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Endocrine System > Anatomy of Thyroid & Parathyroid Glands > Flashcards

Anatomy of Thyroid & Parathyroid Glands Flashcards

1
Q

What is the proliferation process of all glands?

A

All glands begin with the proliferation of epithelial cells and their downward growth into the underlying connective tissue

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2
Q

What is the role of the basal laminate in regards to the proliferating cells of the glands?

A

The basal laminate provides a supporting structure for the proliferating cells

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3
Q

What is the pathway of the exocrine glands?

A
  1. The proliferated cells remain connected to the epithelial surface.
  2. A duct forms, through which secretions are transported to the epithelial surface.
  3. The secretory portion (acinus) develops at the end of the duct.
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4
Q

What is the pathway of the endocrine glands?

A
  1. The connection to the epithelial surface disappears.
  2. The cells arrange themselves into either:
    –> Cords of cells
    –> Follicles
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5
Q

What are cords of cells in the endocrine gland?

A

Associated with capillaries to release hormones directly into the bloodstream.

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6
Q

What are follicles in the endocrine glands?

A

Hollow spherical structures that store secretory products temporarily before releasing them into the surrounding capillaries

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7
Q

What are different examples of endocrine glands? What do they secrete? (8)

A
  1. Pituitary –> Growth hormone & Thyroid stimulating hormone (TSH)
  2. Thyroid
  3. Pancreas –> Insulin
  4. Placenta –> Progesterone and Estrogen
  5. Testis –> Testosterone, estradiol, androstenedione
  6. Ovary –> Progesterone, testosterone, estradiol, androstenedione
  7. Adrenal Glands –> Cortex –> Cortisol, aldosterone, dehydroepiandrosterone, androstenedione
    –> Medulla –> Epinephrine, norepinephrine
  8. Pineal –> Melatonin
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8
Q

What are the layers of the deep cervical fascia?

A
  1. Investing Layer
  2. Pretracheal Fascia
  3. Prevertebral Fascia
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9
Q

What do the layers of the deep cervical fascia form?

A

The carotid sheath

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10
Q

What is the investing layer?

A

The outermost layer of the deep cervical fascia surrounds the entire neck, surrounding superficial muscles like the sternocleidomastoid (SCM) and trapezius

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11
Q

Which glands does the investing layer enclose?

A

Encloses the submandibular gland and forms the capsule of the parotid gland

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12
Q

What are the superior attachments of the investing layer of the deep cervical fascia?

A

Superiorly –> External occipital protuberance and the superior nucha line of the skull

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13
Q

What are the inferior attachments of the investing layer of the deep cervical fascia?

A

Spine and acromion of the scapula, the clavicle, and the manubrium of the sternum

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14
Q

What are the posterior attachments of the investing layer of the deep cervical fascia?

A

Nuchal ligament of the vertebral column

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15
Q

What are the anterior attachments of the investing layer of the deep cervical fascia?

A

Hyoid bone

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16
Q

What is Ludwig’s angina?

A

Acute infection of the submandibular fascial space and is commonly seen secondary to dental infection

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17
Q

What are the different parts of the pretracheal fascia?

A

Muscular part and Visceral part

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18
Q

What is the muscular part like?

A

It is a round muscle which encloses the infrahyoid muscles

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19
Q

What are the infrahyoid muscles?

A

3 to 4 muscles below the hyoid

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20
Q

What is the visceral part of the pretracheal fascia like?

A

It encloses the thyroid gland, trachea, and esophagus

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21
Q

How many layers does the pericardium have?

A

3

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22
Q

Why does the thyroid gland move up and down when swallowing? Is it normal?

A

It is normal for the thyroid to move up and down when swallowing, it is because of its attachment to the pre-tracheal fascia

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23
Q

What is the superior attachment of the prevertebral layer?

A

Base of the skull

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24
Q

What is the inferior attachment of the prevertebral layer?

A

Endothoracic fascia of the rib cage

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25
Q

What is the posterior attachment of the prevertebral layer?

A

Nuchal ligament of the vertbral column

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26
Q

What is the anterior attachment of the prevertebral layer?

A

Transverse processes and vertebral bodies of the vertebral column

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27
Q

What is the retropharyngeal space?

A

The space between the prevertebral fascia and the buccopharyngeal fascia, it includes lymphnodes

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28
Q

What happens if the lymph nodes of the retropharyngeal space get enlarged?

A

They can get enlarged due to infection or malignancy –> which will cause dysphagia

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29
Q

Which carotid artery is within the carotid sheath?

A

Internal carotid artery

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30
Q

What are the contents of the carotid sheath?

A
  1. Common carotid artery (and internal carotid artery above the bifurcation).
  2. Internal jugular vein.
  3. Vagus nerve (CN X).
  4. Deep cervical lymph nodes.
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31
Q

Where does the external carotid artery branch off to?

A

Head and neck

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32
Q

What is the location of the thyroid gland?

A

Root of the neck, anterior to the larynx, ventral to C5 to T1

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33
Q

What is the function of the thyroid gland?

A

It is an endocrine gland which secretes:
1. Thyroxine (T4)
2. Triiodothyronine (T3)
3. Calcitonin

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34
Q

What is the function of T3 and T4?

A

Metabolic functions of the body

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35
Q

What is the function of Calcitonin?

A

Calcium metabolism

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36
Q

What is the structure of the thyroid gland?

A

It is a butterfly-shaped (cone-shaped) organ that has two lobes and the isthmus which connects the lobes

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37
Q

Where is the apex of the thyroid gland?

A

At the oblique line of the thyroid cartilage

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38
Q

Where is the base of the thyroid gland?

A

At the 5th or 6th tracheal ring

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39
Q

What are the anterolateral relations to the thyroid gland?

A

Superior belly of omohyoid
Anterior border of sternoclidomastoid
Sternohyoid and sternothyroid muscles

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40
Q

What are the medial relations to the thyroid gland?

A

Thyroid and cricoid cartilages
Upper 6 tracheal rings

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41
Q

What are the posterior relations to the thyroid gland?

A

Carotid sheath & acquainted structures
Inferior thyroid artery
Parathyroid glands
Recurrent laryngeal nerve

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42
Q

What is the recurrent laryngeal nerve a branch of?

A

The vagus nerve

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43
Q

Where are the left and right recurrent laryngeal nerves derived from?

A

Left –> arch of aorta
Right –> subclavian artery

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44
Q

In patients with goiter, how does the relation between thyroid and trachea affect patients?

A

The close relationship between the thyroid lobes and the trachea commonly results in pressure on the trachea

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45
Q

What is a retrosternal goiter, when does it happen and what can it lead to?

A

Retrosternal goiter occurs when the thyroid is abnormally located behind the sternum; it can compress the trachea and cause dangerous dyspnea and severe venous compression

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45
Q

Where is the isthmus of the thyroid located?

A

Passes anterior to the 2nd to 4th tracheal rings, encompasses a cranially extending thyroid tissue usually left to midline

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46
Q

What is the Pyramidal lobe?

A

It is only found in 50% of individuals; the distal end of the thyroglossal gland

47
Q

In case that the pyramidal lobe is present, what structure connects it to the hyoid bone?

A

A fibromuscular band connects the pyramidal lobe to the hyoid bone; the muscular part is the levator glandulae thyroideae

48
Q

What is the levator glandulae thyroideae?

A

Embryological remnants of the thyroglossal duct, which in most cases completely disappears

It elevates the thyroid gland

49
Q

What are the anterior relations of the isthmus? (4)

A
  1. Sternothyroids
  2. Sternohyoids
  3. Anterior jugular veins
  4. Fascia and skin
50
Q

What are the posterior relations of the isthmus? (3)

A
  1. 2nd ring of trachea
  2. 3rd ring of trachea
  3. 4th ring of trachea
51
Q

What is the importance of knowing the location of the anterior jugular vein?

A

In cases where the trachea has to be reached through tracheostomy, the location of ther vein needs to anterior jugulabe known so that it is not hurt

51
Q

What is the fascial covering of the thyroid gland?

A

Thin fibrous capsule –> Capsula glandulae thyroidea

52
Q

What are the relations of the fascial covering of the thyroid gland?

A

Anterior –> Pretracheal layer
Posterolateral –> Carotid sheath

52
Q

What does the fascial covering attach the gland to posteriorly?

A

Cricoid cartilage and upper tracheal rings

53
Q

What are the arteries of the thyroid gland?

A
  1. External carotid artery –> which gives rise to superior thyroid artery
  2. Throcervical trunk –> which gives rise to inferior thyroid artery
  3. Arch of the aorta or Brachiocephalic –> which give rise to thyroidea ima
54
Q

In what % of the population is the thyroidea ima artery present?

A

10%

55
Q

Which nerve is related to the superior thyroid artery?

A

External laryngeal nerve

56
Q

Which nerve is related to the inferior thyroid artery?

A

Recurent laryngeal nerve

57
Q

Which nerve runs with the thyroidea ima artery?

A

No nerve runs along with it, but clinical relevance to tracheostomy along with anterior jugular vein

58
Q

What are the veins of the thyroid?

A
  1. Superior thyroid vein
  2. Middle thyroid vein
  3. Inferior thyroid vein
59
Q

Where do the superior and middle thyroid veins drain into?

A

Internal jugular vein

60
Q

Where does the inferior thyroid vein drain into?

A

Left brachiocephalic vein

61
Q

What is the lymph drainage of the thyroid gland (superiorly)?

A

Prelaryngeal lymph nodes

62
Q

What is the lymph drainage of the thyroid gland (inferiorly)?

A

Pretracheal lymph nodes

63
Q

What is the lymph drainage of the thyroid gland (medially)?

A

Paratracheal lymph nodes

64
Q

What is the lymph drainage of the thyroid gland (laterally)?

A

Inferior deep cervical lymph nodes

65
Q

Where do all the thyroid lymph nodes drain into?

A

Deep cervical lymph nodes

66
Q

What are the innervations of the thyroid gland?

A

Sympathetic and Parasympathetic

67
Q

What are the nerves of the sympathetic nervous system that are associated with the thyroid gland?

A

Superior cervical ganglia
Middle cervical ganglia
Inferior cervical ganglia

68
Q

How do the sympathetic ganglia reach the thyroid?

A

Through superior and inferior thyroid periarterial plexuses

69
Q

What are the nerves associated with the parasympathetic nervous system of the thyroid gland?

A

Vagus nerve (X)
–> Superior laryngeal nerve
–> Recurrent laryngeal nerve

70
Q

What is the autonomic innevration of the thyroid gland like?

A

Mainly vasomotor, endocrine secretion is hormonally regulated by the pituitary gland

71
Q

What are the microscopic features of the thyroid gland?

A

Follicles
Follicular cells
Parafollicular cells

72
Q

What are follicles?

A

Spherical cyst-like structures

73
Q

What do the follicles of the thyroid gland contain?

A

Colloid material (T3 and T4 bound to thyroglobulin)

74
Q

What do follicles become?

A

Follicular (principal) cells

75
Q

What are follicular cells?

A

Single layer of epithelial cells which secrete T3 and T4

76
Q

What is the secretion of T3 and T4 like?

A

Extracellular, and can be stored for a long time, in case there is no stimulus for the hormones to be released, they can be stored up to 3 months

77
Q

What is the epithelium of follicular cells like?

A

When hyperactive: columnar
When at rest: squamous

78
Q

What are parafollicular (C) cells?

A

They are larger and less stained than follicular cells and they secrete calcitonin

79
Q

Where are parafollicular cells found?

A

In the middle of the thyroid gland

80
Q

What is the embryonic structure of Parafollicular cells?

A

Pharyngeal endoderm, 4th or 5th pharyngeal pouch

81
Q

What is the development of the thyroid gland like?

A

From median endodermal thickening in the floor of the pharynx, between the first and second pharyngeal arches

82
Q

What does the descent of the thyroid gland begin with?

A

With the growth of the embryo and root of the tongue

83
Q

What is the descent of the thyroid gland like?

A

Descends and enlarges ventral to the hyoid bone

84
Q

What is the thyroid like in the early stages of development?

A

It is hollow in the early stages of development

85
Q

What does the thyroid become like later on in its development process?

A

Becomes a solid mass that divides into two lobes connected by an isthmus

86
Q

What connects the thyroid to the tongue?

A

The thyroglossal duct

87
Q

When does the thyroglossal duct attain its final shape and destination?

A

Week 7

88
Q

What happens to the thyroglossal duct?

A

It degenerates and disappears

89
Q

What does the proximal opening of the thyroglossal duct persist as?

A

Foramen cecum

90
Q

What does the distal end of the thyroglossal duct persist as?

A

Pyramidal lobe

91
Q

What is a thyroglossal cyst?

A

A remnant of thyroglossal duct that persists and forms a cyst in the anterior part of the neck

92
Q

What happens if there is an internal opening of the thyroglossal cyst?

A

Thyroglossal fistula

93
Q

What are the presentations of thyroglossal cyst?

A

Painless, enlarged movable median mass
Asymptomatic unless it becomes infected

94
Q

Where are thyroglossal cysts usually located?

A

In the midline of the neck, close to the hyoid bone

95
Q

What is a thyroglossal sinus?

A

After infection of the thyroglossal cyst, perforation of the skin occurs in the neck anteriorly, opens cyst to the outside

96
Q

What are the ectopic thyroid tissues?

A

In the tongue: lingual thyroid tissue
In the anterior neck: along the root of the thyroglossal duct, usually at or inferior to the hyoid bone –> sublingual thyroid tissue

97
Q

What causes ectopic thyroid tissue?

A

Frequently due to incomplete descent of the thyroid gland, only thyroid tissue is present

98
Q

Which is the most common ectopic thyroid tissue location?

A

Lingual thyroid tissue

99
Q

What is the parathyroid gland?

A

Small, flattened, and oval in shape, it lies outside fibrous capsule of posterior surface thyroid goland

100
Q

How many glands does the parathyroid gland usually have?

A

Usually 4, two superior and two inferior

101
Q

Where are the superior glands of the parathyroid found?

A

Level of the inferior border of the cricoid cartilage: just because the name is “superior,” it does not mean they are found on the superior part of the thyroid

102
Q

Where are the inferior glands of the parathyroid found?

A

Level of inferior poles of thyroid gland

103
Q

What % of individuals have more than four glands of the parathyroid?

A

5%

104
Q

What is the arterial supply of the parathyroid gland?

A

Superior and inferior thyroid arteries
However, in some cases, both superior and inferior glands are supplied by inferior thyroid arteries only

105
Q

What is the venous drainage of the parathyroid gland?

A

Parathyroid veins into thyroid plexus of veins

106
Q

How are the endocrine cells of the parathyroid arranged?

A

In cords

107
Q

What are the two types of cells of the parathyroid gland?

A

Chief cells and oxyphil cells

108
Q

WHat are chief cells like?

A

Small polygonal cells, slightly acidophilic cytoplasm
Granules in their cytoplasm –> parathyroid hormone

109
Q

What is the main regulator of parathyroid hormone?

A

Calcium levels of the body

110
Q

What is the function of parathyroid hormone and where does it function?

A

Increases calcium, and functions in the DCT and collecting duct of the kidneys, bones

111
Q

What are the oxyphil cells like?

A

Smaller in population but larger polygonal cells, the cytoplasm contains many acidophilic mitochondria

Transitional derivatives of chief cells

112
Q

What is the development of the superior parathyroid glands like?

A

Develop from endodermal cells of the fourth pharyngeal pouch

113
Q

What is the development of the inferior parathyroid glands like?

A

Arise together with the thymus gland from endodermal cells of the third pharyngeal pouch

114
Q
A

Endocrine System (10 decks)

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