5. Endo/Pulm/Gastro Flashcards
Thyroid Gland (the largest endocrine gland, produces Thyroid Hormone).
What are its parts?
1. Right lobe of thyroid gland
2. Left lobe of thyroid gland
3. Isthmus of thyroid gland
What are the parathyroid glands?
Four pieces of glandular tissue on the posterior surface of the thyroid gland
Names of 4 parathyroid glands
- Right Superior Parathyroid Gland
- Left Superior Parathyroid Gland
- Right Inferior Parathyroid Gland
- Left Inferior Parathyroid Gland
Which cervical triangle contains the thyroid and parathyroid glands?
Muscular triangle
CN: _______________ can be seen anywhere along the embryonic Thyroglossal Duct (from tongue -> thyroid).
Aberrant thyroid glandular tissue.
Can form a lump. If it is too big, it can interfere with hyoid and affect swallowing/speaking.
Is thyroid gland near thyroid cartilage?
no. it is more inferior.
surrounds pharynx
CN: Thyroglossal Duct Cysts
- Cyst that forms along the thyroglossal duct as the thyroid gland -> to the lower part the Neck.
- Cysts can damage hyoid bone and swallowing and may need to be surgically removed.
What is a accessory thyroid gland?
Remnants of thyroglassal duct that can appear anywhere along embryonic course of development thyroglossal duct.
CN: Pyramidal Lobe of the thyroid gland
Pyramidal lobe of thyroid gland is remnant of thyroglossal duct that formed an accessory thyroid gland.
Branches up from the isthmus of the thyroid gland. It can go all the way up to the hyoid bone and connected by band of CT.
Approximately ____ of Thyroid Glands possess a Pyramidal Lobe varying in size and location.
Can it exist if isthmus of thyroid gland is not present?
50%.
Yes
CN: Thyroid ima artery
What is it?
Why is it clinically important?
- 10% of people, a small, unpaired thyroid ima artery, branching from the brachiocephalic trunk. This small ima artery goes to the anterior surface of the trachea -> isthmus of the thyroid gland, sending branches to both structures.
- CN important bc it must be considered before a tracheotomy or cricothyrotomy
Thyroid ima artery can also branch from what?
- arch of the aorta
- right common carotid A.
- subclavian A.
- internal thoracic As.
Exophthalmic Goiter is produced by _________
and can result in _______________________.
too much TH
eyeballs
CN: Thyroidectomy refers to removal of the Thyroid Gland or an associated tumor or as a potential treatment for Hyperthyroidism. This procedure can be difficult why?
- Rich blood supply
- Presence of laryngeal nerves
- Parathyroid glands, which are typically left in place.
Goiter causes a swelling in the neck that may compress the _________________.
When the gland enlarges, it may do so in what directions?
- trachea, ESO, and recurrent laryngeal nerves
- anteriorly, posteriorly, inferiorly, or laterally. It cannot move superiorly because of the superior attachments of the overlying sternothyroid and sternohyoid muscles.
How to conduct a total thyroidectomy.
- Make a cut 2 fings below laryngeal prominence
- Break pretracheal fascia; DO NOT cut inferior thyroid a.
- Refect sternohyoid and sternothyroid ms.
- Remove thyroid and leave parathyroid glands.
- Cauterize as. or ns.
- Suture
How can we take out thyroid glands w/o leaving a visible scar?
Transoral thyroidectomy: remove from space between teeth and lip.
Risk of injury to what is present during neck surgery?
Recurrent laryngeal nerves: run between thyroid gland and trachea -> larynx
- R recurrent laryngeal nerve runs posteior, anterior or between inferior thyroid artery and its branches. Thus, the inferior thyroid artery is ligated lateral to the thyroid gland, where it is not close to the nerve.
- Danger of damaging L recurrent laryngeal nerve during surgery is not as great
________ is the usual sign of unilateral recurrent nerve injury; however, temporary aphonia or disturbance of phonation (voice production) and laryngeal spasm may occur.
hoarseness
What is your pharynx and where is it located?
- Pharynx (throat) is a space where we send food and liquid and air
- Goes from base of skull -> inferior border of the Cricoid Cartilage
- Located immediately behind the nasal cavity, behind the mouth and above the ESO and larynx.