue

    RIGHT SUPRARENAL GLAND


    Pyramidal in shape Has 2 well defined lower projectionslimbs Parts Apex Base 2 surfaces anterior & posterior 3 borders anterior, medial & lateral

    RT SUPRARENAL-RELATIONS
    Apex Bare area of liver Base Upper pole of Right kidney Anterior surface Medially Inferior vena cava Laterally Bare area of Right lobe of liver Inferiorly 2nd part of duodenum Posterior surface Upper part Right crus of diaphragm Lower part superior aspect of upper pole of Rt kidney

    RELATIONS - contd
    Anterior border it presents the hilum a little below the apex - where the right suprarenal vein emerges Medial border Right coeliac ganglion Right inferior phrenic artery Lateral border Liver

    LEFT SUPRARENAL GLAND


    Semilunar in shape flattened in anteroposterior plane Slightly larger than right suprarenal Parts 2 ends Upper narrow end Lower rounded end 2 borders medial convex & lateral concave 2 surfaces anterior & posterior

    LT SUPRARENAL-RELATIONS
    Upper end Posterior end of spleen Lower end near the lower end is the hilum through which Lt suprarenal vein emerges Anterior surface Upper part Cardiac end of stomach, spleen Lower part Splenic artery, pancreas

    RELATIONS - contd
    Posterior surface Laterally Kidney Medially Left crus of diaphragm Medial border Left coeliac ganglion Left inferior phrenic artery Left gastric artery Lateral border Stomach

    ARTERIAL SUPPLY
    Suprarenal & thyroid viscera having greatest supply per gram of tissue Supplied by 3 arteries: Superior suprarenal artery branch of inferior phrenic artery Middle suprarenal artery branch of abdominal aorta Inferior suprarenal artery branch of renal artery

    ARTERIAL SUPPLY

    VENOUS DRAINAGE & LYMPHATIC DRAINAGE


    Each gland is drained by one vein Rt suprarenal V drains into inferior vena cava Lt suprarenal V drains into Lt renal V Since venous drainage from each gland is via a single vein, damage to a suprarenal vein is more likely to cause infarction of that gland than damage to one of the suprarenal arteries Lymphatic drainage to para aortic lymph nodes

    VENOUS DRAINAGE

    NERVE SUPPLY
    Largest autonomic supply than any other organ Pre-ganglionic sympathetic fibers originate in the lower thoracic spinal segments Fibers reach suprarenal plexus via branches from coeliac ganglion & plexus and via greater splanchnic nerve These fibers synapse with large medullary chromaffin cells, which may be considered homologous with post-ganglionic sympathetic neurones

    MICROSTRUCTURE
    Outer part Cortex Inner part Medulla Cortex forms the main mass yellowish in color Medulla 1/10th of the gland - dark red/grayish in color Gland has a thick collagenous capsule

    CHANGES OF ADRENAL CORTEX IN NEWBORN INFANT


    2 components Outer true cortex Central foetal cortex 80% 2 weeks after birth foetal cortex decreases in size by 50% Foetal cortex disappears completely by 6 months of age

    HISTOLOGY OF SUPRARENAL

    HISTOLOGY-CORTEX
    Cortex composed of 3 zones: Zona glomerulosa - narrow region of small polyhedral cells in rounded clusters-deeply staining nuclei & basophilic cytoplasm Zona fasciculata - large polyhedral cells arranged in straight columns with venous sinusoids between them Zona reticularis - branching interconnected network of rounded cells

    SUPRARENALCORTEX HISTOLOGY

    CORTEX-FUNCTIONS
    Cells in Zona glomerulosa Mineralocorticoids (eg. Aldosterone), which regulate electrolyte & water balance Cells in Zona fasciculata Glucocorticoids (eg. Cortisol), which maintain carbohydrate balance Cells in Zona reticularis Sex hormones (progesterone, estrogens, androgens) Cortex is essential to life, complete removal is lethal without replacement therapy

    SUPRARENAL MEDULLA
    Composed of groups & columns of chromaffin cells separated by large venous sinusoids Chromaffin cells form part of neuro endocrine system & are functionally equivalent to post-ganglionic sympathetic nerones Chromaffin cells synthesize, store & release the catecholamines (adrenaline & nor adrenaline) into the venous sinusoids Medulla is not essential to life

    SUPRARENAL MEDULLA HISTOLOGY

    DEVELOPMENTAL ANOMALIES
    Agenesis of suprarenal glands Fusion of suprarenal glands Hypoplasia of suprarenal glands Accessory suprarenal glands - small accessory glands composed of cortical tissue may occur in the areolar tissue near the main suprarenal glands & also in spinal cord, epididymis & broad ligament of uterus Congenital adrenal hyperplasia

    APPLIED ANATOMY
    Suprarenal glands best visualized by CT scan Surgery is the treatment of choice for all benign, functional or malignant adrenal tumors Adrenal glands may be approached by 3 open methods Posterior retroperitoneal Anterior transperitoneal Lateral transthoracic Laparoscopic adrenalectomy for small tumors

    SURGERY OF SUPRARENAL

    DISEASES OF SUPRARENAL
    Hypofunction of adrenal cortex Addisons disease Hyperfunction of adrenal cortex : 2 types Adrenogenital syndrome (excess androgens) Cushing syndrome (excess cortisol) Tumour of adrenal medulla pheochromocytoma

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