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ADRENAL GLANDADRENAL GLAND

Alvin B. Vibar, M.D.Alvin B. Vibar, M.D.

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Adrenal glandAdrenal gland

CortexCortex mesoderm mesoderm

MedullaMedulla Neural Neural

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Development of AdrenalDevelopment of Adrenalglandgland

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Congenital AdrenalCongenital AdrenalHyperplasiaHyperplasia

Excessive androgenExcessive androgen productionproduction duringduringthe fetal periodthe fetal period

In females, causesIn females, causesmasculinization of masculinization of the externalthe externalgenitaliagenitalia enlargement of theenlargement of theclitoris -clitoris - virilizationvirilization

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Relations:Relations:

Right:Right:

Anteromedially IVCAnteromedially IVC

Anterolaterally Liver Anterolaterally Liver

Post - DiaphragmPost - Diaphragm

Left:Left:

Anterior SpleenAnterior SpleenStomachStomachPancreasPancreas

Post - DiaphragmPost - Diaphragm

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ABDOMINAL AORTAABDOMINAL AORTAAnterior VisceralAnterior Visceral

CeliacCeliacSuperior MesentericSuperior MesentericInferior MesentericInferior Mesenteric

Lateral VisceralLateral Visceral

SuprarenalSuprarenalRenalRenalGonadalGonadal

Lateral AbdominalLateral Abdominal Inferior PhrenicInferior Phrenic

Lumbar Lumbar Terminal branchesTerminal branches

Common iliacCommon iliacMedian SacralMedian Sacral

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Blood Supply:Blood Supply:

Suprarenal arteries arise from 3 sources:Suprarenal arteries arise from 3 sources:

Superior from Inferior PhrenicSuperior from Inferior Phrenic

Middle from Abdominal aortaMiddle from Abdominal aorta

Inferior from RenalInferior from Renal

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INFERIOR VENA CAVAINFERIOR VENA CAVAAnterior VisceralAnterior Visceral

R / L hepaticR / L hepaticLateral VisceralLateral Visceral

R suprarenalR suprarenal

R / L renalR / L renalR gonadalR gonadal

Lateral AbdominalLateral Abdominal Inferior phrenicInferior phrenic

Lumbar Lumbar

Veins of originVeins of origin R / L common iliacR / L common iliac

Median sacralMedian sacral

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Venous Drainage:Venous Drainage:

Right Adrenal vein drains into IVCRight Adrenal vein drains into IVC

Left Adrenal vein drains into Left renalLeft Adrenal vein drains into Left renalvein - IVCvein - IVC

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Lymph Drainage:Lymph Drainage:

Lateral Aortic nodesLateral Aortic nodes

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Addisons diseaseAddisons disease

Adrenocortical insufficiencyAdrenocortical insufficiency

Characterized clinically by:Characterized clinically by:Increased pigmentationIncreased pigmentationMuscular weaknessMuscular weakness

Weight lossWeight lossHypotensionHypotension

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Cushings syndromeCushings syndrome

Cortical hyperplasia due to adenoma or carcinomaCortical hyperplasia due to adenoma or carcinomaof the cortexof the cortex

Clinically manifested by:Clinically manifested by:Moon shaped faceMoon shaped faceTruncal obesityTruncal obesityAbnormal hairiness / HirsutismAbnormal hairiness / HirsutismHypertensionHypertension

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Adrenal CortexAdrenal Cortex

HyposecretionHyposecretion Addisons diseaseAddisons disease bronze tone of thebronze tone of the

skinskin

HypersecretionHypersecretion CushingsCushingssyndromesyndrome moon moon

face and buffaloface and buffalohumphump

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PITUITARY GLANDPITUITARY GLAND

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Pituitary GlandPituitary Gland

EctodermalEctodermal in originin origin2 sources2 sources

Oral ectodermOral ectoderm Hypophysial pouch from Hypophysial pouch fromroof of stomodeum roof of stomodeum AdenohypophysisAdenohypophysis //glandular partglandular part

NeuroectodermNeuroectoderm Neurohypophysial bud Neurohypophysial budfrom the floor of diencephalon from the floor of diencephalon NeurohypophysisNeurohypophysis / nervous part/ nervous part

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Development of PituitaryDevelopment of PituitaryGlandGland

Hypophysial pouchHypophysial pouch //RathkeRathke upgrowth upgrowthfrom roof of primitivefrom roof of primitive

mouthmouth

NeurohypophysialNeurohypophysialbudbud downgrowth downgrowthfrom the forebrainfrom the forebrain( diencephalon)( diencephalon)

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PharyngealPharyngealhypophysishypophysis persistence of persistence of

remnant of stalk of remnant of stalk of Rathkes pouchRathkes pouch

CraniopharyngiomaCraniopharyngioma from remnants of thefrom remnants of thestalk of hypophysialstalk of hypophysialpouchpouch

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Hypophysis cerebriHypophysis cerebri Master endocrineMaster endocrineglandgland

Small, oval structureSmall, oval structureattached to theattached to theundersurface of theundersurface of thebrain by thebrain by theInfundibulumInfundibulumProtected by the SellaProtected by the Sellaturcica of Sphenoidturcica of Sphenoidbonebone

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Relations:Relations:

Superiorly DiaphragmaSuperiorly DiaphragmasellaesellaeInferiorly Body of Inferiorly Body of SphenoidSphenoidLaterally CavernousLaterally CavernoussinussinusPosteriorly DorsumPosteriorly Dorsumsellae, Basilar artery,sellae, Basilar artery,PonsPons

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Divisions:Divisions:

Anterior lobe or Anterior lobe or AdenohypophysisAdenohypophysisSubdivided into:Subdivided into:

Pars distalisPars distalisPars intermediaPars intermediaPars tuberalisPars tuberalis

Posterior lobe or Posterior lobe or NeurohypophysisNeurohypophysis

Pars nervosaPars nervosa

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Pituitary glandPituitary gland

Pars distalis:Pars distalis:ACIDOPHILSACIDOPHILS ::

Growth hormoneGrowth hormone

ProlactinProlactinBASOPHILSBASOPHILS ::

FSHFSHLHLHTSHTSHACTHACTH

Pars intermediaPars intermediaMSHMSH

Pars nervosaPars nervosareleases: ADHreleases: ADH

OxytocinOxytocin

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Blood supply:Blood supply:

Derived from the superior and inferior Derived from the superior and inferior hypophyseal arteries branches of thehypophyseal arteries branches of theInternal carotid arteryInternal carotid artery

Veins drain into the intercavernousVeins drain into the intercavernoussinuses.sinuses.

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Pituitary GlandPituitary Gland

HyposecretionHyposecretion of of GHGH results toresults to pituitarypituitary

dwarfismdwarfism but bodybut bodyproportions areproportions arenormalnormal

HypersecretionHypersecretion of of GHGH duringduring childhoodchildhood results inresults in GigantismGigantism ;;inin adultsadults --

AcromegalyAcromegaly

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