Anatomy of the adrenal gland

The adrenal The adrenal gland gland

(Suprarenal)(Suprarenal)ByBy

Dr. Mohammed Ahamed Dr. Mohammed Ahamed AhamedAbuelnorAhamedAbuelnor

Position and locationPosition and location The adrenal glands located on the The adrenal glands located on the

upper poles of each kidney on the upper poles of each kidney on the right and left sidesright and left sides

They are covered by peritoneum on They are covered by peritoneum on the posterior abdominal wall they the posterior abdominal wall they are embedded into pre renal fat are embedded into pre renal fat

The left one is larger and higher The left one is larger and higher than the right than the right

Location:Location: Rest superiorly to Rest superiorly to

kidneyskidneys Hormones Produced:Hormones Produced:

~30 steroid hormones!~30 steroid hormones!

Adrenal gland position Adrenal gland position &location&location

The right adrenal glandThe right adrenal gland It is triangular in shape located on It is triangular in shape located on

the upper pole of the right kidney the upper pole of the right kidney behind the inferior vena cavabehind the inferior vena cava

It is related anterior to the inferior It is related anterior to the inferior vena cava and the right lobe of the vena cava and the right lobe of the liverliver

Posterior it is related to the right Posterior it is related to the right cruse of diaphragm cruse of diaphragm

Relation of the right Relation of the right glandgland

The left adrenal glandThe left adrenal gland It is crescent in shape located on the It is crescent in shape located on the

upper pole of the left kidney behind upper pole of the left kidney behind the stomachthe stomach

Anterior it is related to the stomach, Anterior it is related to the stomach, the tail of pancreas and the lesser the tail of pancreas and the lesser sacsac

Posterior it is related to the left Posterior it is related to the left cruse of diaphragm cruse of diaphragm

Relation of the left glandRelation of the left gland

The blood supplyThe blood supply Each adrenal gland supply by three arteries Each adrenal gland supply by three arteries

superior ,middle and inferior supra renal superior ,middle and inferior supra renal arteries arteries

The superior supra renal artery branch from The superior supra renal artery branch from inferior phernic artery which is branch from inferior phernic artery which is branch from the aorta, the middle supra renal artery the aorta, the middle supra renal artery branch from the aorta and the inferior supra branch from the aorta and the inferior supra renal artery branch from the renal arteryrenal artery branch from the renal artery

The venous drainage by the supra renal vein The venous drainage by the supra renal vein on the right side at the inferior vena cava and on the right side at the inferior vena cava and on the left side at the left renal vein on the left side at the left renal vein

Arterial supplyArterial supply

Structure of adrenal Structure of adrenal glandgland

The adrenal gland formed of outer The adrenal gland formed of outer cortex which is yellow forming the cortex which is yellow forming the main mass of the gland and inner main mass of the gland and inner medulla completely enclosed by the medulla completely enclosed by the cortex except at the hilum the gland cortex except at the hilum the gland enclosed by capsule of connective enclosed by capsule of connective tissuetissue

The cortex has mesoderm The cortex has mesoderm development while the medulla development while the medulla developed from the neural crest developed from the neural crest

The cortex and capsuleThe cortex and capsule

The adrenal cortexThe adrenal cortex The cortex of the adrenal cortex consist of The cortex of the adrenal cortex consist of

three layers arranged from outer to inner three layers arranged from outer to inner the zona glomerulosa, fasciculata, and the zona glomerulosa, fasciculata, and reticularisreticularis

ZonaZona glomerulosaglomerulosa : it is the outer layer : it is the outer layer located close to the capsule .located close to the capsule .

it is cells stimulated by ACTH and it is cells stimulated by ACTH and angiotensin 2 to secret minralocorticoids angiotensin 2 to secret minralocorticoids hormones which are the aldesterone and hormones which are the aldesterone and deoxycorticosterone they control the fluid deoxycorticosterone they control the fluid and electrolytes balance in the body by and electrolytes balance in the body by affecting the renal tubules affecting the renal tubules

Zona fasciculataZona fasciculata It is the middle largest layer of the It is the middle largest layer of the

cortex cortex

the cells of this layer secret the the cells of this layer secret the glycocorticoids which are the glycocorticoids which are the cortisol and hydrocortisone which cortisol and hydrocortisone which are maintain the carbohydrate are maintain the carbohydrate balance balance

Adrenal HistologyAdrenal Histology

Adrenal cortexAdrenal cortex

Structure of the cortexStructure of the cortex

Steroids produced by the Steroids produced by the AdrenalsAdrenals::

1.1. AldosteroneAldosterone2.2. CortisolCortisol3.3. Epinephrine (Adrenaline)Epinephrine (Adrenaline)4.4. AndrogenAndrogen

AldosteroneAldosterone Target Cell:Target Cell:

Kidneys!Kidneys! Exocrine GlandsExocrine Glands

Effect of Hormone:Effect of Hormone: Maintains balance of NaMaintains balance of Na+ + in the in the

bloodstreambloodstream aldosterone aldosterone conservation of Na conservation of Na++

CortisolCortisol Produced when ACTH levels are Produced when ACTH levels are

high!high! Act as negative feedback for the Act as negative feedback for the

pituitary glandpituitary gland Converts adipose Converts adipose

tissue to glucose!tissue to glucose! Occurs during high Occurs during high

stress periodsstress periodsEmotional distressEmotional distressPhysical distress Physical distress (exercise, (exercise, hemorrhagehemorrhage))

Zona reticularisZona reticularis It is the inner layers it is cells secret It is the inner layers it is cells secret

the gonadocorticoids hormone which the gonadocorticoids hormone which are the estrogen and androgen are the estrogen and androgen which supplemented the sex which supplemented the sex hormones hormones

AndrogensAndrogens ““malemale”” sex hormone sex hormone Converted (mostly) to Testosterone Converted (mostly) to Testosterone

in Males !in Males ! Converted (mostly) to Estrogen in Converted (mostly) to Estrogen in

Females!Females!

Adrenal medullaAdrenal medulla The adrenal medulla developed from the The adrenal medulla developed from the

neural crest it is formed of group and neural crest it is formed of group and columns of cells called chromaffin cells columns of cells called chromaffin cells

The chromaffin cells secreted the The chromaffin cells secreted the adrenalin and noradrenalin which they adrenalin and noradrenalin which they activated the sympathetic stimulation activated the sympathetic stimulation

Chromaffin cellChromaffin cell

EpinephrineEpinephrine

Stimulated by Sympathetic Nervous Stimulated by Sympathetic Nervous SystemSystemto initiate to initiate ““fight or flightfight or flight”” response! response!

Stored in adrenal gland until needed! Stored in adrenal gland until needed! Effects of EpinephrineEffects of Epinephrine

blood sugarblood sugar heart rateheart rate blood flow to brain, heart, musclesblood flow to brain, heart, muscles

Clinical problemsClinical problems Various clinical condition due to the lesion of Various clinical condition due to the lesion of

the adrenal cortex or medulla affect the the adrenal cortex or medulla affect the secretion of the adrenal hormone hyper secretion of the adrenal hormone hyper secretion of the hormones of the adrenal cortex secretion of the hormones of the adrenal cortex result in Cushing syndrome which result in Cushing syndrome which characterized by redistribution of fat the characterized by redistribution of fat the spindle limbs, swollen face, diabetes mellitus spindle limbs, swollen face, diabetes mellitus and slow of wound heeling the and slow of wound heeling the

Hypo secretion cause the Addison disease Hypo secretion cause the Addison disease which is characterized by weight loss muscular which is characterized by weight loss muscular weakness and hypoglycemia, low blood weakness and hypoglycemia, low blood pressure and dehydrationpressure and dehydration

The hypo secretion of gonad corticoids cause The hypo secretion of gonad corticoids cause condition called adrenogenital syndrome condition called adrenogenital syndrome

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