THE SUPRARENAL GLANDS 



1325 



look ventro-laterally. It is marked by a distinct transverse, oblique, or nearly 

 vertical fissure, the hilus suprarenalis. At this point a small artery enters and the 

 principal suprarenal vein takes exit from the gland. These surfaces are in 

 relation with different organs on the right and left sides. 



The anterior surface of the right gland is in the greatest part of its extent in contact with the 

 posterior surface of the hver, upon which it produces the suprarenal irnpression. The medial 

 edge of this surface is overlapped, cephalically by the inferior vena cava and caudally by the 

 duodenum. The gland is situated between the two layers of the coronary ligament, in most 

 cases, in direct contact with the liver to which it is bound by loose connective tissue; but, at 

 times, the peritoneum which covers the ventral surface of the kidney extends for a greater or less 

 distance between the suprarenal and the liver. 



The anterior surface of the left gland, in some cases, may be in contact in its cephalic part 

 with the left lobe of the liver and also, at times, with the spleen. The middle and major part 

 lies against the fundus and cardiac end of the stomach, while caudally the suprarenal is often 



Fig. 1080. — Ventral View of the Suprarenal Glands, in Situ. X J. (From Toldt's 



Atlas.) 



Hepatic veins 



Diaphragm, 

 central tendon 



Colic art 



Superior 

 mesen- 

 teric art. 



Diaphragm, pars lumbalis 



Left suprarenal 



Renal 

 vessels 



Cisterna chyli 



Internal sper 

 ma tic vessels 



Quadratus 

 lumborum 



crossed by the tail of the pancreas and the splenic artery and vein. The whole or a large part of 

 the anterior surface of the left suprarenal is covered by the parietal peritoneum of the omental 

 bursa. 



The posterior surface [facies posterior] of both the suprarenals is distinctly 

 smaller than the anterior surface. It is flat or convex and looks dorso-medially. 



It is in relation with the lumbar part of the diaphragm, to which it is bound by connective 

 tissue, but from which it is separated by an extension of the renal adipose capsule. 



The base [basis gl. suprarenalis] is a narrow elongated surface distinctly 

 hollowed out, which lies in contact with the superior extremity of the kidney or its 

 medial margin, cephalic to the hilus. 



This surface looks dorsally, laterally, and somewhat caudally with the result that it extends 

 farther on the anterior surface than on the posterior surface of the kidney. 



The medial border [margo medialis] is sharp, thin, and irregularly convex. It 

 extends more or less vertically to meet the superior border. 



On the right it lies dorsal to the inferior vena cava cephalically and to the duodenum caudally 

 and is close to, if not in contact with, the sympathetic coeliac ganglion. On the left the medial 

 border lies dorsal to the stomach and caudally may be crossed by the pancreas and splenic 

 vessels. It is in close proximity to the aorta and the coeliac sympathetic ganglion. 



The superior border [margo superior] is sharp and thin and differs somewhat 

 on the two sides. 



( 



