At the end of the presentation ,we 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. Development of adrenal gland and common anomalies.

1. ANATOMY OF SUPRARENAL
(ADRENAL) GLANDS
Dr. NDAYISABA CORNEILLE
CEO of CHG
MBChB,DCM,BCSIT,CCNA Supported BY

2. Objectives
• At the end of the presentation ,we 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.
• Development of adrenal gland and common
anomalies.
Dr Ndayisaba Corneille

3. Suprarenal Glands
• The suprarenal (adrenal) gland is a
component of the hypothalamic-
pituitary-suprarenal axis that is
responsible for coordinating stress
response and metabolism.
• They are yellowish retroperitoneal
organs that lie on the upper poles of
the kidneys,
• just above the level of the last
thoracic vertebra (T12).
• They are surrounded by renal fascia
(but are separated from the kidneys by
the perirenal fat).
• Each gland has an outer yellow cortex
and an inner dark brown medulla.
Dr Ndayisaba Corneille

4. •Suprarenal glands surrounded by connective tissue containing
considerable perinephric fat
• Suprarenal glands are enclosed by renal fascia by which they are attached to the
crura of the diaphragm
• Each gland has a hilum, where the veins and lymphatic vessels exit the gland;
whereas arteries and nerve enter the glands at multiple sites
• They are separated from the kidneys by a thin septum (part of the renal fascia)
•The medial borders of the suprarenal glands are 4-5 cm apart. In this area, from
right to left, are the IVC, right of the diaphragm, celiac ganglion, celiac trunk, SMA
and the left of the diaphragm.
Suprarenal Glands
Dr Ndayisaba Corneille

5.  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.
Dr Ndayisaba Corneille

6.  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.
Dr Ndayisaba Corneille

7. PARTS OF SUPRA RENAL GLANDS
•Each suprarenal gland
has two parts :
~ Suprarenal cortex
~ Suprarenal medulla
Dr Ndayisaba Corneille

8. SUPRARENAL CORTEX
• Derives from mesoderm
Three zones in suprarenal
cortex
Outer zone / zona
glomerulosa
Mineralocorticoid
hormone
middle zone /
zona fasciculata
Glucocorticoid
hormone
Inner zone /
Zona reticularis
Androgen
hormone
Dr Ndayisaba Corneille

9. • Aldosterone is the major
mineralocorticoid.
• It regulates homeostasis
of two mineral ions,
namely sodium ions (Na)
and potassium ions (K),
and helps adjust blood
pressure and blood
volume.
• Aldosterone also
promotes excretion of H+
in the urine; this removal
of acids from the body can
help prevent acidosis
Mineralocorticoid
Dr Ndayisaba Corneille

10. •include cortisol (hydrocortisone),
corticosterone, and cortisone
•Function : Protein breakdown, glucose
formation, lipolysis, resistance to stress,
anti-inflammatory effects, depression of
immune responses
Glucocorticoid
Dr Ndayisaba Corneille

11. •The major androgen secreted by the
adrenal gland is
dehydroepiandrosterone (DHEA)
•Function : promote libido (sex drive)
and are converted into estrogens
(feminizing sex steroids) by other body
tissues; after menopause, when ovarian
secretion of estrogens ceases all female
estrogens come from conversion of
adrenal androgens; stimulate growth of
axillary and pubic hair in boys and girls
and contribute to the prepubertal
growth spurt.
Androgen
Dr Ndayisaba Corneille

12. SUPRARENAL MEDULLA
• Derive from neural crest cells associated with the
sympathetic nervous system
• The cromaffin cells secrete catecholamines / epinephrine
and norepinephrine (NE), also called adrenaline and
noradrenaline, respectively.
• Unlike the hormones of the adrenal cortex, the hormones of
the adrenal medulla are not essential for life since they only
intensify sympathetic responses in other parts of the body.
Dr Ndayisaba Corneille

13. Action of catecholamine :
1. Increased heart rate
2. Increased force of cardiac muscle contraction
3. Elevated blood pressure
4. Increased breathing rate
5. Decreased activity in the digestive system
Dr Ndayisaba Corneille

14.  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: A single vein emerges from
the hilum of each gland and drains
• into the inferior vena cava on the
right and
• into the left renal vein on the left.
Dr Ndayisaba Corneille

15.  Nerve Supply:
 Preganglionic sympathetic fibers
 derived from the splanchnic nerves supply the glands.
 Most of the nerves end in the medulla of the gland.
 Lymph Drainage:
 The lymph drains into the lateral aortic nodes.
Dr Ndayisaba Corneille

16. 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
Dr Ndayisaba Corneille

17. 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. Dr Ndayisaba Corneille

18.  The cortex
• During the 6th week of
development,
• by aggregation of the
mesenchymal cells
• between dorsal mesentery and
developing gonads.
• This fetal cortex is derived from
the mesothelium lining the
posterior abdominal wall.
 The medulla
• It forms a mass medial to the
fetal cortex
• derived from the adjacent
sympathetic ganglion;
• from neural crest cells.
Dr Ndayisaba Corneille

19. Permanent cortex
•A second wave of
mesenchymal cells
arise from the mesothelium,
enclose the fetal cortex.
•forms a thinner definitive
(permanent) cortex.
Dr Ndayisaba Corneille

20. • Differentiation of the characteristic
suprarenal cortical zones begins during
the late fetal period.
• Zona glomerulosa &
• zona fasciculata
are present at birth, but
• zona reticularis
is not recognizable until the end of third
year.
Dr Ndayisaba Corneille

21. • The suprarenal gland of the fetus is 10-20 times larger than the adult glands
relative to the body weight, and are large compared with the kidneys. This is
because of the extensive size of the fetal cortex. The medulla remains
relatively small until after birth.
• The suprarenal glands rapidly become smaller during the first 2-3 weeks after
birth, due to the rapid regression of the fetal cortex.
• Its involution is largely completed in the first year of life.
• During the process of involution, the cortex is friable and susceptible to
trauma at birth leading to severe hemorrhage.
• Congenital adrenal hyperplasia (CAH):
• An abnormal increase in the cortical cells results in excessive androgen
production; during the fetal period.
• In females, it may lead to musculization of external genitalia and enlargement
of clitoris.
• In males, it may remain undetected in early infancy.
• Later in childhood, in both sexes, androgen excess may lead to rapid growth
and accelerated skeletal maturation.
Dr Ndayisaba Corneille

22. END
THANKS FOR LISTENING
By
DR NDAYISABA CORNEILLE
MBChB,DCM,BCSIT,CCNA
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Dr Ndayisaba Corneille