Pituitary And Suprarenal Glands

Question 1

Relations of pituitary gland

Answer 1

Anteriorly : tubercullum sellae and sphenoid sinus ( pituitary gland is accessed through this sinus surgically)

Posteriorly : dorsum sellae ,posterior intercavernous sinus , the pons and basilar artery

Laterally : cavernous sinus

Superiorly : diaphragma sellae ( fold from dura mater) and optic chiasm

Inferiorly : sphenoid sinus

Question 2

Talk about sella turcica

Answer 2

• Saddle shaped cavity
• In sphenoid bone in the middle cranial fossa of skull
• The depression is called pituitary or hypophyseal fossa
• It is limited Anteriorly by tubercullum sellae and posteriorly by dorsum sellae Inferiorly by sphenoid air sinus and superiorly by diaphragma sellae

Question 3

Blood supply of pituitary gland

Answer 3

Arterial
•From the ICA there are 2 branches
~Superior hypophyseal artery supply infundibulum

~ inferior hypophyseal artery supply posterior lobe

~ anterior lobe is supplied by the superior hypophyseal artery

Superior hypophyseal artery forms capillary network around hypothalamus then blood from this network is transported to a secondary capillary plexus surrounding the anterior lobe known as hypothalamo hypophysial portal system , this structure allow hypothalamus to communicate with the antrior lobe via release of neurotransmitters in blood

Venous supply :
Veins formed drain to the cavernous sinus

Question 4

What symptoms during pituitary gland tumour

Answer 4

Hormones disturbance
+ intra cranial pressure
~ continous severe headache
~ blurred vision
~ persistent vomiting

Question 5

Talk about suprarenal glands

Answer 5

• Paired retroperitoneal organs that
lie on the kidneys
•They secrete steroid and catecholamine hormones directly into the
blood.
•They are surrounded by the renal fascia
• Separated from the kidneys by the perirenal fat
•Each gland has a yellow cortex and a dark brown medulla.

Question 6

Compare between right and left suprarenal glands

Answer 6

•Left suprarenal gland is crescentic in shape

*Extends along the medial border of the left kidney from the upper pole to the hilum

~It lays behind The pancreas, Spleen, The stomach
~It rests posteriorly on the left crus of diaphragm

•The right suprarenal gland is pyramidal in shap

• and caps the upper pole of the right kidney ( higher)

~It lies behind the right lobe of the liver and the IVC
~It rests posteriorly on the diaphragm

Question 7

Blood supply of suprarenal glands

Answer 7

Arteries
Three arteries supplying each gland,
1- Superior suprarenal artery: from inferior phrenic artery

2- Middle suprarenal from: aorta
3- Inferior suprarenal artery : renal artery

Veins
A single vein from the hilum of each gland:
The right suprarenal vein drains into the IVC ( short)
The left suprarenal vein drains into the left renal artery ( long)

Question 8

Nerve supply and lymphatic drainage of suprarenal glands

Answer 8

• Preganglionic sympathetic fibers derived from the splanchnic nerves

•Most of the nerves end in the medulla of the gland

•The lymph drains into the lateral aortic nodes ( paraortic lymph nodes)

Question 9

Talk about cavernous sinus + relations

Answer 9

A dural venous sinus (not a venous plexus) creating a cavity
bordered by Anteriorly: superior orbital fissure.
Posteriorly: apex of petrous temporal bone.
Superiorly: internal carotid artery.
Inferiorly: sphenoid bone.
Medially: sella turcica and sphenoidal air sinus.
Laterally: temporal lobe with uncus.

Question 10

Structures within the lateral wall of cavernous sinus

Answer 10

1- 3rd nerve
2- 4th nerve
3- V1 ( ophthalmic) n
4- V2 ( maxillary) n
5- 6th nerve

Question 11

Tributaries of cavernous sinus

Answer 11

• central retinal veins
• s. Ophthalmic vein
• i. Ophthalmic vein

• sphenoparital sinus
• meningeal veins
• superficial middle cerebral vein

Question 12

Drainage of cavernous sinus

Answer 12

Drainage:
-Superior petrosal sinus to transverse sinus
- Inferior petrosal sinus to internal jugular

Question 13

Communications of cavernous sinus

Answer 13

Medially : right Cavernous sinus connect with left through ant and post interncavernous sinus Inferiorly

-Pterygoid plexus of vein

-Pharyngeal plexus

• Anteriorly -Anterior facial vein
  Directly to cavernous sinus by superior ophthalmic vein or inferior ophthalmic vein

Indirectly by pterygoid venous plexus by inferior ophthalmic vein or deep facial vein

Question 14

Applied anatomy of cavernous sinus

Answer 14

•It is the only anatomic location in the body in which an artery travels
completely through a venous structure.

•If the internal carotid artery
ruptures within the cavernous sinus, an arteriovenous fistula is created

•Cavernous Sinus thrombosis: if there is infection

•pituitary adenoma

• ophthalmoplegia (from compression
  of the oculomotor nerve, trochlear
  nerve, and abducens nerve),
  *ophthalmic sensory loss (from compression of the ophthalmic nerve)
  *maxillary sensory loss (from compression of the maxillary nerve)
  *Horner’s syndrome.