Anatomy of the Adrenals - Addisons Disease and Other

supra-renal, plexus, renal and arteries

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h e blood-vessels are 111111101'011S and imbedded in the trabeculie. A rich plexus of capillaries invests the cortical portion. The medulla is furnished with a very rich vascular supply of capillaries. The supra-renal arteries arise on each side of the aorta opposite to the superior mesenteric artery. They pass to the under surface of the organs, anastomosing with capsular branches from the phrenic and renal arteries. In the hdus these arteries are as large as the renal arteries. The right supra-renal vein opens into the versa cava infe rior, and the left into the left phrenic or left renal vein.

Lymphatics.—Lymph-spaces and sinuses exist throughout the organ, but are best seen between the cells of the zona fasciculata. They occupy the intercellular spaces and lacunae. The lymphatic vessels lie in the capsule and in the connective tissue around the cen tral veins. They are provided with valves, and pass into the lumbar lymph glands.

The nerves to the supra-renal bodies are derived from the renal and solar plexuses, and thus have sympathetic elements in them com ing from distant parts, with necessarily dependent wide radial associ ations and relations. The splanchnic nerves come into relation with the nerve-supply through the solar or epigastric plexus and its semi lunar ganglia. The right pneumogastric nerve also terminates in the

solar plexus.

The supra-renal plexus is also joined by the phrenic nerves, a gan glion occurring at their junction. The branches of this plexus are remarkably large in relation to the size of the bodies they supply.' From the position of these bodies, they long remain warm in the cadaver, full of blood which gravitates toward them, and so are more than many other parts prone to decompose early, and to lose the as pect which is natural to them during life. In fat subjects they are not always easy to find, and are often torn or cut in hasty manipula tion in a necropsy.

Very slight pressure will, under these conditions, cause a rupture to occur between the medullary and cortical portions, the latter being of firmer consistence than the former, and so a cavity is not seldom found in their interior which may wrongly be assumed to have been present during life.

In cases of congenital absence of one kidney, it is usual to find a supra-renal body in its proper situation. This fact plainly indicates that there is no embryological connection between the kidney and the adrenal body, and that they are thus physiologically distinct.

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