Adrenal (Suprarenal)

Glands
Anatomy

Dr Sivanandan Ramar
Professor of anatomy
 Objectives
• At the end of the lecture, the students should be able
to describe the:
• Location, shape and relations of the right and left
adrenal glands.
• Blood supply, lymphatic drainage and nerve supply of
right and left adrenal glands
• Parts of adrenal glands and function of each part.
• Suprarenal glands – pair of
importance endocrine glands situated
on the posterior abdominal wall over
the upper pole of the kidneys.
• The suprarenal (adrenal) gland is a
component of the hypothalamic-
pituitary-suprarenal axis that is
responsible for coordinating stress
response and metabolism.
• Made up of two parts
– Outer cortex – 9/10th -
mesodermal origin secretes
steriod hormone
– Inner medulla – 1/10th -neural
crest origin secretes adrenalin and
noradrenalin
 Location

• They are yellowish retroperitoneal

organs that lie on the epigastrium
at the upper poles of the kidneys,
• just at the the level of the 11th
thoracic vertebra (T11).
 Size, shape and weight
• In humans, the right adrenal gland is pyramidal
in shape, whereas the left is semilunar or crescent
shaped and somewhat larger.
• The adrenal glands measure approximately 5.0 cm
in length ,3 cm in width,and up to 1.0 cm in
thickness.
• Their combined weight in an adult human ranges
from 7 to 10 grams (Average 5 grams)
Sheaths/coverings

• Inner fatty sheath

• Outer renal fascia
– Separated from kidney by
septum
External features
 Right suprarenal gland
 a) Apex
 b) Base: Related to upper pole of the right kidney.
Two surfaces:
 Anterior surface: is devoid of peritoneum except for a small part inferiorly.
Medially it is related to inferior venecava.
Laterally it is related to liver.
Inferiorly it is related to duodenum.
 Posterior surface :  Related to right crus of the diaphragm
Three borders:
Anterior border: A little below the apex it presents the hilum where the supra renal
vein emerges.
Medial border: Related to right coeliac ganglion & Right inferior phrenic artery.
Lateral border
 Left suprarenal gland
Two ends:
Upper narrow end - posterior extremity of the spleen
Lower rounded end - hilum through which the left supra renal vein
emerges
Two borders:
Medial; convex border; related to the left coeliac ganglion, left inferior
phrenic artery & left gastric artery.
Lateral; concave border.
Two surfaces:
Anterior: From above downwards it is related to the cardiac end of
stomach, the splenic artery & the pancreas.
Posterior: Related to the kidney laterally & the left crus of the
diaphragm medially.
 The right suprarenal gland
 Is pyramid shaped.
 Caps the upper pole of the right
kidney.
• Relations:
• Anterior: right lobe of the
liver and inferior vena cava.
• Posterior: diaphragm.

 The left suprarenal gland

 Is crescentic in shape
 Extends along the medial
border of the left kidney from
the upper pole to the hilus.
• Relations:
• Anterior: pancreas, lesser
sac, and stomach
• Posterior: diaphragm.
 Arteries:
Arteries The arteries supplying
each gland are three in number:
 superior,
 middle, and
 inferior suprarenal arteries
 arise from;
 inferior phrenic artery,
 abdominal aorta, and
 renal artery, respectively.
• Veins:
Veins A single vein emerges from
 Nerve Supply:
Supply
the hilum of each gland and drains
 Preganglionic sympathetic fibers
• into the inferior vena cava on the
right and  derived from the splanchnic nerves
• into the left renal vein on the left. supply the glands.
 Most of the nerves end in the medulla
 Lymph Drainage:
Drainage of the gland.
 The lymph drains into the
lateral aortic nodes.
 Functions

 The cortex of the suprarenal glands secretes hormones that

include:
 Mineral corticoids, which are concerned with the control
of fluid and electrolyte balance
 Glucocorticoids, which are concerned with the control of
the metabolism of carbohydrates, fats, and proteins
 Small amounts of sex hormones, which probably play a
role in the prepubertal development of the sex organs.
 The medulla of the suprarenal glands secretes the
catecholamines: epinephrine and norepinephrine
 Development of the Adrenal Glands

 The two parts of the adrenal

gland i.e. the cortex and the
medulla develop from two
different origins.
 Cortex
• is mesodermal in origin;
• develops from the celomic
epithelium of the posterior
abdominal wall.
 Medulla
• is ectodermal in origin;
• develops from the neural
crest cells.
 CLINICAL CONDITIONS
HYPERFUNCTION OF ADRENAL CORTEX
 Glucocorticoid excess: Cushing’s syndrome (Hypercortisolism)-
obesity, hirsutism, diabetes and hypogonadism
 Mineralocorticoid excess:  Hyper aldosteronism (Conn’s
syndrome)
 Sex corticoid excess: Adrenogenital syndrome
HYPOFUNCTION OF ADRENAL CORTEX
 Adreno cortical insufficiency: Addison s disease – muscle
weakness, low BP, anaemia and pigmentation of skin
HYPER FUNCTION OF ADRENAL MEDULLA
 Phaeochromocytoma – palpitation, head ache, excessive sweating
and pallor of skin
Thank you