ADRENAL GLAND

Alvin B. Vibar, M.D.

Adrenal gland
Cortex – mesoderm Medulla – Neural

Development of Adrenal gland

Congenital Adrenal Hyperplasia
Excessive androgen production during the fetal period In females, causes masculinization of the external genitalia – enlargement of the clitoris - virilization

Relations:
Right: Anteromedially – IVC Anterolaterally – Liver Post - Diaphragm
Left: Anterior – Spleen Stomach Pancreas Post - Diaphragm

ABDOMINAL AORTA
Anterior Visceral Celiac Superior Mesenteric Inferior Mesenteric Lateral Visceral Suprarenal Renal Gonadal Lateral Abdominal Inferior Phrenic Lumbar Terminal branches Common iliac Median Sacral

Blood Supply:
Suprarenal arteries arise from 3 sources: Superior from Inferior Phrenic Middle from Abdominal aorta Inferior from Renal

INFERIOR VENA CAVA
Anterior Visceral R / L hepatic Lateral Visceral R suprarenal R / L renal R gonadal Lateral Abdominal Inferior phrenic Lumbar Veins of origin R / L common iliac Median sacral

Venous Drainage:
Right Adrenal vein – drains into IVC Left Adrenal vein – drains into Left renal vein - IVC

Lymph Drainage:
Lateral Aortic nodes

Addison’s disease
Adrenocortical insufficiency Characterized clinically by: Increased pigmentation Muscular weakness Weight loss Hypotension

Cushing’s syndrome
Cortical hyperplasia due to adenoma or carcinoma of the cortex Clinically manifested by: Moon – shaped face Truncal obesity Abnormal hairiness / Hirsutism Hypertension

Adrenal Cortex
Hyposecretion – Addison’s disease – bronze tone of the skin Hypersecretion – Cushing’s syndrome – “moon face” and “buffalo hump”

PITUITARY GLAND

Pituitary Gland
Ectodermal in origin 2 sources Oral ectoderm – Hypophysial pouch from roof of stomodeum – Adenohypophysis / glandular part Neuroectoderm – Neurohypophysial bud from the floor of diencephalon – Neurohypophysis / nervous part

Development of Pituitary Gland
Hypophysial pouch / Rathke – upgrowth from roof of primitive mouth Neurohypophysial bud – downgrowth from the forebrain ( diencephalon)

Pharyngeal hypophysis – persistence of remnant of stalk of Rathke’s pouch Craniopharyngioma– from remnants of the stalk of hypophysial pouch

Hypophysis cerebri “Master endocrine gland” Small, oval structure attached to the undersurface of the brain by the Infundibulum Protected by the Sella turcica of Sphenoid bone

Relations:
Superiorly – Diaphragma sellae Inferiorly – Body of Sphenoid Laterally – Cavernous sinus Posteriorly – Dorsum sellae, Basilar artery, Pons

Divisions:
Anterior lobe or Adenohypophysis Subdivided into: Pars distalis Pars intermedia Pars tuberalis Posterior lobe or Neurohypophysis Pars nervosa

Pituitary gland
Pars distalis: ACIDOPHILS: Growth hormone Prolactin BASOPHILS: FSH LH TSH ACTH Pars intermedia MSH Pars nervosa releases: ADH Oxytocin

Blood supply:
Derived from the superior and inferior hypophyseal arteries – branches of the Internal carotid artery Veins drain into the intercavernous sinuses.

Pituitary Gland
Hyposecretion of GH results to pituitary dwarfism but body proportions are normal

Hypersecretion of GH during childhood results in Gigantism; in adults Acromegaly

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