The suprarenal glands

The suprarenal glands cap the upper poles of the kidneys and lie against the crura of the diaphragm. The left is related anteriorly to the stomach across the lesser sac, the right lies behind the right lobe of the liver and tucks medially behind the inferior vena cava.

Each gland, although weighing only 3 to 4 g, has three arteries supplying it:

1 a direct branch from the aorta;

2 a branch from the phrenic artery;

3 a branch from the renal artery.

The single main vein drains from the hilum of the gland into the nearest available vessel—the inferior vena cava on the right, the renal vein on the left. The stubby right suprarenal vein, coming directly from the inferior vena cava, presents the most dangerous feature in performing an adrena-lectomy — the tiro should always choose the easier left side and leave the right to his chief.

The suprarenal gland comprises a cortex and medulla, which represent two developmentally and functionally independent endocrine glands within the same anatomical structure. The medulla is derived from the neural crest (neuroectoderm) whose cells also give rise to the sympathetic ganglia. The cortex, on the other hand, is derived from the mesoderm. The suprarenal medulla receives preganglionic sympathetic fibres from the greater splanchnic nerve and secretes adrenaline and noradrenaline. The cortex secretes the adrenocortical hormones.

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