Greetings to all anatomy studies, welcome to a new anatomical video. Today we will talk about the famous adrenal glands or better known as the adrenal glands, these are glands that belong to the endocrine system but also belong to the nervous system, they really have a very impressive physiology, we will not cover them in this video but it would be Good that they read it so that they know it or good respectively when they study physiology they will understand the importance of these glands for life. Very well, the adrenal glands are paired glands that are housed at the level of the upper part of the kidney, they are not unique to humans, in fact they are not necessarily on top of the kidney in the rest of the animals, but they are almost always related to it because they are They derive from the urogenital crest and therefore we can find them in various areas of the abdomen, the most common thing is that they are found above the kidney as you see in this image, but they can even be found at the scrotal level, at the level of the ureters, everything.
the route of the ureters, of the bladder, you can even find accessory adrenal glands, but we are going to talk about the most common thing that is repeated the most and that is that there are two adrenal glands, see that they are a little morphologically different from each other, these glands each One has an approximate weight between 3 to 6 grams, its dimensions will be good in length, which is, let's say, the largest, approximately 3 centimeters, in width of its widest area it will be able to measure up to 2. 5 centimeters and it is said that in the anterior direction. posteriorly we see this cut, so that you understand it this is a transverse section, that is, this entire area here more or less, all this would be anterior and all this would be posterior, so this so that you can see that the anteroposterior diameter is a really diameter short, small that sometimes does not even measure a centimeter, we speak of 0.
8 centimeters, 8 millimeters. Very well, regarding the layers we are going to touch on them a little later in the video but what I want you to know right now is that the outermost part of the adrenal gland or adrenal gland is covered or rather covered by a capsule that It is the famous adrenal capsule, a capsule that fuses with the kidney capsule, of course you have to know more or less the renal anatomy so that you can understand these adrenal glands, it is also called adrenal because well it produces adrenaline that is also called norepinephrine and they produce another hormone called norepinephrine, okay? which is norepinephrine and epinephrine is adrenaline, sorry I confused it at the beginning, that is why the operation where the adrenal glands are removed is called adrenalectomy, because like any gland it is also prone to having certain anatomopathological diseases and Many times you have to remove them.
Speaking then of this sagittal cut, here we are seeing the liver which tells us that it is the adrenal gland on the right side, it is also located within the renal cell because it is surrounded by the renal fascia, notice that it is surrounded by the adrenal capsule itself, is located inside the renal cell and outside it is the renal fascia that surrounds the kidney and the adrenal gland itself, that is, all this fat that is surrounding it would be perinephric fat, which is what fat is called. perirenal, what will the anatomical configuration of this gland be like? well it will have a base that in most cases this base rests on the upper pole of each kidney, then the upper part which is the vertex, this vertex can be pointed, sometimes it can even be bifid or other times it can be blunt, the shape of this adrenal gland is quite variable and this vertex generally looks forward, looks medially and looks upward, that is, the vertex is a little more anterior with respect to the base, that will allow us to each adrenal gland has two faces, one face that we are seeing that looks forward, here we are seeing the adrenal gland on the left side specifically that that face that looks forward would be the anterior face, it is important because it can have different shapes, it can be flat, it can be concave as you can see here or it can even be convex, this part of the anterior face is where the adrenal hilum is practically located because it is the place where the structures that reach it enter and exit, which are basically the arteries and the adrenal vein, speaking specifically of the left adrenal gland we are going to see that its anterior surface is first related to the renal facet of the spleen, see here that there is a clamp that is grabbing the spleen, which is grabbing the pancreas, when I released this clamp, both the spleen, the pancreas, and the stomach are going to be in contact specifically with this anterior face of the adrenal gland.
Here you can see very well how they had to cut the renal fascia to be able to access it and you can see which is surrounded by the same fat of the perinephric space, if we go to the adrenal gland on the left side we see that its anterior face will also be in relation to the liver, it will be related to the duodenum and also in relation to the vein inferior cava, which here is held by these separators, something important about this anterior face is that it is also in relation to an area called the bare area of the liver, that is, in relation to it, it is practically in contact with this bare area of the liver. Now, later on, who is that adrenal gland going to relate to? well later we see the pillars of the diaphragm, behind the pillars of the diaphragm is the extension of the pleura which is the recess or costophrenic space and we see that it is also related to the eleventh and twelfth rib, here is the twelfth, here the eleventh and well more or less it is located behind that adrenal gland, we see it in this section that the relationships are very good, notice this is an extension of the pleural space that would be the diaphragmatic cost recess or phrenic cost, here There is the adrenal gland, see as a posterior relationship also the relationship of the thoracoabdominal diaphragm and also see that it would be posterior to practically both the eleventh and twelfth ribs, I quite like this image because here we can see what I was telling you about the anterior face, as it is.
in direct contact practically with the bare area of the liver, this space that is here that is practically interposed between the liver and the adrenal gland is a space of the large peritoneal cavity called the hepatorenal bursa that is part of the sub hepatic space It is also important that you know it, now, just as it has its base, it has its vertex, it has its faces, it has the edges, an edge that looks medially which would be the internal edge or medial edge and an edge that looks laterally. which is the external edge or lateral edge, that internal edge, if it is on the left side, as you can see here, is related to the abdominal aorta, but if we talk about the right side, we are going to see that this internal edge would be related to the inferior vena cava and Also related to the duodenum. Now we are going to talk specifically about the irrigation of the layers and venous drainage, but first do not leave the video [Music] I invite you to subscribe here in the lower right corner, click [Music] and do not forget to like the video, subscribe to the channel below where you see what I uploaded, click on it and you can automatically access the more than 172 anatomical videos that are on the channel, we continue to grow, we continue making videos, if there is any video that you cannot find in the channel, you write it to me in the comments and I read all the comments and when I have time I made your video, as long as they are anatomical videos, I repeat, many times they ask me for videos of other medical things but really this channel is dedicated to the anatomy.
We then continue talking about the layers of this adrenal gland, and we know the outermost layer, which is the capsule, and basically it will have two large layers from a large anatomical point of view, which is an external cortex and then a medulla, that cortex. Then it has three layers but those are things that will be studied in histology, which is the anatomy of the microscope, but to the eye seen macroscopically we only find the cortex, which is like this, It is actually quite yellowish due to the amount of cholesterol and lipids it contains, while the medulla is a little more, let's say a different color, a more pinkish color, the medulla is the part that belongs to the nervous system in fact, while the cortex It is the part that belongs to the endocrine system, that cortex surrounds all that medulla. Very well, with respect to irrigation, like any gland of the endocrine system, remember that a gland of the endocrine system is one that produces a substance called, in most cases, hormones, which have to stimulate structures that are very far away from them and therefore Therefore they have to travel to the blood, then the secretion product of the endocrine glands goes to the blood, as you have to go to the blood it has to receive enough blood that is why they are all densely irrigated or else look how It is the pancreas, look at what the thyroid gland is like, look at what the pituitary gland is like, it has a lot of irrigation, that is why each adrenal gland has three groups of artery, we are talking about superior adrenal arteries, see that they are several branches, those adrenal arteries superior are branches of the inferior diaphragmatic artery, this inferior diaphragmatic artery is also called the inferior phrenic artery which is one or the first in fact parietal branch of the abdominal aorta, then the next group of arteries are the middle adrenal arteries, this middle adrenal artery arises as a direct branch of the aorta; So don't forget, the upper one is a branch of the lower diaphragmatic, indirectly it will be a branch of the aorta, while the middle one is a direct branch of the aorta.
Now, when you study the inferior adrenal artery you realize that it is a direct branch of the renal artery, in fact if you already saw my renal artery video you may have realized what I told you about this inferior adrenal artery. In the long run, these renal arteries derive from the aorta, in the long run the entire adrenal gland will be irrigated by the abdominal aorta specifically, the venous drainage is a little different because the venous drainage is not that complicated, it would really be through adrenal veins, what's the difference? The difference is the place where each adrenal vein drains, the adrenal vein on the right side, which is practically or generally a single vein, drains the level of the inferior vena cava, the inferior vena cava passes in front of it, remember that it is a previous relationship.
and this vein does not have to travel a long distance to reach the inferior vena cava, but if you look for the adrenal vein on the left side, well, it is more complicated there because it drains into the left renal vein, generally it receives the diaphragmatic or inferior phrenic vein and together as a single trunk, although sometimes they do it separately they drain their blood into the renal vein, that has quite a few implications with what it has to do with the venous pressure of this renal vein, which well are points that I made it clear in the renal vein video that I invite you to look for it on my channel.
