12. =Adrenals.= Weight 4-7.5 grms. measurements are 5-6 cm. long,
2.5-3.5 cm. broad, 0.5-1 cm. thick. Normally the consistence is firm;
it is increased in amyloid degeneration, tuberculosis, syphilis,
fibroid induration and atrophy; diminished in hæmorrhage, soft
caseating tubercles, degenerating tumors. Postmortem autolysis
of the medulla takes place very quickly, the cortical portion
remaining as a hollow capsule. On section note the relations of the
grayish-white cortex (more yellow and opaque in adults from the
amount of fat contained in the cells), the intermediate brown zone
and the central grayish, translucent portion of the medulla. The
most important pathologic conditions are tuberculosis, syphilis,
atrophy, compensatory hypertrophy, hæmorrhage, infarction, thrombosis
of adrenal vessels, secondary tumors (melanotic sarcoma, carcinoma),
primary neoplasms (hypernephroma, accessory adrenals typical and
atypical, lipoma, glioma, neuroma, sarcoma), parasites (echinococcus).
13. =Kidneys.= Right kidney weighs 110-145 grms., and measures
10-12 cm. long, 4.5-5.0 cm. broad, and 3-4.5 cm. thick. Left kidney
weighs 150-180 grms. and measures 12 cm. long, 5-6 cm. broad, 3-4.5
cm. thick. The left kidney is usually larger and heavier than the
right. Note position and movability of kidneys, thickness and color
of fatty capsule (increased in lipomatosis, atrophy of kidney),
purulent infiltrations and fibroid thickenings of the perirenal fat.
Normally the fibrous capsule is thin and translucent, easily stripped
off, the inner layer remaining attached around the blood-vessels
passing from capsule into cortex. The capsule is adherent in chronic
inflammations and over healed infarcts and localized inflammatory
processes, tubercles, tumor-nodules, etc. Note alterations in
_shape_ and _size_ (“horse-shoe kidney,” “hog-back,” round, fœtal
lobulations, fissures; enlarged in acute parenchymatous nephritis,
pyelonephritis, hydronephrosis, chronic passive congestion, etc.;
diminished in atrophy, chronic interstitial nephritis, etc.).
_Character of cortical surface_ (normally smooth, grayish-brown in
color; a fine or coarse, regular or irregular granulation of the
surface occurs in chronic nephritis, the elevations corresponding to
the preserved portions of the parenchyma, the depressed portions to
the areas of connective-tissue increase; localized depressions or
fissures may be caused by old or recent scars of infarcts, abscesses,
rupture, etc. Distinguish fœtal furrows from pathologic depressions.
Flat, puckered or radiating scars point to syphilis. Elevations of
the surface may be due to fresh infarcts, tubercles, abscesses,
neoplasms, etc. Accessory adrenal tissue (resembles adipose tissue)
and small papillary adenomata are very common on the cortical
surface. Retention- and degeneration-cysts are also very common,
particularly in the kidneys of adults). In atrophic kidneys the
glomeruli can be seen through the cortical surface. Note condition
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