Lec 5 Flashcards
What is the thoracic aperature
Borders are manubrium, r1, clavicle, scapula, T1
It is the thoracic inlet for air and food and outlet for art and nerves with the apex of each lung extending into aperature
Describe Thoracic Outlet syndrome
Interference with blood and nerves to the extremities and occurs above aperture in the root of neck. Causes can be physical trauma or abnormal anatomy.
What are the classes of symptoms of thoracic outlet syndrome
- Neurological - compression of brachial plexus leading to pain in shoulder and neck, wasting of muscles in base of thumb (Gilliat - Sumner), weakened grip, numb fingers
- Vascular - compression of Arteries and Nerves leading to arm pain and swelling, paleness of blue tint of head, weak pulse, blood clots
What are the causes of TOS
- Scalene syndrome - spasms or scarring of scalenes compresses subclavian and brachial plexus
- Costoclavicular syndrome - compression of subclavian art btwn clavivle and r1 resulting in pallor and coldness of ULimb and Anson’s sign = reduction in radial pulse
- Cervical rib syndrome - supernumerary rib from c7 leads to inferior trunk of brachial plexus is compressed btwn scalene and ribs = muscle weakness affecting base of thumb
What is the thyroid gland
2 pear shaped lobes around trachea and esophagus and cortid sheath. Base= 5th trachial ring so trachea can be compressed during inflammation.
Sup = sternothyroid
An isthmus connects L+R sides over tracheal ring and the gland secretes thyrotoxin to regulate metabolism
What are the arteries of thyroid gland
sup and inf thyroid arteries from ext carotid and thyrocervical trunk which anastomosis in gland.
Can have a branch from brachicephalic trunk or aortic arch = thyroid IMA art
What is the venous drainage of Thyroid
vein plexus formed by sup, inf, and mid branches, not parallel with arts as mid thyroid vein and IMA dont have counterparts
What are the pathologies associated with the Thyroid
- Thyroglossal cyst
- Goiter
- Graves Disease
- Hashimotos disease
What causes a thyroglossal cyst
epithelial lined tube from embryo remains and can form cyst
What causes a Goiter
swelling of gland due to increased iodine. Due to increased dietary intake, hereditary factors, more prevalent in females leading to goiter to enter carotid triangle and compress trachea
What is Graves Disease
Autoimmune disease activating thyroid stimulating hormone increasing TH levels leading to insomnia, hyperactivity, excess sweating, weight loss, diarrhea, muscle weakness, and goiter ultimately leads to heart dysfunction
What is Hashimotos Disease
Autoimmune of thyroid gland decreasing fx. leads to fatigue, dry skin, weight gain, swollen face. Most prevalent in middle aged women
What are the parathyroid glands
4 in number (up to 7) lying external to thyroid capsule on post surface of thyroid gland receives blood from inf thyroid art and drains to thyroid venous plexus. Function is to maintain body calcium
Pathway of Parathyroid function
decreased calcium releases PTH stims osteoclasts and GI absorption and increased Ca intake by kidneys.
Diseases of Parathyroid
Hypothyroidism results in neuromuscular activity such as spasms and tetany. If destroyed = death
