The arterial blood supply to the adrenal glands is extensive and provided by branches arising from three main sources:

Superior suprarenal arteries - branches of the right and left inferior phrenic arteries that ascend from the abdominal aorta to the diaphragm;
Middle suprarenal artery - usually arises directly from the abdominal aorta;
Inferior suprarenal arteries - arise from the renal arteries and ascend to the suprarenal glands.

The venous drainage from each adrenal gland is usually provided by a single vein leaving the hilum. On the right side, the right suprarenal vein is short and almost immediately enters the inferior vena cava (IVC). On the left side, the left suprarenal vein passes downward and enters the left renal vein, which further drains into the IVC.

The adrenal glands are mainly innervated by preganglionic sympathetic fibers arising from the spinal levels T5 to T8 that pass through the sympathetic trunk and then the prevertebral plexus without synapsing. These fibers directly innervate the cells of the adrenal medulla.

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Blood supply and innervation of adrenal glands