Suprarenal glands, ovary and testis Dr Laxman Khanal MS- Human Anatomy Date-27-04-2012
Pretest1. 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 ??
Pretest5 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 ?
Pretest10 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 weightCortex(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 glandsAdrenal 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 glandMasculinization( virilism)- sex hormoneFeminization- sex hormonePheochromocytomaIncreased adrenalineAssociated with MEN2(+hyperparathyroid and medullary ca of thyroid)
OVARY• Female gonads- produce female gamets and sex hormones(oestrogen and progesterone).• 3cm in diameter• LOCATION Ovarian fossa on lateral pelvic wallAnt- obliterated umbilical arteryPost- ureter and internal iliac artery Nulliparous- long axis vertical Multiparous- 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 relation Prolapse of ovary- laxness of braod ligament and mesovarium( into the pouch of Douglas). Follicular cyst- in unruptured graafian follicles. Luteal cyst- around C.luteum Commonest 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.
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 falseHydrocoeleVaricocoele – common in left side