Where are the adrenal glands located? Adrenal glands: symptoms and causes of the disease, their diagnosis and treatment

The adrenal glands are an important component endocrine system, which governs the operation of all human body. The functions of the adrenal glands contribute to normal life, so any failures in them can lead to irreparable complications. The right adrenal gland has the shape of a triangle, and the left - a kind of crescent. The structure of these paired organs is quite complex, but there are two main components, each of which regulates the synthesis of certain hormones:

outer cortical layer of the adrenal glands;
brain matter.

Basic functions and hormones

Why do we need adrenal glands? Thanks to their work, a person is able to adapt to any conditions, both positive and negative. The main functions of the adrenal glands:

production of hormones and substances - mediators;
maintaining stress resistance;
ensuring full recovery after stress;
stimulation of responses to various stimuli;
participation in metabolic processes.

It is worth understanding in more detail what each gland is responsible for:

Resistance to negative environmental influences and quick adaptation to them.
Synthesis of sex hormones that affect the formation of secondary sexual characteristics, libido, etc.
Hormones formed in the cortical substance control the water-electrolyte balance.
Hormonal stimulation of work of cardio-vascular system and central nervous, kidney and blood glucose regulation, blood pressure and expansion of the lumen in the bronchi occurs due to the synthesis of certain hormones in the medulla.
The adrenal glands are also responsible for volume muscle mass and the rate of aging.
Participation in the metabolism of proteins, fats and carbohydrates.
With their help, the choice of certain taste preferences is regulated.
Supporting the immune system is an integral function of the adrenal glands in the human body.

Support of the immune system is impossible without healthy adrenal glands.

The location and peculiar structure allow these glands to increase in size to increase hormone production in long-term stressful situations. The importance of the functions of the adrenal glands can hardly be overestimated, because without them it will not be easy for any individual to live in an aggressive environment. Any disruption in the functioning of the glands affects the state of the whole organism.

Differences in function between men and women

In men and women, the adrenal glands produce different hormones depending on the gender. The female body receives portions of progesterone and estrogen, as well as a small amount of testosterone. But if estrogen is also capable of producing female ovaries, then in the male body it is produced exclusively by the adrenal glands, like testosterone.

Causes of disruption

Infection in the body disrupts the normal functioning of the adrenal glands.

The normal functionality of the adrenal glands can be impaired by the following factors:

autoimmune diseases, congenital pathologies that negatively affect the functionality of these organs (for example, HIV or inflammatory processes);
tuberculosis, syphilis and other infections of the adrenal glands;
malignant and benign tumors these glands, cysts and metastases from damage to other organs, which, together with blood, deliver cancer cells throughout the body;
surgery resulting in infection;
vascular pathology;
heredity (for example, mutations);
dysfunction of the pituitary or hypothalamus;
liver damage, nephritis or heart failure can lead to the development of a disease such as hyperaldosteronism;
prolonged stress that provokes weakness of the adrenal glands;
reception hormonal drugs, a sharp rejection of them or the introduction of insulin, as well as the negative impact of toxic drugs and substances;
functional failures in the brain, or rather, in the part responsible for the work of the adrenal glands;
exposure to ionizing and radiation radiation;
birth trauma in infants, pregnancy and menopause in women;
wrong mode and diet.

Additional risks for the adrenal glands in the female body

In women, the endocrine system is subjected to increased stress in two cases:

Pregnancy. During this period, hormonal needs increase in future mother, therefore, in the first trimester, she may experience a slight malaise due to the unpreparedness of the body for additional stress. This condition will pass after the body of the fetus begins to produce hormones, which occurs from the 2nd trimester and stabilizes by the 3rd. Then the pregnant woman will not experience discomfort.
The onset of menopause. Sudden menopause is a huge stress for the adrenal glands. They must take over the sole synthesis of estrogen, because the ovaries stop doing this. This adversely affects their activity, causing excessive overload or other important adrenal hormones may be produced in insufficient quantities. There may be pain in the knees, lower back, or an increase in the photosensitivity of the eyes.

General symptomatic picture of disorders of the adrenal glands

Chronic fatigue signals a violation in the function of the adrenal glands.

Untimely treatment of diseases of the adrenal glands can play a negative role in all subsequent human life. Therefore, you need to carefully listen to your body and if you find several of the following symptoms, contact a medical institution:

chronic fatigue, which is permanent;
muscle weakness;
excessive irritability;
bad sleep;
anorexia or, conversely, female-type obesity;
vomiting, feeling of nausea;
increase in pressure;
sometimes increased pigmentation may appear in open areas of the body (skin around the nipples, skin folds on the arms, elbows darken) or the abdomen;
alopecia.

The most common cause of the disease of this organ is an imbalance of one or another hormone or group. Depending on the type of hormone whose synthesis has failed, certain symptoms develop. Here are a couple of examples: Self-diagnosis at the first symptoms of the disease.

If the above signs are found, a person at first can check the work of this component of the endocrine system at home using the following manipulations:

Carry out measurements of blood pressure in the morning and evening in two positions at intervals of 5 minutes: standing and lying down. If the results show that the pressure in the standing position is lower than lying down, then this is a clear indicator of violations.
Carry out measurements of body temperature throughout the day in the amount of 3 times: 3 hours after the rise, then after 2 hours and after 2 more. Perform these manipulations for 5 days and calculate the average temperature after. With a fluctuation of more than 0.2 degrees, it is necessary to undergo a medical examination.
It is necessary to stand in front of a mirror in a dimly lit room and shine a flashlight into the eyes from the side, while observing the state of the pupils. The norm is the narrowing of the pupils, their expansion or the appearance of a sensation of pulsation in them - a signal to visit a doctor.

Adrenal glands (adrenal, adrenal glands) are paired endocrine glands located above the kidneys.

The structure and functions of the adrenal glands

In the structure of the glands, the outer cortical substance and the inner medulla are distinguished. They have different origins, but in the process of historical development they united into one body. The adrenal glands have a different shape - the right triangular, and the left semilunar. Outside, the glands are covered with a capsule, which gives rise to processes inside.

The cortical substance predominates, and is about 9/10 of the mass of the glands. It consists of cells that secrete corticosteroid and sex hormones. The cells are located relative to the blood capillaries so that the secret immediately enters the bloodstream. In the cortical substance of the adrenal glands, there are three zones that differ in cellular composition:

Glomerular (produces aldosterone)
Beam (produces cortisol, corticosterone);
Mesh (synthesizes androgens).

The role of corticosteroid hormones in the body is difficult to overestimate. They participate in key points regulation of metabolism (proteins, fats, carbohydrates, water and salts), energy, in immune protection body, regulation of vascular tone, adaptation to stress.

The medulla in the center of the adrenal gland is not sharply demarcated from the cortical, and consists of chromaffin cells, as well as many nerve fibers and cells. Secretory chromaffin cells synthesize adrenaline, dopamine and norepinephrine. By chemical structure they belong to the group of catecholamines, and are originally formed from the amino acid tyrosine. The release of catecholamines into the blood is stimulated by various stimuli - emotions, hypoglycemia, hypothermia, physical work and etc.

Adrenaline increases the blood glucose level due to the breakdown of glycogen, enhances the breakdown of fats with the release of energy, increases blood pressure, increases the frequency and strength of heart contractions, relaxes smooth muscles in the walls of the bronchi, and increases the formation of heat in the body.

Norepinephrine, a precursor of adrenaline, has slightly different effects - it slows down heart contractions, dilates the arteries that feed the heart, and increases diastolic pressure.

The study of the functions of the adrenal glands

It is impossible to feel the adrenal glands during palpation examination. Ultrasonography allows you to visualize them and determine the dimensions.

Their function is studied by examining the level of hormones and their metabolites in the blood. So, in order to assess the glucocorticoid function of the adrenal glands, the level of 11-hydroxycorticosteroids is determined in the blood, and free cortisol is determined in the urine.

Functional tests allow you to evaluate the response of the adrenal glands to stimulation from the outside. The most commonly used test with dexamethasone, which helps to differentiate the tumor of the adrenal glands from hyperplasia associated with excessive synthesis of ACTH in the pituitary gland. A test with ACTH allows you to identify functional insufficiency of the adrenal glands, but due to potential danger for health, such tests should be carried out in a hospital.

The mineralocorticoid function of the adrenal glands and the formation of the hormone aldosterone can be assessed by the content of potassium and sodium ions in the blood serum. With adrenal insufficiency, the content of sodium is significantly reduced, and potassium is increased, with excessive formation of aldosterone, on the contrary, there will be less potassium, and more sodium.

X-ray methods for examining the adrenal glands - computer and magnetic resonance imaging, angiography. They allow you to identify tumors of the adrenal glands, to assess the size and structure of the glands.

Diseases and approaches to the treatment of the adrenal glands

All diseases of the adrenal glands can be divided into two large groups - one of them is manifested by excessive adrenal function, and the second, on the contrary, is reduced.

A decrease in the work of the glands occurs when the adrenal glands are removed, they are affected by tuberculosis, amyloidosis, sarcoidosis, with hemorrhage in the adrenal glands, or with a decrease in the formation of ACTH in the pituitary gland. Treatment of the adrenal glands in this case requires replacement therapy with those hormones, the lack of which has formed, as well as the elimination of the cause of hypofunction.

Excessive production of hormones occurs with hyperplasia from excessive stimulation of ACTH (for example, with a pituitary tumor) or with a tumor of the adrenal gland. Tumors from the cortical substance - corticosteromas - are often mixed, with them there is an excessive formation of all the hormones of the adrenal cortex. If the tumor originates from cells that produce androgens, it is called an androsteroma. Its manifestation will be virilny syndrome. If cells that form aldosterone have undergone tumor transformation, then aldosteroma is formed, and its manifestation will be pronounced disturbances in the exchange of water and salts.

In Itsenko-Cushing's disease, the sensitivity of the hypothalamus to the inhibitory effect of cortisol is impaired, as a result, the adrenal glands intensively produce it and hypertrophy. In such patients, the carbohydrate metabolism, reduced sexual function. characteristic appearance- fat deposits in the abdomen, torso and neck, red-violet stretch marks on the skin - stretch marks, moon-shaped face, excessive hair growth. Treatment for Itsenko-Cushing's syndrome consists of removal of the adrenal glands and lifelong hormone replacement therapy.

With a benign degeneration of the cells of the adrenal medulla, the course of the tumor is asymptomatic, and it often becomes an accidental finding during the study. Malignant hormonally active tumors are manifested by symptoms of hyperproduction of hormones, hormonally inactive tumors are accompanied by general intoxication and an increase in the abdomen.

Surgical treatment of the adrenal glands in case of a tumor lesion, with malignant tumors must be accompanied by chemotherapy. After removal of the adrenal glands, life is required replacement therapy hormones.

In children, there are congenital dysfunction of the adrenal cortex, Itsenko-Cushing's disease, hypoaldosteronism, chromaffinoma, Addison's disease. Quite often they have a hemorrhage in the adrenal glands, for example, with severe birth trauma, serious infections (meningococcal meningitis, etc.).

The adrenal glands are located at the level of the XI-XII thoracic vertebrae. The right adrenal gland, like the kidney, lies somewhat lower than the left. Its back surface is adjacent to the lumbar part of the diaphragm, its front surface is in contact with the visceral surface of the liver and duodenum, and the lower concave (renal) surface - with the upper end of the right kidney. The medial edge (margo medialis) of the right adrenal gland borders on the inferior vena cava. The left adrenal gland with its medial edge is in contact with the aorta, the anterior surface is adjacent to the tail of the pancreas and the cardial part of the stomach. The posterior surface of the left adrenal gland is in contact with the diaphragm, the lower surface is in contact with the upper end of the left kidney and its medial edge. Each adrenal gland (both right and left) lies in the thickness of the perirenal fat body. The anterior surfaces of the left and right adrenal glands are partially covered by the renal fascia and parietal peritoneum.

The mass of one adrenal gland in an adult is about 12-13 g. The length of the adrenal gland is 40-60 mm, height (width) - 20-30 mm, thickness (anteroposterior size) - 2-8 mm. The mass and dimensions of the right adrenal gland are somewhat smaller than those of the left.

Sometimes in the body there is an additional ectopic tissue of the adrenal cortex (in the kidneys, spleen, retroperitoneal region below the kidneys, along the aorta, in the pelvis, spermatic cord, broad ligament of the uterus). Perhaps the congenital absence of one of the adrenal glands. characteristic feature their cortical substance is its ability to regenerate.

The structure of the adrenal glands

The surface of the adrenal gland is slightly bumpy. On the anterior surface, especially of the left adrenal gland, a deep groove is visible - the gate (hilum), through which the central vein leaves the organ. Outside, the adrenal gland is covered with a fibrous capsule, tightly fused with the parenchyma and extending numerous connective tissue trabeculae deep into the organ. The fibrous capsule from the inside is adjacent to the cortical substance (bark; cortex), which has a rather complex histological structure and consists of three zones. Outside, closer to the capsule, is the glomerular zone (zona glomerulosa), behind it is the middle fascicular zone (zona fasciculate), on the border with the medulla is the inner reticular zone (zona reticularis). The morphological feature of the zones is the distribution of glandular cells, connective tissue and blood vessels, peculiar for each zone.

The cortical layer in an adult accounts for about 90% of the tissue of the adrenal gland. This layer consists of three zones: outer - glomerular, middle - bundle and inner (surrounding the medulla) - mesh. Located directly under the fibrous capsule, the glomerular zone occupies approximately 15% of the volume of the cortical layer; its cells contain a relatively small amount of cytoplasm and lipids, produce the hormone aldosterone. The fascicular zone accounts for 75% of the total cortical substance; its cells are rich in cholesterol and cholesterol esters, produce mainly cortisol (hydrocortisone). The cells of the zona reticularis also produce this substance; they are relatively poor in lipids and contain many granules. In addition to cortisol, the cells of this zone (like the beam zone) produce sex hormones - androgens and estrogens.

More than 50 different steroid compounds are produced in the adrenal cortex. It serves as the only source of glucocorticoids and mineralocorticoids in the body, the most important source of androgens in women, and plays a minor role in the production of estrogens and progestins. Glucocorticoids, named for their ability to regulate carbohydrate metabolism, are important for many vital functions and especially for the body's response to stress. They also take part in the regulation of growth and development processes. The main glucocorticoid in humans is cortisol, and excess or deficiency of this steroid is accompanied by life-threatening changes. Of the mineralocorticoids (named for their ability to regulate salt metabolism), the main one in humans is aldosterone. An excess of mineralocorticoids causes arterial hypertension and hypokalemia, and a deficiency causes hyperkalemia, which may be incompatible with life.

Glomerular zone formed by small, prismatic cells arranged in small groups - glomeruli. In these cells, the endoplasmic reticulum is well developed; lipid droplets about 0.5 μm in size are present in the cytoplasm. The glomeruli are surrounded by tortuous capillaries with fenestrated endothelium.

beam zone (most wide part adrenal cortex) consists of large light multifaceted cells. These cells form long strands (bundles) oriented perpendicular to the surface of the adrenal gland. In the cells of this zone, a non-granular endoplasmic reticulum is well developed, there are mitochondria, numerous lipid drops, ribosomes, particles of glycogen, cholesterol and ascorbic acid. Between the strands of endocrinocytes are blood capillaries with fenestrated endothelium.

mesh zone make up small polyhedral and cubic cells that form small cell clusters. The cells of the reticular zone are rich in elements of the non-granular endoplasmic reticulum and ribosomes.

The listed zones are functionally isolated. The cells of each zone produce hormones that differ from each other not only in chemical composition but also physiologically. The hormones of the adrenal cortex are collectively called corticosteroids and can be divided into three groups: mineralocorticoids - aldosterone secreted by cells of the glomerular cortex; glucocorticoids: hydrocortisone, corticosterone, 11-dehydro- and 11-deoxycorticosterone, formed in the bundle zone; sex hormones - androgens, similar in structure and function to the male sex hormone, estrogen and progesterone, produced by the cells of the reticular zone.

Aldosterone is involved in the regulation of electrolyte and water metabolism, changes the permeability of cell membranes for calcium and sodium, and stimulates the formation of collagen. Glucocorticoids affect protein metabolism, increase the content of glucose in the blood, glycogen - in the liver, skeletal muscles, myocardium. Glucocorticoids also accelerate filtration in the glomeruli of the kidney, reduce water reabsorption in the distal convoluted tubules of nephrons, inhibit the formation of the basic substance of connective tissue and the proliferation of fibroblasts.

In the center of the adrenal gland is the medulla, formed by large cells stained with chromium salts in a yellowish-brown color. There are two types of these cells: epinephrocytes make up the bulk of the cells and produce adrenaline, norepinephrocytes, scattered in the medulla in the form of small groups, produce norepinephrine.

Adrenaline breaks down glycogen, reduces its stores in the muscles and liver, increases the content of carbohydrates in the blood, being, as it were, an insulin antagonist, strengthens and speeds up the contraction of the heart muscle, narrows the lumen of the vessels, thereby increasing blood pressure. The effect of norepinephrine on the body is similar to the action of adrenaline, however, the effect of these hormones on some functions can be completely opposite. Norepinephrine, in particular, slows down the heart rate.

Development of the adrenal glands

The cortical and medulla of the adrenal gland are different in origin. The cortex differentiates from the mesoderm (from the coelomic epithelium) between the root of the dorsal mesentery of the primary gut and the urogenital fold. The tissue that develops from mesodermal cells and is located between the two primary kidneys is called interrenal. It gives rise to the adrenal cortex, from which additional adrenal glands (interrenal bodies, glandulae suprarenales accessoriae) are formed.

The adrenal medulla develops from embryonic nerve cells - sympathoblasts, which are evicted from the laying of the nodes of the sympathetic trunk and turn into chromaffin blasts, and the latter into chromaffin cells of the medulla. Chromaffinoblasts also serve as material for the formation of paraganglia, which, in the form of small clusters of chromaffin cells, are located near the abdominal aorta - the aortic paraganglion (paraganglion aorticum), as well as in the thickness of the nodes of the sympathetic trunk - sympathetic paraganglia (paraganglia sympathica).

The introduction of future cells of the medulla into the interrenal adrenal gland begins in an embryo 16 mm long. Simultaneously with the unification of the interrenal and adrenal parts, the differentiation of the zones of the cortical substance and the maturation of the medulla occur.

Vessels and nerves of the adrenal glands

Each adrenal gland receives 25-30 arteries. The largest of these are the superior adrenal arteries (from the inferior phrenic artery), the middle adrenal (from the abdominal aorta), and the inferior adrenal (from the renal artery) arteries. Some of the branches of these arteries supply blood only to the cortex, while others pierce the adrenal cortex and branch out in the medulla. From the sinusoidal blood capillaries, tributaries of the central vein are formed, which in the right adrenal gland flows into the inferior vena cava, in the left - into the left renal vein. Numerous small veins emerge from the adrenal glands (especially the left), flowing into the tributaries of the portal vein.

The lymphatic vessels of the adrenal glands empty into the lumbar The lymph nodes. The innervation of the adrenal glands involves the vagus nerves, as well as nerves originating from the celiac plexus, which contain preganglionic sympathetic fibers for the medulla.

Age features of the adrenal glands

In a 5-6-week-old fetus, a primitive adrenal cortex forms in the retroperitoneal mesenchyme. Soon it is surrounded by a thin layer of more compact cells. In a newborn, the adrenal cortex consists of two zones - fetal and definitive. The first produces mainly the precursors of androgens and estrogens, while the function of the second is probably the same as in an adult. The fetal zone accounts for the bulk of the gland of the fetus and newborn. By the 2nd week of postnatal life, its mass decreases by a third due to degeneration of the fetal zone. This process begins in the prenatal period. Completely fetal zone disappears by the end of the first year of life. The final formation of the three zones of the adrenal cortex is delayed until the age of 3 years. Then the adrenal glands continue to increase (especially before and during puberty) and by the end of puberty reach the size characteristic of an adult.

Where are the adrenal glands located in humans? Quite often, patients are interested in where these organs are located, can they be felt on their own, do they cause pain? The doctor can easily answer such questions, because it is extremely important to know the structure of your body and prevent diseases that may occur in one or another part of the body.

In this article, we will talk about the location and structure of the adrenal glands, what are their functions, and also learn about the pathologies of these organs.

The adrenal glands are located (glandulae suprarenales) in the retroperitoneal space, above the upper poles of the kidneys, at the level of 11-12 thoracic vertebrae. They have nothing to do with the kidneys, and got their name because of where the adrenal glands are located in humans. The adrenal glands are endocrine glands, the average weight of one gland is 11-13 g.

The structure of the adrenal glands is as follows: outside the gland is covered with a fibrous capsule, to which the cortical substance is adjacent, and in the center, inside the adrenal gland, there is a medulla. The cortex and medulla can be considered as separate endocrine glands producing hormones that have different regulatory mechanisms and functions.

The structure of the adrenal cortex is represented by the glomerular, fascicular and reticular zones, which produce various groups of hormones:

mineralocorticoids;
glucocorticoids;
sex hormones.

By chemical composition, they belong to steroids, and ascorbic acid and cholesterol are necessary for their synthesis.

Note! Where a person has the adrenal glands can be shown by the doctor during an ultrasound examination.

Adrenal functions

The adrenal glands play a very important role, without them the normal functioning of the body is simply impossible. They are involved in the production of hormones that provide various physiological effects. The synthesis and release of hormones by the adrenal cortex is regulated by the hypothalamic-pituitary system, through the secretion of ACTH.

The glucocorticoids produced include:

cortisone;
cortisol;
corticosterone.

Thanks to them, the metabolism of proteins, fats and carbohydrates is regulated, namely: the mobilization of fats from adipose tissue, the promotion of protein breakdown and the manifestation of an antagonistic effect on insulin. In addition, glucocorticosteroids have the ability to inhibit the development of inflammatory processes and stop the production of antibodies (this effect is favorable for the treatment allergic diseases). In addition, they are considered adaptive hormones, as they support muscle activity and brain performance, adapt the body to temperature extremes, oxygen starvation or emotional stress.

What else are the adrenal glands for?

They produce aldosterone, a mineralocorticoid hormone. Thanks to him, the regulation of water-electrolyte metabolism in the human body occurs. Against the background of their functioning, the reverse absorption of sodium and water in the distal tubules of the renal nephrons increases.

In addition, they facilitate the transport of potassium and hydrogen ions in the opposite direction. It is also worth noting the ability of aldosterone to regulate the level of blood pressure by increasing vascular tone or increasing the volume of fluids.

Sex hormones include:

androgens;
estrogens
progesterone.

In children, they contribute to the development of genital organs and secondary sexual characteristics. In addition, estrogens have a pronounced anti-sclerotic effect, and androgens favor an increase in the mass of organs and the body by stimulating protein synthesis.

The adrenal medulla produces epinephrine (80%) and norepinephrine (20%). The action of adrenaline affects:

frequency and force of contractions of the heart;
increase in minute volume of blood;
increased conduction of the heart muscle;
constriction of blood vessels (except in the brain, heart, and skeletal muscles);
relaxation of the bronchial muscles;
inhibition of motility, secretion and absorption in the gastrointestinal tract;
strengthening the trophism of skeletal muscles and increasing their performance;
pupil dilation;
conversion of glycogen to glucose;
increase in blood fatty acids;
metabolism of carbohydrates, fats and proteins.

In addition, adrenaline increases stimulation nervous system, increasing the level of activity and wakefulness, causing mental mobilization, anxiety, anxiety and tension. Thanks to this hormone, the body is resistant to shock and stress; during anxious or dangerous conditions, the body releases adrenaline into the bloodstream, while simultaneously activating the sympathetic nervous system. Thus, this mechanism is responsible for protective adaptive reactions.

Norepinephrine has several other effects, as it affects alpha-adrenergic receptors. It has a more pronounced vasoconstrictive effect, unlike adrenaline. Participates in the regulation of blood pressure and peripheral vascular resistance (for example, when the body position changes, the level of norepinephrine in the blood changes).

May cause an increase in cardiac output and an increase in perfusion pressure in the brain and coronary arteries. The amount of norepinephrine in the body can increase with injuries, blood loss, nervous tension, fear, or burns.

However, this hormone stimulates contractions of the heart less, has little effect on the smooth muscles of the bronchi and gastrointestinal tract. It does not have a pronounced effect on metabolism, it increases the oxygen demand of tissues and myocardium less than adrenaline.

Diseases of the adrenal glands

The clinical picture of diseases of the adrenal glands is very diverse. In order to make a correct diagnosis, the doctor must conduct a number of necessary studies. In most cases, diseases are associated with hypo- or hyperfunction of the glands.

The most common are:

- characterized by bilateral damage to the adrenal cortex and is accompanied by insufficient secretion of hormones. Chronic insufficiency is primary (with damage to the adrenal cortex) or secondary (a consequence of a pathological process in the pituitary region with a decrease in the production of corticotropin). In addition, for the development chronic insufficiency may affect vascular thrombosis, hemorrhage, adrenal tuberculosis, long-term corticosteroid therapy.
As a result, the process of hormone formation is disrupted, which affects all metabolic processes. Outwardly, hyperpigmentation of the skin and mucous membranes, adynamia, hypotension, myocardial atrophy occur, appetite and body weight decrease, immunity and adaptation to stressful situations decrease, muscle hypoplasia and atrophy are observed, which is accompanied by muscle pain.
- occurs as a result of increased production of ACTH, which affects the hyperfunction of the adrenal glands and an increase in their size. Occurs against the background of a pituitary adenoma or an infectious lesion of the central nervous system. The disease is accompanied by obesity, trophic skin changes, hirsutism, osteoporosis, secondary hypogonadism, arterial hypertension, myopathy, disorders of carbohydrate and electrolyte metabolism.
Pheochromocytoma- a tumor that is mainly localized in the adrenal medulla and consists of chromaffin cells. The tumor secretes an impressive amount of catecholamines, often refers to the syndrome of multiple endocrine disorders. The reasons for its appearance are unknown, but in 10% of cases there is a familial form of the disease.
The disease is manifested by arterial hypertension, increased excitability, headaches, fatigue. With pheochromocytoma, a hypertensive crisis can develop, with a frequency of 1 time per year to 15 times per day.
Hyperaldosteronism- a pathology in which there is an increased production of aldosterone. Occurs due to Conn's syndrome, a defect in the 18-hydroxylase enzyme, or develops against the background of pathologies of the kidneys, liver and cardiovascular system (liver cirrhosis, dysplasia and stenosis renal arteries, malignant arterial hypertension, nephrotic syndrome).
Accompanied by disturbances in the water and electrolyte balance, as a result, there is severe arterial hypertension, cardialgia, headaches, heart rhythm is disturbed, changes in the fundus occur. In addition, it is observed fast fatiguability, muscle weakness, convulsions, pseudo-paralysis. In severe cases, pseudodiabetes mellitus, myocardial dystrophy and kaliepenic nephropathy can be observed.
Nelson syndrome- manifested by chronic adrenal insufficiency, the presence of a pituitary tumor, hyperpigmentation of the mucous membranes and skin. It occurs as a complication during the treatment of Itsenko-Cushing's disease, after a total adrenalectomy. It is accompanied by weight loss, weakness, manifestations of hypercortisolism, ophthalmic and neurological disorders.
Adrenogenital syndrome- a group of inherited disorders of the production of corticosteroids of an autosomal recessive nature. It occurs due to disorders in various genes. The disease is accompanied by adrenal insufficiency and an excess of androgens (in girls - pseudohermaphroditism, in boys - hyperpigmentation of the scrotum and an increase in the size of the penis).

The instructions for diagnosing these diseases are rather complicated and involve various laboratory tests, CT or MRI. The price of research, to identify pathological changes on the part of the adrenal glands can be quite high, but it is much more important to achieve a normal state of health.

From the photos and videos in this article, we analyzed the structure and location of the adrenal glands, learned about their functions and diseases that affect these organs.

Frequently asked questions to the doctor

unusual shape

Hello. I recently underwent an ultrasound, where the specialist told me in detail where the adrenal gland is located and why they are needed, but I was alerted that they are of different shapes. This is fine?

Good afternoon. This phenomenon is absolutely normal, you should not worry. In each person, the right adrenal gland has a triangular shape, and the left one is in the form of a crescent. So don't worry, it's not scary.

The location of the adrenal glands is very clearly indicated by their name. These paired glands sit at the top of each of our kidneys and are like little caps that cover the top of the kidneys. The adrenal glands are very modest in size, but their role in our body is difficult to overestimate. They help regulate metabolism and are responsible for our behavior in any unusual or stressful situation. What are these organs made of and how do they work?

What are the adrenal glands and what are they responsible for?

Although the kidneys and adrenal glands are located very close to each other and are tightly soldered by many vessels, they belong to a completely different systems organism. The kidneys are the urinary system. The adrenal glands are the most important part of the endocrine system, along with the pancreas, thyroid glands etc.

The size of the adrenal glands is measured using a special technique developed by a group of scientists led by Genesse Montagne. This technique includes three parameters: the height of the endocrine glands, width and thickness.

For each person, these parameters can vary significantly:

the height of the glands is from 20 to 35 mm,
width - 20-25 mm (sometimes up to 30 mm);
thickness - no more than 10 mm.

And each of these tiny organs weighs up to 10-12 grams!

What are the adrenal glands responsible for? The work of the endocrine system is aimed at regulating all organs and systems of our body with the help of unique substances - hormones. They are produced by the adrenal glands: both organs produce and release into the blood more than 50 hormones, each of which has its own function.

The structure of the adrenal glands

Each endocrine gland consists of the body and legs of the adrenal gland - lateral and medial. The length of such legs differs in the left and right gland: the medial pedicle is usually longer in the right adrenal gland, the lateral one in the left.

The adrenal glands differ in shape. The right organ in front looks like a small flattened triangle with smoothed corners, the top of the second gland is almost flat, it resembles a crescent. They are also located slightly asymmetrically - the right adrenal gland, together with the kidney, lies slightly lower than the left.

However, such external features are the only thing that distinguishes organs. The functions and structure of both endocrine glands are absolutely identical.

The body of the adrenal gland is covered from above with a dense fibrous capsule., and inside consists of two main layers. Layers of the adrenal glands - This is the cortical layer and the medulla. The cortical layer is the main part of the organ (more than 90%), the inner medulla is only 10% of the volume of the gland.

The adrenal cortex includes three zones:

Glomerular zone. It is made up of small cells arranged in glomeruli. It accounts for approximately 15% of the total volume of the cortex;
Beam zone. This is the largest zone of the adrenal glands - about 75% of the entire cortex. Its structure is long bundles of large polyhedral cells.
Mesh zone. This thin layer consists of small cells of various shapes - cubes and polyhedra, forming a grid.

Adrenal hormones

All the work of the adrenal glands and their role in the body consists of the role of each hormone that is formed in the cortical or medulla.

What are the main hormones secreted by the tireless adrenal glands?

The product of the activity of the glomerular zone of the adrenal glands is hormones-mineralcorticoids. These include aldosterone, corticosterone, and deoxycorticosterone. These substances are responsible for the regulation of water-salt metabolism, blood pressure, endurance and strength.
The bundle zone produces glucocorticoids, the main ones being cortisol and cortisone. They are responsible for metabolism, help the body maintain energy balance, enhance our sensitivity, etc.
Unique ones are formed in the mesh zone. They are largely responsible for our puberty.
The adrenal medulla produces only 2 main hormones that provide the body's response to danger. These are norepinephrine (“rage hormone”) and adrenaline (“stress hormone”).

How do the adrenal glands develop?

The development of the adrenal glands in humans begins at the very beginning of embryonic development. The future little man is only 5-6 weeks old, and he already has the first primitive adrenal cortex, which over time becomes overgrown with new cells.

When a baby is born, the cortical layer of the adrenal glands includes only two zones - the fetal one, which atrophies by the end of the first year of life, and the definitive zone. The final formation of the adrenal glands ends only by 3-5 years of age, and then the active growth of these endocrine glands begins. It stops at puberty.

The mass of the adrenal glands changes quite strongly over the course of life. The process proceeds according to a rather unusual scheme: in a newborn baby, the weight of these organs almost coincides with the norm for an adult - 8-9 grams. But after 10-12 months, the glands are actively rebuilt and reduced to 3-4 grams. And by the age of 5, they are fully restored and continue to grow. In adulthood (after 20 years), the human adrenal glands hardly change, only in women during pregnancy they can increase by about 2 grams. After 70 years, the glands begin to slowly decrease.

Despite their small size, the adrenal glands are a very important part of our endocrine system. , are responsible for all aspects of our life - from puberty to the ability to quickly mobilize and react in any stressful situation.