Describe the structures, relations, and functions of the adrenal gland. describe the histological structures and clinical importance of the adrenal gland

1. The adrenal glandThe adrenal gland
(Suprarenal(Suprarenal((
ByBy
Dr. Mohammed Ahamed AhamedAbuelnorDr. Mohammed Ahamed AhamedAbuelnor

2. Position and locationPosition and location
 The adrenal glands located on the upper poles ofThe adrenal glands located on the upper poles of
each kidney on the right and left sideseach kidney on the right and left sides
 They are covered by peritoneum on theThey are covered by peritoneum on the
posterior abdominal wall they are embeddedposterior abdominal wall they are embedded
into pre renal fatinto pre renal fat
 The left one is larger and higher than the rightThe left one is larger and higher than the right

3.  Location:Location:
 Rest superiorly toRest superiorly to
kidneyskidneys
 Hormones Produced:Hormones Produced:
 ~30 steroid hormones!~30 steroid hormones!

4. Adrenal gland position &locationAdrenal gland position &location

5. The right adrenal glandThe right adrenal gland
 It is triangular in shape located on the upperIt is triangular in shape located on the upper
pole of the right kidney behind the inferior venapole of the right kidney behind the inferior vena
cavacava
 It is related anterior to the inferior vena cava andIt is related anterior to the inferior vena cava and
the right lobe of the liverthe right lobe of the liver
 Posterior it is related to the right cruse ofPosterior it is related to the right cruse of
diaphragmdiaphragm

6. Relation of the right glandRelation of the right gland

7. The left adrenal glandThe left adrenal gland
 It is crescent in shape located on the upper poleIt is crescent in shape located on the upper pole
of the left kidney behind the stomachof the left kidney behind the stomach
 Anterior it is related to the stomach, the tail ofAnterior it is related to the stomach, the tail of
pancreas and the lesser sacpancreas and the lesser sac
 Posterior it is related to the left cruse ofPosterior it is related to the left cruse of
diaphragmdiaphragm

8. Relation of the left glandRelation of the left gland

9. The blood supplyThe blood supply
 Each adrenal gland supply by three arteries superiorEach adrenal gland supply by three arteries superior
,middle and inferior supra renal arteries,middle and inferior supra renal arteries
 The superior supra renal artery branch from inferiorThe superior supra renal artery branch from inferior
phernic artery which is branch from the aorta, thephernic artery which is branch from the aorta, the
middle supra renal artery branch from the aorta and themiddle supra renal artery branch from the aorta and the
inferior supra renal artery branch from the renal arteryinferior supra renal artery branch from the renal artery
 The venous drainage by the supra renal vein on theThe venous drainage by the supra renal vein on the
right side at the inferior vena cava and on the left sideright side at the inferior vena cava and on the left side
at the left renal veinat the left renal vein

10. Arterial supplyArterial supply

11. Structure of adrenal glandStructure of adrenal gland
 The adrenal gland formed of outer cortex whichThe adrenal gland formed of outer cortex which
is yellow forming the main mass of the glandis yellow forming the main mass of the gland
and inner medulla completely enclosed by theand inner medulla completely enclosed by the
cortex except at the hilum the gland enclosed bycortex except at the hilum the gland enclosed by
capsule of connective tissuecapsule of connective tissue
 The cortex has mesoderm development whileThe cortex has mesoderm development while
the medulla developed from the neural crestthe medulla developed from the neural crest

12. The cortex and capsuleThe cortex and capsule

13. The adrenal cortexThe adrenal cortex
 The cortex of the adrenal cortex consist of three layersThe cortex of the adrenal cortex consist of three layers
arranged from outer to inner the zona glomerulosa,arranged from outer to inner the zona glomerulosa,
fasciculata, and reticularisfasciculata, and reticularis
 ZonaZona glomerulosaglomerulosa : it is the outer layer located close: it is the outer layer located close
to the capsule .to the capsule .
 it is cells stimulated by ACTH and angiotensin 2 toit is cells stimulated by ACTH and angiotensin 2 to
secret minralocorticoids hormones which are thesecret minralocorticoids hormones which are the
aldesterone and deoxycorticosterone they control thealdesterone and deoxycorticosterone they control the
fluid and electrolytes balance in the body by affectingfluid and electrolytes balance in the body by affecting
the renal tubulesthe renal tubules

14. Zona fasciculataZona fasciculata
 It is the middle largest layer of the cortexIt is the middle largest layer of the cortex
 the cells of this layer secret the glycocorticoidsthe cells of this layer secret the glycocorticoids
which are the cortisol and hydrocortisone whichwhich are the cortisol and hydrocortisone which
are maintain the carbohydrate balanceare maintain the carbohydrate balance

15. Adrenal HistologyAdrenal Histology

16. Adrenal cortexAdrenal cortex

17. Structure of the cortexStructure of the cortex

18. Steroids produced by theSteroids produced by the
AdrenalsAdrenals::
1.1. AldosteroneAldosterone
2.2. CortisolCortisol
3.3. Epinephrine (Adrenaline)Epinephrine (Adrenaline)
4.4. AndrogenAndrogen

19. AldosteroneAldosterone
 Target Cell:Target Cell:
 Kidneys!Kidneys!
 Exocrine GlandsExocrine Glands
 Effect of Hormone:Effect of Hormone:
 Maintains balance of NaMaintains balance of Na++
in the bloodstreamin the bloodstream
 aldosteronealdosterone  conservation of Naconservation of Na++

20. CortisolCortisol
 Produced when ACTH levels are high!Produced when ACTH levels are high!
 Act as negative feedback for the pituitary glandAct as negative feedback for the pituitary gland
 Converts adipose tissueConverts adipose tissue
to glucose!to glucose!
 Occurs during highOccurs during high
stress periodsstress periods
Emotional distressEmotional distress
Physical distressPhysical distress
(exercise,(exercise,
hemorrhagehemorrhage))

21. Zona reticularisZona reticularis
 It is the inner layers it is cells secret theIt is the inner layers it is cells secret the
gonadocorticoids hormone which are thegonadocorticoids hormone which are the
estrogen and androgen which supplemented theestrogen and androgen which supplemented the
sex hormonessex hormones

22. AndrogensAndrogens
 ““malemale”” sex hormonesex hormone
 Converted (mostly) to Testosterone in Males !Converted (mostly) to Testosterone in Males !
 Converted (mostly) to Estrogen in Females!Converted (mostly) to Estrogen in Females!

23. Adrenal medullaAdrenal medulla
 The adrenal medulla developed from the neural crest itThe adrenal medulla developed from the neural crest it
is formed of group and columns of cells calledis formed of group and columns of cells called
chromaffin cellschromaffin cells
 The chromaffin cells secreted the adrenalin andThe chromaffin cells secreted the adrenalin and
noradrenalin which they activated the sympatheticnoradrenalin which they activated the sympathetic
stimulationstimulation

24. Chromaffin cellChromaffin cell

25. EpinephrineEpinephrine
 Stimulated by Sympathetic Nervous SystemStimulated by Sympathetic Nervous System
to initiateto initiate ““fight or flightfight or flight”” response!response!
 Stored in adrenal gland until needed!Stored in adrenal gland until needed!
 Effects of EpinephrineEffects of Epinephrine
 blood sugarblood sugar
 heart rateheart rate
 blood flow to brain, heart, musclesblood flow to brain, heart, muscles

26. Clinical problemsClinical problems
 Various clinical condition due to the lesion of theVarious clinical condition due to the lesion of the
adrenal cortex or medulla affect the secretion of theadrenal cortex or medulla affect the secretion of the
adrenal hormone hyper secretion of the hormones ofadrenal hormone hyper secretion of the hormones of
the adrenal cortex result in Cushing syndrome whichthe adrenal cortex result in Cushing syndrome which
characterized by redistribution of fat the spindle limbs,characterized by redistribution of fat the spindle limbs,
swollen face, diabetes mellitus and slow of woundswollen face, diabetes mellitus and slow of wound
heeling theheeling the
 Hypo secretion cause the Addison disease which isHypo secretion cause the Addison disease which is
characterized by weight loss muscular weakness andcharacterized by weight loss muscular weakness and
hypoglycemia, low blood pressure and dehydrationhypoglycemia, low blood pressure and dehydration
 The hypo secretion of gonad corticoids cause conditionThe hypo secretion of gonad corticoids cause condition
called adrenogenital syndromecalled adrenogenital syndrome

27. Thank YouThank You