Endocrine Flashcards
Surrounding thyroid structures
Trachea
Oesophagus
- Enlargement of thyroid caues breathing/ swallowing
Recurrent laryngeal nerve
- Injury signs
Unopposed action of crico-thyroid muscle (abduction)
- Will be in mid-line
- Problem with breathing
Complications of thyroid surgery
- Immediate
- Early
- Late
Immediate
- Bleeding
Early
- Potential voice change
Late
- Voice change
- Thyroxine/ Calcium/ vitamin D dysregulation
T3 and T4 half life
T4= 6.7 days
- A month before it removes from the bdody
T3= 1.3 days
Thyroid surgery indications
Pressure symptoms
Cancer
Graves disease
Diagnostic reason
Swelling/ cosmetic
Thyroid lump management
Triple assessment:
- Clinical assessment
- Imaging= ultrasound
- Aspiration/ biopsy= cytology/ histology
History of lump
Where
When
How
Had it before?
Has it changed?
Associated symptoms
- Swalloing, breathing
Thyroid cancer
- Risk factors
Radiation in neck in childhood
Exposure to environmental radiation
Chronic lymphocytic thyroiditis
Medullary genetics
Female (2:1)
Anterior triangle of neck
Borders
- Mandible
- Midline of neck
- Anterior= SCM
- Roof= investing fascia
- Floor= pre-vertebral fascia
Posterior triangle of neck
Borders
- Trapezius
- SCM
- Clavicle
Lump neck examination
Inspection:
If it moves with swallowing
- Thyroid gland enlargement
If it does not move with swallowing
- Not thyroid: lipoma, sebaecous cyst
- Lymphadenopathy
Stick tongue out
- If it moves= thyroglossal cysts
Palpation
- Examination regional lymph nodes (all in neck)
- Start with asymptomatic, compare with symptomatic
Thyroid investigations
Imaging
- USS
Biopsy
- Cytology
Thyroid nodules
- Epidemiology
F:M= 4:1
thyroid surgery options
Hemi or total thyroidectomy
- Midline incision
PT gland embryolology
Superior
- From 4th pouch
Inferior
- From 3rd pouch
