Adrenocortical insufficiency is defined as primary (Addison's disease) or secondary to hypopituitarism or suppression following steroid therapy. The cortex and medulla have distinct embryological origins, histological appearances, and physiological and biochemical functions. Each adrenal gland consists of a yellow outer cortex and an inner, pearly grey medulla, surrounded by a connective tissue capsule. In healthy adults, each adrenal weighs approximately 3–4 g although at autopsy, the glands are heavier-approximately 6 g-because of the effects of increased adrenocorticotrophic hormone (ACTH) resulting from terminal stress. The adrenals or suprarenals are paired, triangular glands positioned just above the upper poles of the kidneys. This chapter discusses the disorders of the adrenal cortex.
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