Adrenal Gland

General features
Located antero-superiorly, on the upper pole of the kidneys. Asymmetrical. Yellowish in fresh state. Located within an own compartment formed by renal fascia containing perinephric fat.

Features
Right gland Pyramidal in shape
Posteriorly diaphragm AnteriorlyBare area of the liver Overlapped by IVC medially Left gland Crescentic in shape Larger than right Posteriorly diaphragm Anteriorlylesser sac Body of pancreas Splenic vessels

Microscopic structure
Capsule dense fibrous tissue capsule. sends septae/trabeculae into the parenchyma divide the gland into lobules. Parenchyma Outer yellowish cortex three zones Inner grey medulla Two regions act as 2 functional & morphological organs. Arise from two different germ layers. Cortex-intermediate mesoderm Medulla- neural crest cells

Capsule

Zona glomerulosa

Zona fasciculata

Zona reticularis

Medulla

Cortex
Divided into 3 concentric layers Based on disposition and appearance of cells. 1. Zona glomerulosa -15% 2. Zona fasciculata 65% 3. Zona reticularis - 07% of total volume Cells are arranged in cords along capillaries

Zona glomerulosa
Lie just beneath the capsule. Columnar or pyramidal cells. Arranged in closely packed rounded clusters. Cell clusters are surrounded by capillaries. Secretes mineralocorticoids aldosterone.

Macula densa of DCT renin angiotensinogen system aldosterone act directly on renal tubules to increase Na & water retention increase ECF volume increase BP

Zona fasciculata
Intermediate zone. Broadest of the 3 zones. Cells are arranged in straight cords. One or two cell thick. Run at a right angles to the capsule. Sinusoidal capillaries run in between them Cells polyhedral Lipid droplets in the cytoplasm Secrete Glucocorticoids Cortisole (mainly) Androgen (small amount)

Hypothalamus CRH Anterior pituitary ACTH act on Adrenal gland Cortisole

Zona reticularis
Inner most zone adjacent to medulla. Thinnest layer out of 3 zones. Cells smaller than other two layers. Cytoplasm is darkly stained. Arranged in closely packed irregular cords that form a net work. Capillaries are present between cell cords. Secrete androgens.

Cells of Adrenal cortex

Do not store secretory products in granules. Synthesize & secrete products on demand. Typical steroid secreting cells Acidophilic Central nucleus Cytoplasm with lipid droplets Exceptionally rich SER Elongated mitochondria- tubular cristae

Adrenal medulla
Polyhedral parenchymal cells. Basophilic cytoplasm. Cells store secretory products. Arranged in cords or clumps. Supported by a reticular fibre network. Rich capillary supply. Rich sympathetic supply Few parasympathetic ganglion cells. Arise from neural crest cells- as do the post ganglionic neurons of sympathetic/parasympathetic ganglia.

 Cells are regarded as modified sympathetic post ganglionic neurons because they secrete E & NE under control of sympathetic nervous system. Cells have abundant membrane bound electron dense secretory granules Granules contain
Epinephrin Nor-epinephrin ATP Protein- chromogranins Dopamine hydroxylase

 Epinephrin and Nor- epinephrin are secreted by two different cells types. 1. Epnephrin secretory granules small less electron dense 2. Norepnephrin secretory granules large more electron dense Innervated by cholenergic endings of preganglionic sympathetic neurons.

 Cortical cells do not store hormones. Medulla store their hormones. Hormones are secreted in large quantities in response to intense emotional stress. Effects are - vaso constriction hypertension Change in heart rate Elevated blood glucose levels

Blood supply
Three main groups 1. Superior suprarenal Inferior phrenic artery. 2. Middle suprarenal Aorta.

3. Inferior suprarenal Renal A.

3 arteries form a plexus just beneath the capsule.

Arterial branches subcapsular plexus arteries to capsule arteries to cortex capillary bed drain to medulla arteries to medulla pass through cortex medullary capillaries
Medulla dual blood supply Medullary arteries arterial blood Cortical arteries venous blood

Medullary vein suprarenal vein