Endo: Adrenal Flashcards
Weight of Adrenal gland
4grams
Yellowish in color. Retroperitoneal organ; lies on the upper pole of kidney.
Adrenal gland
The Adrenal glands are surrounded by ___________ but separated from the kidney by __________.
Gerota’s fascia. Perirenal fat.
Cortex is ________ in origin.
Mesodermal
Week __ - __ : start from ________ mesoderm adjacent to urogenital ridge.
4-6. Coelomic.
Week __: differentiate into thin definite __________ and thick ___________,
- Outer cortex. Inner fetal cortex.
Fetal cortex produce ________ during gestation and involutes at birth.
Steroid
Definite cortex develop into
Functional adrenal cortex
Medulla is derived from
Neural crest cell
Develop with sympathetic nervous system
Adrenal Medulla
Week __: neural crest cell migrate to ________ & _________ region towards medial aspect of adrenal cortex.
- Para-aortic & Para-vertebral.
Extra adrenal chromaffin cells located to the ___________ near the origin of _____.
Left of aortic bifurcation. IMA.
Embryology: neural crest cell migrates ________.
Ventrally
Embryology: _______ cells migrate from epithelium.
Mesothelium
Embryology: neural crest cell are from
Sympathetic ganglion
Embryology: mesenchyme cells are from
Fetal adrenal cortex
Embryology: _______ from sympathetic ganglia continue to migrate
Neural crest cells
Color of the cortex. Outer and inner.
Outer: bright yellowish, Inner: reddish brown
Concern with metabolism of carbohydrates, fats and proteins.
Glucocorticoids
Concern with fluid & electrolyte balance
Mineralocorticoids
Plays a role in the prepubertal development of the sex organs
Sex hormones
Parts of Adrenal cortex: thick middle zone. Present at birth.
Zona fasciculata
Parts of Adrenal cortex: inner zone. Develop during first year of life.
Zona reticularis
Parts of Adrenal cortex: thin outer portion. Present at birth.
Zona glomerulosa
Hormone secreted by Zona Glomerulosa
Aldosterone & Deoxycorticosterone “AD”
Hormone secreted by Zona Fasciculata
Cortisol & Cortisone “CC”
Hormone secreted by Zona Reticularis
Progesterone, Estrogen & Testosterone “PET”
Characteristics of the medulla
Thin and gray color
Disorders associated with adrenal cortex
Addison’s disease & Cushing’s syndrome
Adrenal medulla produces what hormone
Catecholamines
Two cathecolamines
Nor Epi & Epinephrine
Disorder associated with adrenal medulla
Pheochromocytoma
Shape of the Right Suprarenal gland
Pyramidal
Shape of Left Suprarenal gland
Crescentic
Right Suprarenal gland is located behind the _______ and ____. Rest posteriorly in the _______.
Right lobe of liver & IVC. Diaphragm.
Left suprarenal gland is located behind the ______, ______ & _______.
Pancreas, Lesser sac & Stomach.
Blood supply of the Adrenal glands
Suprarenal brach of Aorta, Inferior phrenic nerve & Renal artery “AIR”
Venous drainage of the Adrenal glands
Adrenal vein
Right adrenal vein drains to
IVC
Left adrenal vein drains to
Left renal vein
Lymph drainage of the adrenal glands
Lateral aortic nodes
Nerve supply of the adrenal glands
Preganglionic sympathetic nerve fibers and Majority ends in tye medulla.
Imaging: finding are non specific. May be helpful in detecting mass in adrenal area and calcification.
Plain Abdominal X-ray
Imaging: investigation of first choice in infant, children & pregnant women. Indication is adrenal mass larger than _____.
Ultrasound. 2cm.
Imaging Ultrasound: adult appearance. Entirely ______. ______ with straight margin.
Hypoechoic. Concave.
Imaging Ultrasound: Newborn. Cortex _______, Medulla ______. Cortex __ Medulla thickness. _______ border.
Hypoechoic. Hyperechoic. > . Convex.
Imaging: on precontrast scan adrenal have soft tissue density similar to that of liver. Consist of body, medial limb and lateral limb.
CT scan
Imaging CT scan: normal adrenal appear __________ shape within retroperitoneal fat.
Inverted V or Y.
Indication for CT scan imaging
Cyst, Abscess, Masses(adenoma & cancer) and Metastasis “CAM Me”
Imaging: equally effective as CT scan in imaging adrenal disorders
MRI
Imaging: selective injection of contrast into the adrenal vein with an angiographic catheter.
Adrenal venogram
Imaging Adrenal venogram indications: for localization of hormone _______. For adrenal ______ & _______. And for ______ disease.
Active tumor. Hyperplasia & Adenoma. Cushing’s.
Imaging: procedure in which contrast is injected into adrenal arteries to detect any vascular pathology.
Arteriography.
Imaging: Indications for arteriography
Adrenal tumor, CONN syndrome & Adrenal hyperplasia “ACA”
Imaging: usual role of this is to clarify inconclusive result of imaging
Scintigraphy
Indication of Scintigraphy: functional status of ________. Assess _______ adrenal function. Detect functional _______. Detect ______ after surgery. Detect ______ site of hormone production.
Adrenal nodule. Contralateral. Metastasis. Recurrence. Ectopic.
Imaging: adrenocortical imaging agent
NP-59 ( 6-B-iodomethyl-19-norcholestero) and Selenium-75 6-B-selenomethylnorcholesterol.
Imaging: Sympathoadrenal imaging agent
Metaiodobenzylguanidine (MIBG)
Indication for MIBG
Pheochromocytoma, Adrenal metastasis, Neuroblastoma & Carcinoid. “PANC”
Indication for NP-59
Adrenocortical carcinoma, Adenoma & Adrenal hyperplasia “A3”