Adrenal Cortex

cortex glandulae suprarenalis

The adrenal cortex is the yellowish outer layer of each adrenal gland and makes up most of its bulk. It is arranged in three zones, from outside in: glomerulosa, fasciculata and reticularis, which make salt-retaining, sugar-regulating and sex steroid hormones respectively ('salt, sugar, sex').

Anatomical Data

Structure & Secretions

Location	Outer layer of each adrenal gland, surrounding the medulla, beneath a fibrous capsule
Secretes	Aldosterone Cortisol Dehydroepiandrosterone (DHEA) and other adrenal androgens
Blood Supply	Superior, middle and inferior suprarenal arteries via a subcapsular plexus
Venous drainage	Sinusoids draining through the medulla to the central suprarenal vein

Biomechanics

Function & Actions

Produces steroid hormones from cholesterol: mineralocorticoids for sodium and blood pressure control, glucocorticoids for the stress response and metabolism, and weak androgens.

Clinical Relevance

Clinical Notes

Cortisol production is controlled by ACTH from the pituitary, so long-term steroid medication suppresses the cortex and must be tapered rather than stopped suddenly. Congenital adrenal hyperplasia, most often from 21-hydroxylase deficiency, blocks cortisol and aldosterone production and diverts precursors into androgens. Adrenocortical carcinoma is rare but aggressive.

Pathology

Common Injuries & Conditions

Congenital Adrenal Hyperplasia

Inherited enzyme defects in steroid synthesis causing cortisol deficiency, androgen excess and, in salt-wasting forms, dangerous salt loss in infancy.

Adrenal Suppression from Steroid Therapy

Atrophy of the cortex after prolonged glucocorticoid treatment, risking adrenal crisis if the medication is stopped abruptly.

Adrenocortical Carcinoma

A rare malignant cortical tumour that often secretes excess hormones and is frequently large at diagnosis.

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