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point of identification and clinical significant of adrenal gland

Publié dans : Santé & Médecine
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  1. 1. ADRENAL GLAND Covered with thick CT capsule from which trabeculae extend into parenchyma, carrying blood vessels & nerves OUTER YELLOWISH CORTEX - Steroid- secreting - 90% of the gland by weight - Mesodermal mesenchyme - Controlled in part by anterior pituitary gland - Regulate metabolism & maintain normal electrolyte balance ZONA GLOMERULOSA mineralocorticoids ZONA FASICULATA glucocorticoids ZONA RETICULARIS androgens DARK INNER MEDULLA - Catecholamine-secreting - Form center of the gland - Neuroectoderm - Richly innervated by preganglionic sympathetic fibers CHROMAFFIN CELLS catecholamines SYMPATHETIC GANGLION CELLS
  2. 2. Cortex Zona glomerulosa mineralocorticoids (aldosterone) Zona fasiculata glucocorticoids (cortisol) Zona reticularis Androgens (dehydroepiandosterone(DHEA)) Medulla catecholamines (epinephrine & norepinephrine)
  3. 3. • Cells arranged into three concentric zones – differentiated based on the pattern produced by cords of cells – boundaries between zones are indistinct ZONA GLOMERULOSA: narrow outer zone that constitutes up to 15% of the cortical volume ZONA FASICULATA: thick middle zone that constitutes nearly 80% of the cortical volume ZONA RETICULARIS: inner zone that constitutes only 5% to 7% of the cortical volume but is thicker than the glomerulosa because of its more central location
  4. 4. • small columnar cells • arranged in closely packed ovoid clusters & curved columns • spherical nuclei appear closely packed and stain densely • rich network of fenestrated sinusoidal capillaries surrounds each cell cluster • lipid droplets are sparse • SECRETES MINERALOCORTICOIDS (ALDOSTERONE, DEOXYCORTICOSTERONE) – Maintain fluid & electrolyte balance
  5. 5. • large polyhedral cells • arranged in long straight cords, one or two cells thick, separated by sinusoidal capillaries • lightly staining spherical nucleus • Binucleate cells are common • numerous lipid droplets – contain neutral fats, fatty acids, cholesterol, & phospholipids (precursors for the steroid hormones) • SECRETES GLUCOCORTICOIDS (CORTISOL, CORTICOSTERONE) – Regulate metabolism of carbohydrate, protein & lipid (gluconeogenesis, proteolysis, lipolysis) – Suppress inflammation & immune response – Impair healing process
  6. 6. • dark acidophilic cells – abundant lipofuscin pigment granules • Smaller cells compared to cells in zona fasciculata, nuclei are more deeply stained – less cytoplasm; thus the nuclei appear more closely packed. • arranged in anastomosing cords, separated by fenestrated capillaries • cells have relatively few lipid droplets • SECRETES ANDROGENS (DEHYDROEPIANDOSTERONE, ANDROSTENEDIONE) – Weak masculinizing effect – Libido, body hair (female)
  7. 7. • Consist of: – Chromaffin cell (most abundant cell) – CT – Sinusoidal blood capilaries – Nerves • Myelinated – Sympathetic ganglion cells • round or polygonal with prominent nuclei • May be in cluster
  8. 8. • Pheochromocytes • Large, pale-staining epithelioid cells • Organized in ovoid clusters & short interconnecting cords • Intimate relation with blood capillaries • Granular cytoplasm due to hormone-containing granules can be observed – Stain intensely with Chromaffin salts • SECRETES CATECHOLAMINES (ADRENALINE, NORADRENALINE) – Augment sympathetic system activity – Major role in acute response to stress
  9. 9. Chromaffin cells arranged in clusters, usually around medullary veins Ganglion cells (round or polygonal with prominent nuclei)
  10. 10. • Insufficient cortical secretion – Addison’s disease • Excessive cortical secretion – Cushing’s syndrome  hypercortisolism – Masculinization (virilism)  excessive adrogens in women – Feminization  excessive estrogens in men – Adrenogenital syndrome  excessive sex hormone in children
  11. 11. • Abnormal medullary secretion – Hyposecretion • Not much problem if sympathetic function is normal • Some attenuation of acute response to stress – Hypersecretion • Pheochromocytoma  benign tumours of adrenal medulla The tumor cells in pheochromocytoma may be arranged in alveolar (nesting), trabecular, solid/diffuse, or mixed patterns. Alveolar pattern is shown here
  12. 12. • Histology of adrenal gland – http://arbl.cvmbs.colostate.edu/hbooks/pathphys/endocrine/adrenal/histo_overview.html • Histology: A Text and Atlas by Ross M.H. and Pawlina W. – https://www.inkling.com/read/histology-michael-ross-and-wojciech-pawlina-6th/chapter- 21/adrenal-glands#4652fc36484946c9a323b2baa04cd87b • DiFiore's Atlas of Histology with Functional Correlations By Victor P. Eroschenko, Mariano S. H. di Fiore – http://books.google.com.my/books?id=sH87M12QswcC&pg=PA463&lpg=PA463&dq=histologi cal+structure+adrenal+gland%27s+correlation+with+function&source=bl&ots=zP80SNqbej&si g=Cxhx-znWfbs0TdVCSrUFGTdCxBk& hl=en&sa=X&ei=LJwAVOapO5CcugSGuoLQDg&redir_esc=y#v=on epage&q=histological%20structure%20adrenal%20gland's%20correlation%20with%20functio n&f=false • Adrenal Medulla Development Movie – http://embryology.med.unsw.edu.au/embryology/index.php?title=Adrenal_Medulla_Develop ment_Movie