a.adrenal

• Adrenal gland


  Normal 4 gms
• Zones of Adrenal cortex

  • Zona Glomerulosa - aldosterone
  • Zona Fasciculata - cortisol; 75% of the cortex
  • Zona Reticularis - androgens
• Adrenal cortex


  • Essential to life and produces steroid hormones, including Mineralocorticoids (Aldosterone), Glucocorticoids (ex. Cortisone) and sex hormones
• Adrenal medulla


  Secretes Epinephrine and Norepinephrine
• Adrenal Cortex Zones


  • Glomerulosa - "salty" (aldosterone)
  • Fasciculata – "sweet" (cortisol)
  • Reticularis – "sex" (androgens)
• Right : triangular

  • Anteromedially - IVC
  • Anterolaterally - Liver
  • Post - Diaphragm
• Left: Crescent (Lunar)

  § Anterior – Spleen

  Stomach Pancreas

  § Post – Diaphragm
• Embryologic origin


  • Cortex - mesoderm
  • Medulla - Neural crest
• Blood supply to suprarenal glands


  1. Suprarenal arteries arise from

  2. Superior from Inferior Phrenic

  3. Middle from Abdominal aorta

  4. Inferior from Renal
• Right Adrenal vein


  Drains into IVC
• Left Adrenal vein


  Drains into Left renal vein - IVC
• Lymphatics


  Lateral aortic
• Addison disease


  Adrenocortical insufficiency
• Addison disease


  • Increased pigmentation
  • Muscular weakness
  • Weight loss
  • Hypotension
• Cushing syndrome


  Cortical hyperplasia due to adenoma or carcinoma of the cortex
• Cushing syndrome


  • Moon-shaped face
  • Truncal obesity
  • Abnormal hairiness / Hirsutism
  • Hypertension
• Congenital adrenal hyperplasia


  Excessive androgen production during the fetal period
• Congenital adrenal hyperplasia in females

  • Masculinization of the external genitalia - enlargement of the clitoris - virilization
  • External genitalia showing an enlarged clitoris and fused labia majora
  • Extreme masculinization
• Hyposecretion


  Addison disease - bronze tone of the skin
• Hyposecretion


  Addison disease - bronze tone of the skin