Anatomy Adrenal

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ANATOMY OF ADRENALGLAND

Dr.Udhayabharathi.G

Dept of Anatomy

GMKMC SALEM

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History2

Claudius Galen - accessory renal tissue.

"loose flesh .

The first anatomist to give a detailed

description of the human adrenal glands, wasBartholomeus Eustachius (1520- 1574) In his

publication of 1563.


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Thomas Addison presented a paper on theclinical features of patients with adrenal

disease. In 1856, Charles Brown-Squard

provided experimental proof of the vital role of

the adrenals by performing adrenalectomies

(removing the adrenals) from several species of

animals.

Sir William Osler found that symptoms ofadrenal insufficiency (Addison's disease) could

be temporarily improved by an adrenal extract


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Introduction

Among mostimportant and vitalendocrine organ

Small bilateralyellowishretroperitoneal organ

Lies just abovekidney in gerotasfascia

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Anatomy5

Right adrenal is triangular, related to upper

pole Right kidney

Left adrenal is crescent shaped, related to

upper and medial part Left kidney

Size : 50x30x10 mm

Weight : 5 gm app


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Anatomy6


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Embryology7

Cortex is mesodermal in origin

Week 46 : start from coelomic

mesoderm adjacent tourogenital ridge

Week 8 : differentiate into thin definite

outer cortex and thick innerfetal cortex


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Embryology8


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Cont:9

Fetal cortex produce steroid during gestation

and involutes at birth

Definite cortex develop into functional adrenal

cortex


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Embryology10

Medulla derived from neural crest cells

Develop with sympathetic nervous system

Week 5 : neural crest cell migrate to

Para-aortic and Para-vertebral

region towards medial aspect ofadrenal cortex


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Cont:11

Extra adrenal chromaffin cells located to the

left of aortic bifurcation near the origin of IMA


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Embryology12


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Embryology13


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Embryology14


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Relations

RT ADRENAL

AnteriorlyIVC

Liver

Posteriorly

Diaphragm

LT ADRENAL

AnteriorlyPancreas

Stomach

Posteriorly

Diaphragm

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Relations

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Histology18

Adrenal cortex consists of three distinct zones

Zona Glomerulosa : Small cells arranged into

small rounded groups Zona Fasiculata : cell cords arranged

radially arranged cell cords separated by

fenestrated sinusoid capillaries.cell cytoplasm

is also light and often "foamy" or "spongy"

appearance (due to lipid droplets)


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Cont :19

Zona Reticularis : small cells with largenucleus, and eosinophilic cytoplasm and

arranged as anastomosing cords. (lipofucsin

accumulates with age, orange colour in H&E).

Zona glomerulosa and fasiculata present at

birth

Zona reticularis develops during first year of life


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Histology

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Physiology

Adrenal gland has

two distinct zones

Adrenal cortex

Adrenal medulla

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Physiology24

Adrenal cortex produces

-Mineralocorticoids (Zona Glomerulosa)

-Glucocorticoids (Zona Fasciculata)

-Adrenal androgens (Zona Reticularis)


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Physiology25

Adrenal medulla produces-Epinephrine (adrenaline)

-Norepinehrine (noradrenaline)

Help inc in cardiac output, vascular resistanceand mediate stress response

All are absolutely required for life


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Functions

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Aldosterone helps in Na reabsorption &potassium excretion & preventing dehydration

Cortisol stimulate protein breakdown, inhibitionof tissue response in injury & antagonism to

action of insulin

Androgens helps in early development of male

sex organ in childhood


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Functions27


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Vascular supply29

Blood to adrenal supplied by

Inferior phrenic artery (superiorly)

Aorta (medially)

Renal artery (inferiorly)


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Vascular supply30

Right Adrenal : drained to IVC via adrenal

vein

Left Adrenal : drained into left adrenal veinor directly to IVC

Lymphatics : drained to Para-aortic andpara-caval lymph nodes


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Vascular supply

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Vascular supply32


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APPLIED ASPECT33

Congenital adrenal hyperplasia

Pheochromocytoma

Adenoma/carcinoma

Acute/chronic adrenal insufficiency(Addisons

disease)

Cushings disease/syndrome.


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Addisons disease34


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Cushings syndrome35


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Adrenal Adenoma36


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Adrenal Carcinoma37


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Normal Adrenal On MRI38

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Anatomy Adrenal