The inner part of the adrenal gland is called

(a)  

The outer part of the adrenal gland is called the (a)  

1

(a)  

2

(a)  

The cortex is derived from (a)   cells of the intermediate mesoderm near the urogenital ridge

The medulla is derived from (a)   cells (ectoderm origin) that migrate into the developing cortex

• (a)   invade this area to form the medulla, which will later produce catecholamines (epinephrine and norepinephrine).

• (a)   produces steroid precursors

Zona glomerulosa, zona fasciulata, and the zona reticularis all make up the (a)  

• Zona glomerulosa is responsible for (a)  

• Zona fasciculata is responsible for (a)  

• Zona reticularis is responsible for (a)  

• The adrenal gland receives a rich blood supply from (a)   main suprarenal arteries

Superior suprarenal arteries are derived from the (a)  

Middle suprarenal artery is derived from the (a)  

Inferior suprarenal artery is derived from the (a)  

Blood leaves the adrenal glands from the (a)  

The right suprarenal veins drain directly into the (a)  

The left suprarenal vein drains into the (a)  

• The outer part of the adrenal gland. It produces steroid hormones — mainly aldosterone, cortisol, and androgens

• The central part of the gland. It is made up of chromaffin cells, which come from neural crest cells

1

(a)  

2

(a)  

3

(a)  

4

(a)  

5

(a)  

• The outermost layer.

• Primarily responsible for producing mineralocorticoids, such as aldosterone, which regulate sodium and potassium balance in the body

• The middle layer.

• Produces glucocorticoids, such as cortisol, which are involved in metabolism and the body's response to stress

• The innermost layer of the cortex.

• Secretes androgens, which are male sex hormones, contributing to the development of secondary sexual characteristics

The (a)   is the central portion of the adrenal gland. It sits inside the outer cortex and is made up of chromaffin cells, which come from neural crest cells during development

• These (a)   cells act like modified nerve cells — they are part of the sympathetic nervous system (the system that prepares the body for “fight or flight” situations).

The medulla's main job is to secrete epinephrine and nonepinephrine

(a)  

The hormones produced by the (a)   increases heart rate, raises blood pressure, boosts blood flow to muscles, and increases energy availability

• These hormones are released into the blood when the body is under stress or danger

The adrenal glands sit in the (a)   space, just above the kidney and within renal fascia (gerona's fascia)

The adrenal glands are separated from the kidney by a later of (a)   fat

The right adrenal gland is (a)   related to the liver and IVC

The right adrenal gland (a)   rests on the diaphragm

The right adrenal gland (a)   is close to the IVC and right crus of diaphragm

The left adrenal gland is (a)   related to the stomach (lesser sac) and pancreas

The left adrenal gland (a)   rests on the diaphragm

The left adrenal gland is (a)   close to the aorta and left crus of diaphragm

• In newborns, the adrenal glands are relatively (a)   compared to the kidneys

• In adults, each adrenal gland is about (a)   cm in height

• Small, indistinct, low-gray structures that are hypoechoic relative to adjacent anatomy. In some cases only the highly reflective fat that surrounds them is seen

• Thin, hyperechoic core surrounded by a thick, anechoic zone

These images show the right and left adrenal glands in a (a)  

Absence of one or both adrenal glands

(a)  

One adrenal gland missing

(a)  

Both glands are absent (very rare)

(a)  

Causes: developmental failure of the adrenal primordium or neural crest migration defect

(a)  

depends on whether one or both glands are affected

Unilateral: usually no symptoms (other gland compensates)

Bilateral: life-threatening adrenal insufficiency in newborns

(a)  

The cortex makes up the outer part of the gland and secretes (a)   hormones

• - Controls salt (Na⁺) and water balance by acting on the kidneys

• - Helps maintain blood pressure and fluid balance

• - Regulates metabolism, glucose levels, and helps the body handle stress

• - Also has anti-inflammatory and immunosuppressive effects

• - Produces small amounts of androgens (sex hormones).

• - Contribute to secondary sexual characteristics, especially during puberty.

1. Mineralocorticoids = (a)  

1. Glucocorticoids = (a)  

1. Gonadal Hormones / Sex Steroids = (a)  

Catecholamines = (a)  

The medulla forms the inner part of the adrenal gland.
It acts as a neuroendocrine organ — part of the sympathetic nervous system.

(a)  

• Epinephrine (adrenaline) and Norepinephrine (noradrenaline) are secreted by (a)   cells.

• The medulla functions as part of the (a)   system, releasing hormones directly into the bloodstream to act on distant organs

• This helps coordinate the body’s rapid stress response

Epinephrine and nonepinephrine = (a)  

Excess cortisol secretion

• Pituitary overproduction of ACTH

• Adrenal tumor or prolonged steroid use

• Moon face, central obesity

• Muscle weakness, thin skin, purple striae

• Hypertension, osteoporosis, diabetes

Enzyme defect (↓ cortisol → ↑ ACTH → ↑ androgens)

(a)  

In females this syndrome can cause virilization, ambiguous genitalia

(a)  

In males this syndrome can cause precocious puberty

(a)  

This syndrome is treated by steroid replacement therapy

(a)  

aldosterone from adrenal cortex (zona glomerulosa)

• Often due to aldosterone-secreting adenoma

• Sodium & water retention → hypertension

• Potassium loss → muscle weakness, fatigue

The treatment for this disease is remove tumor / aldosterone antagonists

(a)  

(Primary Adrenal Insufficiency)

(a)  

• is a chronic disorder caused by failure of the adrenal cortex to produce sufficient glucocorticoids (cortisol) and mineralocorticoids (aldosterone).

• Blood sugar drops, blood pressure falls, and salt and water are lost.

• ACTH levels rise (because the pituitary tries to stimulate the adrenals), which also increases melanin, causing skin darkening

In conn's disease, aldosterone is (a)  

In Addisons disease, aldosterone is (a)  

In cushings disease/syndrome cortisol is (a)  

In Addisons disease, cortisol is (a)  

In Addisons disease, ACTH is (a)  

In cushings syndrome ACTH is (a)  

In cushings disease ACTH is (a)  

In pheochromocytoma (adrenal medulla tumor) Catecholamines are (a)  

in pheochromocytoma and paraganglioma total metanephrines are (a)  

Measured in plasma or urine as metabolites of catecholamines

(a)  

Final urinary metabolite of catecholamines

(a)  

in pheochromocytoma Vanillylmandelic Acid (VMA) is (a)  

Decreased hematocrit may suggest (a)   , especially in newborns or trauma cases

Hypertension is used to evaluate for (a)   such as Pheochromocytoma or Aldosterone-producing adenoma

Excess catecholamines

(a)  

Conn’s disease

(a)  

Helps identify secondary causes of hypertension

(a)  

Occurs due to excess androgen production

(a)  

Use the highest frequency and a smaller footprint transducer

(a)  

3–5 MHz curvilinear transducer

(a)  

7–12 MHz linear or small curvilinear probe

(a)  

between liver, upper pole of right kidney, and IVC

(a)  

between aorta, spleen, and upper pole of left kidney

(a)  

The cortex (outer zone) appears (a)   – darker on the screen

The medulla (central part) appears (a)   – bright or reflective line in the center

The liver and occasionally the right kidney serve as effective (a)   windows

For transverse scans, apply an intercostal approach to locate the IVC, which lies __ and __ to the upper kidney pole

(a)  

In (a)   % of cases, at least one gland can be visualized after 26–27 weeks of gestation.

Located anterior, medial, and superior to the kidneys

(a)  

The normal adrenal texture appears homogeneous and hypoechoic.

Glands are typically surrounded by highly (a)   fat

When using (a)   transducers (e.g., for endoscopic or intraoperative imaging), the glands may show Hyperechoic medullary echoes, Hypoechoic cortex, Hyperechoic halo of surrounding fat

This image shows

(a)  

The pancreatic tail and splenic vein mark the (a)   superior border

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this shows the

(a)