5Adrenal Gland

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Adrenal gland

In mammals, the adrenal glands (also known assuprarenal glands) are endocrine glands that are lo-cated on the top of the kidneys. They are chiefly re-sponsible for releasing hormones in response to stressthrough thesynthesisof corticosteroidssuch ascortisolandcatecholaminessuch asadrenaline(epinephrine) andnoradrenaline. They also produceandrogensin their in-nermost cortical layer. The adrenal glands affect kid-ney function through the secretion of aldosterone, andrecent data (1998) suggest that adrenocortical cells un-

derpathologicalas well as underphysiologicalconditionsshowneuroendocrineproperties; within normal adrenalglands, this neuroendocrine differentiation seems to berestricted to cells of thezona glomerulosaand might beimportant for anautocrineregulation of adrenocorticalfunction.[1]

1 Structure

The adrenal glands are located bilaterally in theretroperitoneum superior and slightly medial to the

kidneys.

Histology section of human adrenal gland, showing the differ-

ent layers that compose it. From the surface to the center: zona

glomerulosa, zona fasciculata, zona reticularis, medulla. In the

medulla, the central adrenomedullary vein is visible.

In humans, the right adrenal gland is triangular in shape,whereas the left adrenal gland is semilunar in shape;[2] innon-humans, they are quadrilateral in shape. The com-bined weight of the adrenal glands in an adult human

ranges from 7 to 10 grams.

[3]

They are surrounded by anadipose capsuleandrenal fascia.

Each adrenal gland has two distinct structures, the outer

adrenal cortexand the innermedulla, both of which pro-duce hormones. The cortex mainly producescortisol,aldosterone and androgens, while the medulla chiefly pro-ducesadrenalineandnoradrenaline. In contrast to the di-rect innervation of the medulla, the cortex is regulatedbyneuroendocrinehormones secreted from thepituitaryglandwhich are under the control of the hypothalamus,as well as by therenin-angiotensin system.

1.1 Cortex

Main article:Adrenal cortex

The adrenal cortex is devoted to production ofcorticosteroidandandrogen hormones. Specific corticalcells produce particular hormones includingaldosterone,cortisol, andandrogenssuch asandrostenedione. Undernormal unstressed conditions, the human adrenal glandsproduce the equivalent of 3540 mg of cortisone acetateper day.[4]

The adrenal cortex comprises three zones, or layers.

This anatomic zonation can be appreciated at the mi-croscopic level, where each zone can be recognized anddistinguished from one another based on structural andanatomic characteristics.[5] The adrenal cortex exhibits

functional zonationas well: by virtue of the characteris-tic enzymes present in each zone, the zones produce andsecrete distinct hormones.[5]

1.1.1 Zona glomerulosa

Sections of human adrenal glandsimmunostainedforneuronal

cell adhesion molecule (NCAM). Staining for NCAM was re-

stricted to the zona glomerulosa(zg) and the adrenal medulla

(m).[1]

The outermost layer, the zonaglomerulosa is the main sitefor production of aldosterone, amineralocorticoid, by the

1
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2 2 FUNCTION

action of the enzyme aldosterone synthase (also known asCYP11B2).[6][7] Aldosterone is largelyresponsiblefor thelong-termregulation of blood pressure.[8]

The expression of neuron-specific proteins in the zonaglomerulosa cells of human adrenocortical tissues has

been predicted and reported by several authors

[1][9][10]

and it was suggested that the expression of proteins liketheneuronal cell adhesion molecule(NCAM) in the cellsof the zona glomerulosa reflects the regenerative featureof these cells, which would lose NCAM immunoreactiv-ity after moving to thezona fasciculata.[1][11] However,together with other data on neuroendocrine properties ofzona glomerulosa cells, NCAM expression may reflect aneuroendocrine differentiation of these cells.[1] Voltage-dependent calcium channels have been detected in thezona glomerulosaof the human adrenal, which suggeststhatcalcium-channel blockersmay directly influence theadrenocortical biosynthesis ofaldosteronein vivo.[12]

1.1.2 Zona fasciculata

Situated between the glomerulosa and reticularis,the zona fasciculata is responsible for producingglucocorticoids, such as 11-deoxycorticosterone,corticosterone, andcortisolin humans.[13]

1.1.3 Reticularis Zone

The inner most cortical layer, thezona reticularis pro-

duces androgens, mainly dehydroepiandrosterone(DHEA), DHEA sulfate (DHEA-S), andandrostenedione (the precursor to testosterone) inhumans.[13]

1.2 Medulla

Main article:Adrenal medulla

Theadrenal medulla is the core of the adrenal gland,and is surrounded by the adrenal cortex. It secretes

approximately 20% noradrenaline (norepinephrine) and80% adrenaline (epinephrine).[13] The chromaffin cells ofthe medulla, named for their characteristic brown stain-ing withchromic acidsalts, are the bodys main sourceof the circulating catecholaminesadrenaline and nora-drenaline. Catecholamines are derived from the aminoacid tyrosineand these water-soluble hormones are themajor hormones underlying thefight-or-flight response.

To carry out its part of this response, the adrenal medullareceives input from the sympathetic nervous systemthroughpreganglionic fibersoriginating in the thoracicspinal cord from T5T11.[14] Because it is innervated

bypreganglionic nerve fibers, the adrenal medulla canbe considered as a specializedsympathetic ganglion.[14]

Unlike other sympathetic ganglia, however, the adrenal

medulla lacks distinct synapses and releases its secretionsdirectly into the blood.

Cortisol also promotes adrenaline synthesis in themedulla. Produced in the cortex, cortisol reachesthe adrenal medulla and at high levels, the hormone

can promote the upregulation of phenylethanolamineN-methyltransferase (PNMT), thereby increasingadrenaline synthesis and secretion.[5]

1.3 Blood supply

Although variations of the blood supply to the adrenalglands (and indeed the kidneys themselves) are common,there are usually three arteries that supply each adrenalgland:

Thesuperior suprarenal arteryis provided by the

inferior phrenic artery The middle suprarenal artery is provided by the

abdominal aorta

The inferior suprarenal artery is provided by therenal artery

Venousdrainage of the adrenal glands is achieved via thesuprarenal veins:

The right suprarenal vein drains into the inferiorvena cava

The left suprarenal vein drains into the left renal veinor the leftinferior phrenic vein.

In the medulla a particular type of blood vessel calledcentral adrenomedullary vein exists. Its structure is dif-ferent from the other veins in that the smooth muscle initstunica media(the middle layer of the vessel) is arrangedin conspicuous, longitudinally oriented bundles.[15]

The suprarenal vein exits the adrenal gland through a de-pression on its anterior surface known as the hilum. Notethat the arteries supplying the suprarenal gland do notpass through thehilum.[16] The suprarenal veinsmay formanastomoseswith theinferior phrenic veins. Since theright supra-renal vein is short and drains directly into theinferior vena cava it is likely to injure the latter duringremoval of right adrenal for various reasons.

The adrenal glands (alongside the thyroid gland) have oneof the greatest blood supply per gram of tissue of any or-gan. Up to 60arteriolesmay enter each adrenal gland.[17]

This may be one of the reasons lung cancer commonlymetastasizes to the adrenals.

2 Function

The adrenal gland secretes a number of different hor-mones which are metabolised byenzymeseither within
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2.4 Adrenaline and noradrenaline 3

the gland or in other parts of the body. These hormonesare involved in a number of different pathways.[18]

2.1 Aldosterone and mineralocorticoids

Aldosterone's effects are on thedistal convoluted tubuleandcollecting duct of the kidney where it causes in-creased reabsorption of sodium and increased excre-tion of both potassium (by principal cells) and hydro-gen ions (by intercalated cells of the collecting duct).[8]

Sodium retention is also a response of the distal colon,and sweat glands to aldosterone receptor stimulation. Al-though sustained production of aldosterone requires per-sistentcalciumentry through low-voltage activatedCa2+

channels, isolated zona glomerulosa cells are considerednonexcitable, with recorded membrane voltages that aretoo hyperpolarized to permit Ca2+ channels entry.[19]

However, mouse zona glomerulosa cells within adrenalslices spontaneously generate membrane potential oscil-lations of low periodicity; this innate electrical excitabil-ity of zona glomerulosa cells provides a platform for theproduction of a recurrent Ca2+ channels signal that can becontrolled byangiotensin IIand extracellularpotassium,the 2 major regulators of aldosterone production.[19] An-giotensin II originates from plasmaticangiotensin Iafterthe conversion ofangiotensinogenbyreninproduced bythejuxtaglomerular cellsof thekidney.[13]

2.2 Cortisol and glucocorticoids

Cortisol is the main glucocorticoid under normal condi-tions and its actions include mobilization of fats, proteins,and carbohydrates, but it does not increase under star-vation conditions.[13] Additionally, cortisol enhances theactivity of other hormones including glucagon and cate-cholamines. The zona fasciculata secretes a basal levelof cortisol but can also produce bursts of the hormone inresponse toadrenocorticotropic hormone(ACTH) fromtheanterior pituitary.

2.3 Androgen production

Cells inzona reticularis of the adrenal glands producemale sex hormones, orandrogens, the most important ofwhich isDHEA. In general, these hormones do not havean overall effect in the male body, and are converted tomore potent androgens such astestosteroneandDHTortoestrogens(female sex hormones) in thegonads, actingin this way as ametabolic intermediate.[20]

Synthesis of DHEA in the adrenal gland starts withpregnenolone, a common precursor to all steroid hor-mones that is produced from cholesterol. An inter-

mediate step is required to generate DHEA, in whichpregnenolone is converted to 17-hydroxypregnenolone bythe enzyme17-hydroxylase. The same enzyme then

catalizes the conversion of the previous metabolite intoDHEA. A mutation that impairs the ability of the enzymeto catalize the reaction leads to an uncommon form ofcongenital adrenal hyperplasia.[21]

2.4 Adrenaline and noradrenaline

The adrenal glands are responsible for the majority of cir-culatingadrenalinein the body, but only a small amountof circulatingnoradrenaline.[18] These substances are re-leased in the adrenal medulla, which is richly vascu-lar. Under the influence of cortisol, the medulla re-leases adrenaline. The medulla can be considered anextension of thesympathetic nervous systemwhich re-leases adrenaline into the blood stream rather than intoasynapseas aneurotransmitter.[18] Adrenaline and nora-drenaline arecatecholaminesthat act atadrenoreceptors

throughout the body, with effects including constrictionof small arteries, dilation of veins, and increasing theheart rate.[18]

3 Development

The adrenal glands are composed of two very heteroge-nous types of tissue: in the center there is theadrenalmedulla, which produces and releases mostlyadrenalineto the blood in stress situations as part of thesympatheticnervous system. Surrounding the medulla is thecortex,

which produces a wide variety of steroid hormones.These tissues come from differentembryologicalprecur-sors and have distinct prenatal developments.

3.1 Cortex

Adrenal cortex tissue is derived from the intermediatemesoderm, first appearing 33 days after fecundation,showingstereidogenic(steroid hormoneproduction) ca-pabilities by the eighth week and growing rapidly dur-ing the first trimester of pregnancy. The fetal adrenalcortex is different from its adult counterpart, as it iscomposed of two distinct zones: the inner fetal zone,which carries most of the hormone-producing activity,and the outer definitive zone, which is in aproliferativephase. The fetal zone produces large amounts of adrenalandrogens (male sex hormones) that are used by theplacentaforestrogenbiosynthesis.[22] Cortical develop-ment of the adrenal gland is regulated mostly byACTH,a hormone produced by the pituitary gland that stimulatescortisolsynthesis.[23] During midgestation, the fetal zoneoccupies most of the cortical volume and produces 100200 mg/day ofDHEA-S, anandrogenand precursor ofboth androgens andestrogens(female sex hormones).[24]

Adrenal hormones, especially glucocorticoids such ascortisol are considered essential for prenatal developmentof organs, particularly for the maduration of the fetal
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4 7 REFERENCES

lungs. The adrenal gland decreases in size after birth be-cause of the rapid disappearance of the fetal zone, with adecrease in androgen secretion.[22]

3.2 Medulla

The adrenal medulla is derived froma type of cells knownasneural crest cells, which come from theectodermlayerof theembryo. These cellsmigratefrom their initial po-sition and aggregate in the vicinity of thedorsal aorta,a primitive blood vessel, which activates the differentia-tion of these cells through the release of proteins knownasBMPs. These cells then undergo a second migrationstep away from the dorsal aorta to form the the adrenalmedulla, along other organs of thesympathetic nervoussystem.[25] Cells of the adrenal medulla are also calledchromaffin cellsbecause they contain granules that stain

with chromiumsalts, a characteristic not present in allsympathetic organs. Glucocorticoidproduction by theadrenal cortex was thought to be responsible for this dif-ferentiation, but now the available data suggest that BMP-4secreted in the adrenal tissue is the primary responsi-ble for the differentiation, and that glucocorticoids havea role in the posterior development of the cells.[26]

4 Clinical significance

Several adrenal tumors cause symptoms because

they result in the over- or underproduction of cer-tain hormones by the adrenal gland.

In hyperaldosteronismthe adrenal glands producetoo much aldosterone.

In pheochromocytomathe adrenal glands secretesexcessive amounts of catecholamines.

In endogenous Cushings syndrome the adrenalglands produce too much cortisol.

Adrenal insufficiencydenotes a group of diseasescharacterized by underproduction of cortisol or al-

dosterone. They can be caused by problems in theadrenal glands themselves, or by impairment of thepituitary gland or hypothalamus. TheACTH stim-ulation testmay assist in diagnosis.

Addisons diseaseis a rare disorder in whichthe adrenal glands do not produce sufficientamounts ofglucocorticoids(mainly cortisol).This can be caused by anautoimmune reac-tion, by certain infections or by some otherrarer causes.

Congenital adrenal hyperplasias are genetic

defects of enzymes involved in cortisol pro-duction and can affect sex characteristics ofaffected patients.

WaterhouseFriderichsen syndrome is adrenalgland failure due to bleeding into the adrenalglands, caused by severe bacterial infection.

Isolatedhypoaldosteronismcan rarely occur due toaldosterone synthasedeficiency

Absent adrenal gland, rare congenital condition

5 History

5.1 Etymology

The adrenal glands are named for their location rela-tive to the kidneys. The term adrenal comes from ad-(Latin, near) andrenes(Latin, kidney).[27] Similarly,suprarenal is derived fromsupra-(Latin, above) and

renes.

6 See also

This article uses anatomical terminology; for an

overview, seeanatomical terminology.

Addison disease

Adrenocorticotropic hormone

Cushings syndrome

Pheochromocytoma

7 References

[1] Ehrhart-Bornstein M, Hilbers U (JuneJuly 1998). Neu-roendocrine properties of adrenocortical cells.. HormMetab Res. 30 (6-7): 436439. doi:10.1055/s-2007-978911.PMID 9694576.

[2] FeedBack What Is Adrenal Gland? Adrenal Gland Dis-eases. OrgansOfTheBody. Retrieved 2013-09-17.

[3] Page 18 in: Bou A, Nicolas A, Montagnon B (June1971). Reinfection with rubella in pregnant women.Lancet 297 (7712): 12513. doi:10.1016/S0140-6736(71)91775-2.PMID 4104713.

[4] Jefferies, William McK (2004). Safe uses of cortisol.Springfield, Ill: Charles C. Thomas.ISBN 0-398-07500-X.

[5] Whitehead, Saffron A.; Nussey, Stephen (2001). En-docrinology: an integrated approach. Oxford: BIOS. p.122.ISBN 1-85996-252-1.

[6] Curnow KM, Tusie-Luna MT, Pascoe L, Natarajan R, Gu

JL, Nadler JL, White PC (October 1991). The productof the CYP11B2 gene is required for aldosterone biosyn-thesis in the human adrenal cortex.. Mol. Endocrinol. 5
https://en.wikipedia.org/wiki/Special:BookSources/1-85996-252-1https://en.wikipedia.org/wiki/International_Standard_Book_Numberhttps://en.wikipedia.org/wiki/Special:BookSources/0-398-07500-Xhttps://en.wikipedia.org/wiki/Special:BookSources/0-398-07500-Xhttps://en.wikipedia.org/wiki/International_Standard_Book_Numberhttps://www.ncbi.nlm.nih.gov/pubmed/4104713https://en.wikipedia.org/wiki/PubMed_Identifierhttps://dx.doi.org/10.1016%252FS0140-6736%252871%252991775-2https://dx.doi.org/10.1016%252FS0140-6736%252871%252991775-2https://en.wikipedia.org/wiki/Digital_object_identifierhttp://journals.lww.com/obgynsurvey/Citation/1972/01000/Reinfection_With_Rubella_in_Pregnant_Women.4.aspxhttp://www.organsofthebody.com/adrenal-glands/http://www.organsofthebody.com/adrenal-glands/https://www.ncbi.nlm.nih.gov/pubmed/9694576https://en.wikipedia.org/wiki/PubMed_Identifierhttps://dx.doi.org/10.1055%252Fs-2007-978911https://dx.doi.org/10.1055%252Fs-2007-978911https://en.wikipedia.org/wiki/Digital_object_identifierhttps://en.wikipedia.org/wiki/Pheochromocytomahttps://en.wikipedia.org/wiki/Cushing%E2%80%99s_syndromehttps://en.wikipedia.org/wiki/ACTHhttps://en.wikipedia.org/wiki/Addison_diseasehttps://en.wikipedia.org/wiki/Anatomical_terminologyhttps://en.wikipedia.org/wiki/Absent_adrenal_glandhttps://en.wikipedia.org/wiki/Aldosterone_synthasehttps://en.wikipedia.org/wiki/Hypoaldosteronismhttps://en.wikipedia.org/wiki/Waterhouse%E2%80%93Friderichsen_syndromehttps://en.wikipedia.org/wiki/Congenital_adrenal_hyperplasiahttps://en.wikipedia.org/wiki/Autoimmune_reactionhttps://en.wikipedia.org/wiki/Autoimmune_reactionhttps://en.wikipedia.org/wiki/Glucocorticoidhttps://en.wikipedia.org/wiki/Addison%2527s_diseasehttps://en.wikipedia.org/wiki/ACTH_stimulation_testhttps://en.wikipedia.org/wiki/ACTH_stimulation_testhttps://en.wikipedia.org/wiki/Adrenal_insufficiencyhttps://en.wikipedia.org/wiki/Cushing%2527s_syndromehttps://en.wikipedia.org/wiki/Pheochromocytomahttps://en.wikipedia.org/wiki/Hyperaldosteronismhttps://en.wikipedia.org/wiki/Adrenal_tumorhttps://en.wikipedia.org/wiki/Bone_morphogenetic_protein_4https://en.wikipedia.org/wiki/Bone_morphogenetic_protein_4https://en.wikipedia.org/wiki/Glucocorticoidhttps://en.wikipedia.org/wiki/Chromiumhttps://en.wikipedia.org/wiki/Chromaffin_cellshttps://en.wikipedia.org/wiki/Sympathetic_nervous_systemhttps://en.wikipedia.org/wiki/Sympathetic_nervous_systemhttps://en.wikipedia.org/wiki/Bone_morphogenetic_proteinhttps://en.wikipedia.org/wiki/Dorsal_aortahttps://en.wikipedia.org/wiki/Cell_migrationhttps://en.wikipedia.org/wiki/Embryohttps://en.wikipedia.org/wiki/Ectodermhttps://en.wikipedia.org/wiki/Neural_cresthttps://en.wikipedia.org/wiki/Lungs


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5

(10): 15131522.doi:10.1210/mend-5-10-1513. PMID1775135.

[7] Zhou M, Gomez-Sanchez CE (July 1993). Cloningand expression of a rat cytochrome P-450 11 beta-hydroxylase/aldosterone synthase (CYP11B2) cDNAvariant.. Biochem Biophys Res Commun. 194(1): 112

117.doi:10.1006/bbrc.1993.1792.PMID 8333830.

[8] Marieb Human Anatomy & Physiology 9th edition, chap-ter:16, page:629, question number:14

[9] Lefebvre H, Cartier D, Duparc C, Lihrmann I, Con-tesse V, Delarue C, Godin M, Fischmeister R, VaudryH, Kuhn JM (2002). Characterization of serotonin(4)receptors in adrenocortical aldosterone-producing adeno-mas: in vivo and in vitro studies.. J Clin EndocrinolMetab. 87 (3): 12111216. doi:10.1210/jc.87.3.1211.PMID 11889190.

[10] Ye P, Mariniello B, Mantero F, Shibata H, Rainey WE

(2007). G-protein-coupled receptors in aldosterone-producing adenomas: a potential cause of hyperaldostero-nism.. J Endocrinol. 195(1): 3948.doi:10.1677/JOE-07-0037.PMID 17911395.

[11] Haidan A, Bornstein SR, Glasow A, Uhlmann K,Lbke C, Ehrhart-Bornstein M (February 1998). Basalsteroidogenic activity of adrenocortical cells is increased10-fold by coculture with chromaffin cells.. Endocrinol-ogy. 139 (2): 772780. doi:10.1210/en.139.2.772.PMID 9449652.

[12] Saulo J.A. Felizola, Takashi Maekawa, Yasuhiro Naka-mura, Fumitoshi Satoh, Yoshikiyo Ono, Kumi Kikuchi,Shizuka Aritomi, Keiichi Ikeda, Michihiro Yoshimura,Katsuyoshi Tojo, Hironobu Sasano. (2014). Voltage-gated calcium channels in the human adrenal and primaryaldosteronism.. J Steroid Biochem Mol Biol. 144(partB): 410416. doi:10.1016/j.jsbmb.2014.08.012. PMID25151951.

[13] Dunn R. B.; Kudrath W.; Passo S.S.; Wilson L.B. (2011).10. Kaplan USMLE Step 1 Physiology Lecture Notes. pp.263289.

[14] Sapru, Hreday N.; Siegel, Allan (2007). Essential Neu-roscience. Hagerstown, MD: Lippincott Williams &Wilkins.ISBN 0-7817-9121-9.

[15] Ross M, Pawlina W (2006). Histology: A Text and Atlas.5th edition. Lippincot Williams & Wilkins. p. 708.ISBN978-0781772211.

[16] http://medicine.academic.ru/130143/hilum_glandulae_suprarenalis

[17] Mirilas P, Skandalakis JE, Colborn GL, Weidman TA,Foster RS, Kingsnorth A, Skandalakis LJ, SkandalakisPN (2004). Surgical Anatomy: The Embryologic AndAnatomic Basis Of Modern Surgery. McGraw-Hill Pro-fessional Publishing.ISBN 960-399-074-4.

[18] Britton, the editors Nicki R. Colledge, Brian R. Walker,Stuart H. Ralston ; illustrated by Robert (2010). David-sons principles and practice of medicine. (21st ed. ed.).Edinburgh: Churchill Livingstone/Elsevier. pp. 768778.ISBN 978-0-7020-3085-7.

[19] HuC,RusinCG,TanZ,GuagliardoNA,BarrettPQ(June2012). Zona glomerulosa cells of the mouse adrenalcortex are intrinsic electricaloscillators.. J Clin Invest.122 (6): 20462053. doi:10.1172/JCI61996. PMID22546854.

[20] Hall JE, Guyton AC (2010). Guyton and Hall Textbook ofMedical Physiology, 12th edition. Saunders. ISBN 978-1416045748.

[21] Miller WL, Auchus RJ (2011).The Molecular Biology,Biochemistry, and Physiology of Human Steroidogenesisand Its Disorders. Endocrinology Reviews32 (1): 81151.doi:10.1210/er.2010-0013.

[22] Ishimoto H, Jaffe RB (2011). Development and Func-tion of the Human Fetal Adrenal Cortex: A Key Com-ponent in the Feto-Placental Unit. Endocrinology Re-views32 (3): 317355.doi:10.1210/er.2010-0001.PMC3365797.PMID 21051591.

[23] Hoeflich A, Bielohuby M. (2009). Mechanismsof adrenal gland growth: signal integration byextracellular signal regulated kinases1/2. Jour-nal of Molecular Endocrinology 42 (3): 191203.doi:10.1210/edrv.18.3.0304.PMID 19052254.

[24] Mesiano S, Jaffe RB (1997). Developmental andFunctional Biology of the Primate Fetal Adrenal Cor-tex. Endocrinology Reviews 18 (3): 378403.doi:10.1210/edrv.18.3.0304.PMID 9183569.

[25] Huber K (2006). The sympathoadrenal cell lin-eage: Specification, diversification, and new perspec-tives. Developmental Biology 298 (2): 335343.doi:10.1016/j.ydbio.2006.07.010.PMID 16928368.

[26] Unsicker K, Huber K, Schober A, Kalcheim C (2013).Resolved and open issues in chromaffin cell develop-ment. Mechanisms of Development130(68): 324329.doi:10.1016/j.mod.2012.11.004.PMID 23220335.

[27] What Are The Adrenal Glands?". About.com. Retrieved2013-09-18.

8 External links

MedlinePlus Encyclopedia002219

Virtual Slidebox at Univ. IowaSlide 272

Anatomy Atlases - Microscopic Anatomy, plate

15.292- Adrenal Gland

Histology image: 14501loa Histology LearningSystem at Boston University

Anatomy photo:40:03-0105 at the SUNY Down-state Medical Center - Posterior Abdominal Wall:The Retroperitoneal Fat and Suprarenal Glands

Adrenal Gland, from Colorado State University

Cross section image: pembody/body8a- Plastina-tion Laboratory at the Medical University of Vienna
http://www.meduniwien.ac.at/plastination/pembody/body8a-text.htmlhttp://arbl.cvmbs.colostate.edu/hbooks/pathphys/endocrine/adrenal/index.htmlhttp://ect.downstate.edu/courseware/haonline/labs/l40/030105.htmhttp://www.bu.edu/histology/p/14501loa.htmhttp://www.anatomyatlases.org/MicroscopicAnatomy/Section15/Plate15292.shtmlhttp://www.anatomyatlases.org/MicroscopicAnatomy/Section15/Plate15292.shtmlhttp://www.path.uiowa.edu/cgi-bin-pub/vs/fpx_gen.cgi?slide=272&viewer=java&view=0&lay=nlmhttps://en.wikipedia.org/wiki/University_of_Iowahttp://www.nlm.nih.gov/medlineplus/ency/article/002219.htmhttps://en.wikipedia.org/wiki/MedlinePlushttp://psychology.about.com/od/aindex/g/adrenal-glands.htmhttps://www.ncbi.nlm.nih.gov/pubmed/23220335https://en.wikipedia.org/wiki/PubMed_Identifierhttps://dx.doi.org/10.1016%252Fj.mod.2012.11.004https://en.wikipedia.org/wiki/Digital_object_identifierhttp://www.sciencedirect.com/science/article/pii/S0925477312001153http://www.sciencedirect.com/science/article/pii/S0925477312001153https://www.ncbi.nlm.nih.gov/pubmed/16928368https://en.wikipedia.org/wiki/PubMed_Identifierhttps://dx.doi.org/10.1016%252Fj.ydbio.2006.07.010https://en.wikipedia.org/wiki/Digital_object_identifierhttp://www.sciencedirect.com/science/article/pii/S0012160606009924http://www.sciencedirect.com/science/article/pii/S0012160606009924http://www.sciencedirect.com/science/article/pii/S0012160606009924https://www.ncbi.nlm.nih.gov/pubmed/9183569https://en.wikipedia.org/wiki/PubMed_Identifierhttps://dx.doi.org/10.1210%252Fedrv.18.3.0304https://en.wikipedia.org/wiki/Digital_object_identifierhttp://press.endocrine.org/doi/full/10.1210/edrv.18.3.0304http://press.endocrine.org/doi/full/10.1210/edrv.18.3.0304http://press.endocrine.org/doi/full/10.1210/edrv.18.3.0304https://www.ncbi.nlm.nih.gov/pubmed/19052254https://en.wikipedia.org/wiki/PubMed_Identifierhttps://dx.doi.org/10.1210%252Fedrv.18.3.0304https://en.wikipedia.org/wiki/Digital_object_identifierhttp://jme.endocrinology-journals.org/content/42/3/191.longhttp://jme.endocrinology-journals.org/content/42/3/191.longhttp://jme.endocrinology-journals.org/content/42/3/191.longhttps://www.ncbi.nlm.nih.gov/pubmed/21051591https://en.wikipedia.org/wiki/PubMed_Identifierhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3365797https://en.wikipedia.org/wiki/PubMed_Centralhttps://dx.doi.org/10.1210%252Fer.2010-0001https://en.wikipedia.org/wiki/Digital_object_identifierhttp://press.endocrine.org/doi/full/10.1210/er.2010-0001http://press.endocrine.org/doi/full/10.1210/er.2010-0001http://press.endocrine.org/doi/full/10.1210/er.2010-0001https://dx.doi.org/10.1210%252Fer.2010-0013https://en.wikipedia.org/wiki/Digital_object_identifierhttp://press.endocrine.org/doi/abs/10.1210/er.2010-0013http://press.endocrine.org/doi/abs/10.1210/er.2010-0013http://press.endocrine.org/doi/abs/10.1210/er.2010-0013https://en.wikipedia.org/wiki/Special:BookSources/978-1416045748https://en.wikipedia.org/wiki/Special:BookSources/978-1416045748https://en.wikipedia.org/wiki/International_Standard_Book_Numberhttps://www.ncbi.nlm.nih.gov/pubmed/22546854https://en.wikipedia.org/wiki/PubMed_Identifierhttps://dx.doi.org/10.1172%252FJCI61996https://en.wikipedia.org/wiki/Digital_object_identifierhttp://www.jci.org/articles/view/61996http://www.jci.org/articles/view/61996https://en.wikipedia.org/wiki/Special:BookSources/978-0-7020-3085-7https://en.wikipedia.org/wiki/International_Standard_Book_Numberhttps://en.wikipedia.org/wiki/Special:BookSources/960-399-074-4https://en.wikipedia.org/wiki/International_Standard_Book_Numberhttp://medicine.academic.ru/130143/hilum_glandulae_suprarenalishttp://medicine.academic.ru/130143/hilum_glandulae_suprarenalishttps://en.wikipedia.org/wiki/Special:BookSources/978-0781772211https://en.wikipedia.org/wiki/International_Standard_Book_Numberhttps://en.wikipedia.org/wiki/Special:BookSources/0-7817-9121-9https://en.wikipedia.org/wiki/International_Standard_Book_Numberhttps://www.ncbi.nlm.nih.gov/pubmed/25151951https://en.wikipedia.org/wiki/PubMed_Identifierhttps://dx.doi.org/10.1016%252Fj.jsbmb.2014.08.012https://en.wikipedia.org/wiki/Digital_object_identifierhttp://www.researchgate.net/publication/264979242_Voltage-gated_calcium_channels_in_the_human_adrenal_and_primary_aldosteronismhttp://www.researchgate.net/publication/264979242_Voltage-gated_calcium_channels_in_the_human_adrenal_and_primary_aldosteronismhttp://www.researchgate.net/publication/264979242_Voltage-gated_calcium_channels_in_the_human_adrenal_and_primary_aldosteronismhttps://www.ncbi.nlm.nih.gov/pubmed/9449652https://en.wikipedia.org/wiki/PubMed_Identifierhttps://dx.doi.org/10.1210%252Fen.139.2.772https://en.wikipedia.org/wiki/Digital_object_identifierhttps://www.ncbi.nlm.nih.gov/pubmed/17911395https://en.wikipedia.org/wiki/PubMed_Identifierhttps://dx.doi.org/10.1677%252FJOE-07-0037https://dx.doi.org/10.1677%252FJOE-07-0037https://en.wikipedia.org/wiki/Digital_object_identifierhttps://www.ncbi.nlm.nih.gov/pubmed/11889190https://en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6 9 TEXT AND IMAGE SOURCES, CONTRIBUTORS, AND LICENSES

9 Text and image sources, contributors, and licenses

9.1 Text

Adrenal glandSource: http://en.wikipedia.org/wiki/Adrenal%20gland?oldid=644764854Contributors:AxelBoldt, TwoOneTwo, Kpjas,Bryan Derksen, Alex.tan, Andre Engels, Redmist, Kosebamse, Looxix, Ahoerstemeier, Angela, Habj, Kimiko, Andrewman327, Robbot,Stewartadcock, Fuelbottle, Diberri, Cutler, Giftlite, Nmg20, Mintleaf, SoCal, Jfdwolff, Guanaco, OldakQuill, Knutux, Doops, PFHLai,DanielCD, Rich Farmbrough, Guanabot, Bender235, Rubicon, Bobo192, Vanished user sdfkjertiwoi1212u5mcake, Truthflux, Robotje,Brim, Arcadian, Minghong, Alansohn, Keenan Pepper, Axl, Wtmitchell, Abanima, Darked, Scjessey, Eras-mus, Hovea, Magister Mathe-maticae, Rjwilmsi, Yamamoto Ichiro, FlaBot, Celebere, WriterHound, YurikBot, Hede2000, Manop, Slodave, Nephron, DeadEyeArrow,David Underdown, Aeon1006, Anarch21, robot, Sarah, Andreas Erick, Bomac, Delldot, Iph, Swerdnaneb, Gilliam, Bluebot, Per-sian Poet Gal, Jerome Charles Potts, DHN-bot, Rrburke, Mipchunk, Smooth O, Acdx, The undertow, Spiritia, SashatoBot, NathanaelBar-Aur L., Dono, Cajolingwilhelm, Waggers, Novangelis, Saxbryn, Courcelles, JForget, Robotsintrouble, Basawala, Chmee2, DShantz,Maxxicum, Yaris678, Anthonyhcole, Roberta F., Kozuch, Wyvyrn, Thijs!bot, Epbr123, Andyjsmith, Anupam, Massimo Macconi, Escar-bot, AntiVandalBot, Seaphoto, Jj137, JackSparrow Ninja, MER-C, Acroterion, Magioladitis, Allstarecho, DerHexer, MartinBot, Anax-ial, Tgeairn, Trusilver, Numbo3, Cocotel33, Mikael Hggstrm, Liveste, Bobianite, Lanternix, Pope Tetsuo, Adrian43, Adam 2323, Ni-troshockwave, VolkovBot, CWii, Bertinho, Philip Trueman, TXiKiBoT, Zidonuke, RadiantRay, Michael.w.simpson, Synthebot, Dgarth,Ziphon, Burntsauce, Andypanda15, SieBot, Skingski, Threelakesgirl, Gerakibot, Dawn Bard, Cooladoola, Flyer22, LearnAnatomy, Es-cape Orbit, ClueBot, Drravikanojia, Osm agha, Fenwayguy, Blanchardb, DragonBot, Lartoven, Tnxman307, Egmontaz, Dark Mage, TonyK10, Jovianeye, Matt641, Betterusername, A racercar named desire, Leszek Jaczuk, Diptanshu.D, Download, Dmenet, Echo R314,Tide rolls, Zorrobot, Legobot, , Luckas-bot, Yobot, Amirobot, South Bay, AnomieBOT, Jim1138, IRP, JackieBot, King-pin13, Jmarchn, Xqbot, Oidapanta, Gondwanabanana, Yayitsnay, The Evil IP address, Almabot, GrouchoBot, RibotBOT, Brn2bme, Fres-

coBot, Bill9999, Jelly12345, Pinethicket, MastiBot, TobeBot, Trappist the monk, Eamondo2, Weedwhacker128, Jhenderson777, Devo995,Keegscee, MrArifnajafov, RjwilmsiBot, J36miles, EmausBot, Immunize, Devin, Solarra, Wikipelli, K6ka, Werieth, Tolly4bolly, Feralmage, Polisher of Cobwebs, EdoBot, ClueBot NG, Rsc227, Tatigreicy, Frietjes, Widr, BG19bot, Roberticus, RGshredfox, Gautehuus, Ap-ktraceur, Crrnorthwestern, NotWith, Dr Bilal Alshareef, Armanjain11, Pratyya Ghosh, ChrisGualtieri, Andrux, JakobSteenberg, SFK2,Drajay1976, Changem333, Iztwoz, Wethar555, Herizora, Babitaarora, LT910001, Binko100, Monkbot, Vieque, Purplecarib, FCGRIM-WOOD, Tilifa Ocaufa, Prettylittleliars13 and Anonymous: 310

9.2 Images

File:Adrenal_cortex_labelled.jpg Source: http://upload.wikimedia.org/wikipedia/commons/c/c6/Adrenal_cortex_labelled.jpgLicense:CC0Contributors: https://commons.wikimedia.org/wiki/File:Adrenal_gland_%28cortex%29.JPGOriginal artist:Jpogi

File:Commons-logo.svgSource:http://upload.wikimedia.org/wikipedia/en/4/4a/Commons-logo.svg License:? Contributors:? Originalartist:?

File:Human_adrenals_immunostained_for_neuronal_cell_adhesion_molecule_(NCAM).jpg Source: http://upload.wikimedia.

org/wikipedia/en/e/eb/Human_adrenals_immunostained_for_neuronal_cell_adhesion_molecule_%28NCAM%29.jpg License: Fair useContributors:Original publication: Ehrhart-Bornstein M, Hilbers U 1998 Neuroendocrine properties of adrenocortical cells. HormMetab Res. 30:436-439.

Immediate source:Ehrhart-Bornstein M, Hilbers U 1998 Neuroendocrine properties of adrenocortical cells. Horm Metab Res. 30:436-439.

Original artist:Ehrhart-Bornstein M, Hilbers U

9.3 Content license

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