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Y2S1 ANATOMY > Anatomy of the adrenal gland > Flashcards

Anatomy of the adrenal gland Flashcards

1
Q

What is the adrenal (suprarenal) gland?

A
  • A yellowish retro-peritoneal organ, that lies on the superomedial part of each kidney
  • The right one is triangular/pyramidal
  • The left one is semilunar in shape
  • They are not covered by the peritoneum, instead surrounded by connective tissue and embedded in perirenal fat
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2
Q

What is the vertebral relation of the adrenal gland?

A

T11

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2
Q

What separates the adrenal gland from the kidneys?

A

The perinephric fat

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3
Q

What encloses the adrenal gland?

A

The RENAL FASCIA (true capsule) is formed by the connective tissue around the kidneys

  • A common fascial sheath that encloses the kidney and the adrenal gland
  • It covers the whole kidney even the portion underneath the adrenal gland
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4
Q

What attaches the adrenal gland to the (crura) of the diaphragm above?

A

The RENAL FASCIA which attaches it to the crura of the diaphragm

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5
Q

What are the relations of the renal fascia?

A

It splits and encloses the kidney after that it splits and encloses the suprarenal glands, and after that, it fixes itself to the inferior surface of the diaphragm.

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6
Q

What are the different types of fat around the kidneys and adrenals?

A

1) Perirenal fat: Around the kidney, protects it inside the renal fascia

2) Pararenal fat: a thick layer of fat located more posteriorly outside the renal fascia

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7
Q

What will happen if someone loses weight suddenly?

A

The kidney will go down, but the adrenals will stay up due to their attachment to the crura of the diaphragm

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8
Q

What is the anterior relation of the right (triangular) adrenal gland?

A

1) Liver

2) IVC

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9
Q

What is the medial relation of the triangular adrenal gland?

A

IVC

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10
Q

What is the posterior relation of the right (triangular) adrenal gland?

A

Diaphragm

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11
Q

What is the anterior “superior” relation of the left (semilunar) adrenal gland?

A

Stomach

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12
Q

What is the anterior “inferior” relation of the left (semilunar) adrenal gland?

A

1) Pancreas

2) Splenic vessels

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13
Q

What is the Posterior relation of the left (semilunar) adrenal gland?

A

Diaphragm

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14
Q

What is the Medial relation of the left (semilunar) adrenal gland?

A

Abdominal aorta

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15
Q

What are the parts of the adrenal glands?

A

1) Outer cortex (80-90%)

2) Inner medulla (10-20%)

16
Q

What is the embryological origin of the outer cortex?

A

Mesodermal origin

17
Q

What is the embryological origin of the inner medulla?

A

Neuroectodermal (neural crest, which also gives rise to the sympathetic and parasympathetic ganglia)

  • They are considered to be modified sympathetic and postganglionic, who have lost their axons and dendrites during development and became secretory cells
18
Q

Summary

A

The adrenal glands consist of an outer connective tissue capsule, a cortex and a medulla. Veins and lymphatics leave each gland via the hilum, but arteries and nerves enter the glands at numerous sites.
The outer cortex and inner medulla are the functional portions of the gland. They are two separate endocrine glands, with different embryological origins:
Cortex – derived from the embryonic mesoderm.
Medulla – derived from the ectodermal neural crest cells.
The cortex and medulla synthesise different hormones.

19
Q

Describe the arterial blood supply of the adrenal gland

A

1) Superior: Inferior phrenic artery

2) Middle: Aorta

3) Inferior: Renal artery

20
Q

What is the venous supply of the right (triangular) adrenal gland?

A

The right suprarenal vein, which drains into the inferior vena cava

21
Q

What is the venous supply of the left (semilunar) adrenal gland?

A

The left suprarenal vein, drains into the renal vein then the renal vein will drains into the inferior vena cava

22
Q

Why should we ligate the right adrenal gland vein first in surgery?

A

As you can see from the diagram, the right suprarenal vein is very short so it can be easily cut off in surgery by mistake. That’s why you need to take care of it and ligate it first

  • Not ligating the vessels before an adrenal gland surgery can cause a lot of its hormones to be released as a response to you playing with the glands in the surgery and this will affect the stability of the patient
23
Q

What is the nerve innervation of the adrenal cortex?

A

Only by the vasomotor innervation

  • Preganglionic nerves arising from spinal cord 🡪 travel through the sympathetic trunk 🡪 through the celiac ganglia 🡪 postganglionic nerves to the blood vessels present in the cortex to supply vasomotor innervation
24
Q

What is the nerve supply of the medulla?

A

The preganglionic sympathetic fibers, which arise from the lateral horn of the gay matter of spinal segments (T10-L1)

  • Sympathetic chain - Celiac ganglion - Celiac plexus - Medulla (chromaffin cells “postganglionic without axon & dendrites”)
25
Q

What is the lymphatic drainage of the adrenal glands?

A

The para-aortic lymph nodes

26
Q

Describe the histological layers of the cortex of the adrenal gland

A
  • The cortex is yellowish in color
  • The cortex contains a lot of fat in their cytoplasm
  • This division is based on their shape and the things they secrete
  • CGFR

1) Capsule (most superior)

2) Zona glomerulosa (oval balls)

3) Zona fasciculata (columns)

4) Zona reticularis (very messy all around the place)

-Then the Adrenal medulla

27
Q

What are the different functions of the adrenal cortex?

A
  • Made up of hormone-secreting epithelial columns, between which connective tissue, blood vessels, and nerves run radially from the cortex toward the medulla, All three layers form steroid hormones, called corticosteroids (Mineralocorticoids, Glucocorticoids, Gonadocorticoids)

1) Zona glomerulosa: Secretes mineralcorticoids (aldosterone)

2) Zona fasciculate: Secretes glucocorticoids (cortisol), and some small amount of androgen

3) Zona reticularis: Secretes androgens (like dehydroepiandrosterone) and small amount of corticosteroids

28
Q

What does the adrenal medulla secrete?

A

Catecholamines (like epinephrine and norepinephrine)

29
Q

What is the histological structure of the cells of the zona glomerulosa?

A

Columnar/pyramidal (inverted columns with capillaries), they secrete aldosterone “mineralocorticoid”

30
Q

What is the histological structure of the zona fasiculata?

A

Polyhedral cells that are arranged in one or two layers with capillaries in between (they secrete glucocorticoids “cortisol”

31
Q

What is the histological structure of the zona reticularis?

A

Irregularly arranges cluster of cells that secretes androgens

Y2S1 ANATOMY (15 decks)

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