Adrenal gland Flashcards
Adrenal gland Surrounded by ____________ but separated from the kidney by _____________
Gerotas’s fascia
Perirental fat
Cortex of adrenal gland is __________ in origin
Mesodermal
start from coelomic mesoderm adjacent to urogenital ridge
Week 4-6
differentiate into thin definite outer cortex and thick inner fetal cortex
Week 8
Fetal cortex produce ___________ during gestation and involutes at birth
Steroid
develop into functional adrenal cortex
Definite cortex
Medulla derived from
Neural crest cell
Week 5 : neural crest cell migrate to ______________ and ____________ region towards medial aspect of adrenal cortex
Para-aortic and para vertebral
located to the left of aortic bifurcation near the origin of IMA
Adrenal chromaffin cell
Form fetal adrenal cortex
Mesenchyme cells
Form symphatetic ganglia
Neural crest cells
Outer bright yellowish, Inner reddish brown
Cortex
Concern with fluid and electrolyte balance
Mineral corticoids
Concern with metabolism of carbohydrates, fats and proteins
Glucocorticoids
Plays a role in the prepubertaldevelopment of the sex organs
Sex hormones
Present at birth
Zona glomerulosa
Zona fasciculata
Develop during first year of life
Zona reticularis
Secretes on zona glomerulosa
Aldosterone, Deoxycorticosterone
Zona fasciculata
Cortisol
Cortisone
Zona reticularis
Testosterone
Estrogen
Progesterone
a syndrome resulting from inadequate secretion of corticosteroid hormones due to the progressive destruction of the adrenal cortex
Addisons disease
the condition resulting from excess amounts of corticosteroid hormones in the body.
Cushings syndrome
Thin and gray in color
Medulla
n. a small vascular tumour of the inner region (medulla) of the adrenal gland. Many tumours function by their uncontrolled and irregular secretion of the hormones adrenaline and noradrenaline. They cause attacks of raised blood pressure, increased heart rate, palpitations, and headache.
Pheochromocytoma
Medulla secretes
Catecholamine
Right suprarenal gland
Pyramidal in shape Behind the right lobe of liver and IVC Rest posteriorly in the diaphragm
Left suprarenal gland
Crescenticin shape Behind the pancreas, lesser sac and stomach
Artery of suprarenal gland
Suprarenal branch of inferior phrenic nerve Suprarenal branch of Aorta Suprarenal branch of Renal artery
Right adrenal vein
drains to inferior vena cava
Left adrenal vein
Drain to left renal vein
Lymph drainage of adrenal gland
Lateral aortic nodes
Nerve supply adrenal gland
Preganglionic symphateticfibers Majority ends in the medulla
May be helpful in detecting mass in adrenal area Calcification in adrenal
Plain abdominal X- ray
Hypoechoic
Dark mass in ultrasound
Ultrasound Adult appearance
Entirely hypoechoic ○Concave with straight margin
Ultrasound in Newborn ○Cortex _________, Medulla ____________
Hypoechoic
Hyperechoic
Ultrasound indication
adrenal masses ( larger than 2 cm
On precontrastscan adrenal have soft tissue density similar to that of liver
CT scan
CT scan Normal adrenal appear inverted _________shape within retroperitoneal fat
V or Y
CT scan indication
masses (adenoma & cancer) Cyst abscess metastasis
Equally effective as CT in imaging adrenal disorder
MRI
Selective injection of contrast into the adrenal vein with an angiographic catheter
Adrenal venogram
Indication of adrenal venogram
hormone active tumor
adrenal hyperplasia & adrenal adenoma Cushing’s diseases
Procedure in which contrast is injected into adrenal arteries to detect any vascular pathology
Arteriography
Indication of arteriography
Adrenal tumor Adrenal hyperplasia CONN syndrome
Usual role of scintigraphyis to clarify inconclusive result of imaging
Scintigraphy
Indication of scintigraphy
Functional status of adrenal nodule Assess contralateral adrenal function Detect functional metastasis Detect recurrence after surgery Detect ectopic site of hormone production
NP-59 ( 6-B-iodomethyl-19-norcholesterol ) Selenium-75 6-B-selenomethylnorcholesterol
Adrenocortical imaging agent
MIBG ( metaiodobenzylguanidine
Symphatoadrenal imaging agent
Indication for mibg
Pheochromocytoma Neuroblastoma, carcinoid, adrenal metastasis
Adrenocortical carcinoma Adenoma Adrenal hyperplasia
NP- 59
