Primary Regulatory Control
Secretory products
Renin-angiotensin Zona glomerulosa Aldosterone
ACTH, hypothalamic CRH Zona fasciculata Cortisol and sex hormones
ACTH, hypothalamic CRH Zona reticularis Sex hormones (e.g. androgens)
Preganglionic sympathetic fibers Medulla Catecholamines (Epi, NE)
  • Glomerulosa (salt), fasciculata (sugar), reticularis (sex)
    • "The deeper you go, the sweeter it gets." 
Adrenal Circulation
  • Both the left and right adrenals receive arterial blood supply in the same fashion
    • Paired superior suprarenal arteries - derived from inferior phrenic arteries
    • Paired middle suprarenal arteries - derived directly from abdominal aorta
    • Paired inferior suprarenal arteris - derived from the adjacent renal arteries
  • The left and right adrenals have differing venous drainage
    • The left adrenal venous drainage is through the left adrenal vein to the left renal vein and finally to the IVC
    • The right adrenal venous drainage is through the right adrenal vein to the IVC
  • Recall the same pattern for the left and right gonadal artery/vein
Selected Pathology
  • Pheochromocytoma
  • Neuroblastoma
  • Conn's syndrome
  • Cushing's syndrome
  • Addison's disease

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