23. Suprarenal Glands PPT.pptxhuidjjhdkkk

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1. Suprarenal Glands Or ADRENAL GLAND

2. There are two adrenal glands . The two glands have a similarity in anatomical structure , function & in secretion of hormones. The two glands are situated on the posterior abdominal wall over the upper pole of the kidney behind the peritoneum & in front of crus of diaphragm opposite the 11 th interc o stal space & 12 th rib. Adrenal glands are also termed suprarenal glands, as it lies above the kidney[renal] . The term (adrenal) comes from the fact that these glands secrete the hormone (adrenaline) in cases of stress. Position Or Location

3. Size, shape & weight Size:- height- 50 mm Breadth - 30 mm Thickness - 10 mm. At Birth :-It is 1/3 rd of the kidney & In adult :- 1/30 th of kidney Weight:- 5gm The medulla is 1/10 th of the gland Shape:- Right suprarenal:- Triangular or Pyramidal Left Suprarenal:- Semilunar in shape Sheath:- The glands are surrounded by connective tissue containing perinephric fat, enclosed within the renal fascia, and separated from the kidneys by a small amount of fibrous tissue .

4. The relations of the suprarenal glands differ on the two sides. The pyramidal right gland is more apical related to the right kidney, lies anterolateral to the right crus of the diaphragm, and makes contact with the IVC anteromedially and the liver anterolaterally. The crescent-shaped left gland is medial to the superior half of the left kidney and is related to the spleen, stomach, pancreas, and the left crus of the diaphragm. Each gland has a hilum , where the veins and lymphatic vessels exit the gland; whereas arteries and nerves enter the glands at multiple sites. The medial borders of the suprarenal glands are 4-5 cm apart. In this area, from right to left, are the Inferior vena cava, right crus of the diaphragm, celiac ganglion, celiac trunk, Superior mesenteric artery, and the left crus of the diaphragm. Relations

5. Relations

6. Each suprarenal gland has two parts: The suprarenal cortex and suprarenal medulla ; these parts have different embryological origins and different functions The suprarenal cortex derives from mesodermal lining of peritoneal cavity, and secretes corticosteroids and androgens. These hormones control the electrolyte & water balance, maintain blood sugar concentration, liver & muscle glycogen & also control inflammatory reaction. The suprarenal medulla is a mass of nervous tissue permeated with capillaries and sinusoids that derives from neural crest cells ( neuro ectoderm) associated with the sympathetic nervous system. The chromaffin cells of the medulla are related to sympathetic ganglion (postsynaptic) neurons. These cells secrete adrenaline and noradrenalin . Structure

7. Structure

8. Cortex:-Three zones Zona glomerulosa : The outer most layer of the cortex. It is the main site for production of Mineralcorticoids,which maintain electrolyte & water balance. (2) Zona fasciculata:- The middle zone of the adrenal cortex . It is the main site for production of ( Glucocorticoids ) The primary glucocorticoid in human is ( cortisol ) . Zona fasciculata secretes a basal level of cortisol but also produce a Small amount of hormone in response to ACTH . (3) Zona reticularis:- The inner zone of the adrenal cortex . It is responsible for production of sex hormone , Androgens and Estrogens The main adrenal androgen is Testosterone

9. The Suprarenal Arteries and Veins The endocrine function of the suprarenal glands makes their abundant blood supply necessary. The suprarenal arteries branch freely before entering each gland so that 50-60 arteries penetrate the capsule covering the entire surface of the glands . Suprarenal arteries arise from three sources: Superior suprarenal arteries from the inferior phrenic arteries. Middle suprarenal arteries from the abdominal aorta near the level of origin of the SMA. Inferior suprarenal arteries from the renal arteries. The venous drainage of the suprarenal gland is into a large suprarenal vein . The short right suprarenal vein drains into the Inferioir vena cava , whereas the longer left suprarenal vein, often joined by the inferior phrenic vein, empties into the left renal vein. The suprarenal lymphatic vessels arise from a plexus deep to the capsule of the gland and from one in its medulla. The lymph passes to the lumbar lymph nodes. Many lymphatic vessels leave the suprarenal glands. Blood supply & Lymphatics of suprarenal gland

10. Blood supply of suprarenal gland

11. Variation in blood supply of suprarenal gland

12. Nerve supply of supra renal gland The suprarenal glands have a rich nerve supply from the celiac plexus and abdominopelvic (greater, lesser and least) splanchnic nerves. Myelinated presynaptic sympathetic fibers mainly derived from the lateral horn, of gray matter of the spinal cord segments T10-L1 traverse both the paravertebral and the prevertebral ganglia, without synapse, to be distributed to the chromaffin cells in the suprarenal medulla.

13. Applied Due to insufficiency of cortical secretion:- 1. Addison’ disease:- Characterized by muscular weakness, low blood pressure, anaemia, pigmentation & renal failure Due to Excessive cortical secretion 2. Cushing’s syndrome-which is characterized by Moon-shaped face,obesity , hirsutism (excessive hairness ), diabetes, hypogonadism . 3. Masculinization -due to excessive secretion of androgen in female 4. feminization:-due excessive secretion of oestrogen in male

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