Suprarenal glands, ovary and testis

Dr Laxman KhanalMS- Human Anatomy

Date-27-04-2012

Pretest

1. Which ICS is related with the suprarenal gland ???

2. Which histological layer of the adrenal cortex is thickest ??

3. What is the origin of middle suprarenal artery ?

4. What is the anterior boundary of ovarian fossa ??

Pretest

5 Which ligament contain the blood vessels supplying the ovary ??

6 What is the embryological source of spermatogonia and oogonia ??

7 What is the difference between secondary follicles and graffina follicles ??

8 What is pouch of Douglas ??9 What is the fxn of sustentacular cells ?

Pretest

10 What is the functioin of corpus luteum ??

Suprarenal gland

• LOCATIONPosterior abdominal wall, behind peritoneumAt epigastrium, in front of the 11th ICSIn front of the right and left crus of the

diaphragmCovered by renal fascia

Suprarenal gland

• GENERAL STRUCTURE AND DEVELOPEMENT5 gm weight Cortex(90%) and medulla(10%)Cortex develops from embryonic mesodermMedulla develops from neural crests cells

Suprarenal gland

• ARTERIAL SUPPLY3 suprarenal arteriesSuperior-B/O inferior Phrenic arteryMiddle-B/O abdominal aortaInferior-B/O renal artery• VENOUS DRAINAGERight side- to IVCLeft side- to left renal vein

Suprarenal gland

• HISTOLGY AND FUNCTIONS3 layers can be seen in cortex with distinct

functions1. Zona glomerulos- mineralocorticoid2. Zona fasiculata- glucocorticoid3. Zona reticulosa- sex corticoid Rich in smooth ER

Suprarenal glands

• HISTOLGY AND FUNCTIONSAdrenal medulla cells are modified

postganglionic sympathetic neurons.Medulla cells + chromium salt gives yellow

granules in cytoplasm called as chromaffin reaction.

High in rough ERIncluded in APUD system or neuroendocrine

system.

Suprarenal glands

Adrenal medulla secrets catecholamines like epinephrine , nor-epinephrine and Dopamine.

These acts as neurotransmitters for the postganglionic sympathetic fibers.

Directly can stimulate the adrenergic receptor during sympathetic activity

Suprarenal gland

• CLINICAL IMPORTANCEAddison’s disease- decreased ACTHCushing syndrome- increased cortosolCommonest cause is iatrogenicConn’s syndrome- increased AldosteroneAldosterone secreting adenomaIncreased angiotensin

Suprarenal gland

Masculinization( virilism)- sex hormoneFeminization- sex hormonePheochromocytomaIncreased adrenalineAssociated with MEN2(+hyperparathyroid and

medullary ca of thyroid)

http://upload.wikimedia.org/wikipedia/commons/5/5c/Gray1161.png

OVARY

• Female gonads- produce female gamets and sex hormones(oestrogen and progesterone).

• 3cm in diameter• LOCATIONOvarian fossa on lateral pelvic wallAnt- obliterated umbilical arteryPost- ureter and internal iliac arteryNulliparous- long axis verticalMultiparous- long axis horizontal

Ovary

• Gross features 2 pole or extremities--- upper or tubal pole&

lower or uterine 2 borders– anterior or mesovarian, posterior

or free borders 2 surfaces– lateral & medial

Ovary

• Almost entirely covered by peritoneum except along anterior border (mesovarian)

• 2 ligaments1. Ligament of ovary2. Suspensory ligament – contain vessels and

nerves.• Arterial supplyOvarian artery- L1 level

Ovary

• Venous drainageRight side- to IVCLeft side – to left renal vein• Lymphatic drainageLateral aortic and pre-aortic nodes

Ovary

• HistologyOuter lining - germinal epithelium Cuboidal epitheliumTunica albugineaSubstance of ovaryCortex(stroma)- ovarian follicles of diff stagesMedulla- CT and blood vessels

Ovary

• Ovarian cycleFrom formation of ovarian follicles to

degeneration of the corpus luteum. Primordial follicle Primary follicle Secondary follicle Graafian follicle

Ovary

Rupture of graafian follicle and release of the ovum( secondary oocyte)

Formation of corpus luteum Degeneration of the corpus luteum14 wk if ovum get fertilized14 day without fertilization

Ovary

• Clinical relationProlapse of ovary- laxness of braod ligament

and mesovarium( into the pouch of Douglas).

Follicular cyst- in unruptured graafian follicles.Luteal cyst- around C.luteumCommonest site of endometrial cyst also called

as chocolate cyst.Agenesis – in Turner’s syndrome

TESTIS

• One of the internal male reproductive organ• Produce male germ cells and male sex

hormones.• Developed in the posterior abdominal wall .

Around 2 month of IUL they leave the peritonial cavity and come out of body through inguinal canal to the scrotum.

• Lies in the skin pocket called as Scrotum.Cryptorchidism

Testis

• External featureSuspended in scrotum by the spermatic cord.Left testis lower than right one.2 poles, 2 borders and 2 surfaces.Upper border give attachment to the

spermatic cord.Epididymis lies along the lateral border of the

posterior border.

Testis

• Histology Lies in double layer T. vaginalis except for its

posterior border.Covered by T. albuginea and T. vasculosa.Around 200 lobules are present separated by

CT ,which contains interstitial cell or cells of Leydig Made up of large number of semineferous

tubules , which contain male germ cells and sustentacular cells or cells of sertoli.

Testis

• Arterial supplyTesticular artery- at the level of L2Enter the spermatic cord• Venous drainageVein first form the pampiniform plexus , pass

through the inguinal canal and finally drain to the IVC and left renal vein.

Testis

• Lymphatic drainagePreaortic and paraortic group of lymph node• Nerve supply T10 segment of spinal cord

Testis

• Clinical relationVasectomy- b/l cutting of vas deferens for

male sterility. Hermaphroditism- true and falseHydrocoele Varicocoele – common in left side

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