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Small animal (fourth year) > Soft tissue surgery (endocrine) > Flashcards

Soft tissue surgery (endocrine) Flashcards

1
Q

where are the thyroid glands found?

A

paired glands that sit laterally to the trachea (rings 5-8)

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2
Q

what structures sit near the right thyroid gland that we need to be aware of when performing surgery?

A

carotid sheath and recurrent laryngeal nerve

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3
Q

what structures sit near the left thyroid gland that we need to be aware of when performing surgery?

A

oesophagus and recurrent laryngeal nerve

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4
Q

should we be able to feel normal thyroid glands?

A

no - suggests abnormality

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5
Q

what supplies blood to the thyroid glands?

A

cranial/caudal thyroid arteries

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6
Q

what veins drain the thyroid glands?

A

cranial/caudal thyroid veins

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7
Q

where can ectopic thyroid tissue be found?

A

along trachea, thoracic inlet, mediastinum, descending aorta

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8
Q

where does the external pair of parathyroid glands sit?

A

near cranial pole of thyroid gland

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9
Q

where does the internal pair of parathyroid glands sit?

A

embedded within the caudal pole of each thyroid gland

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10
Q

is feline hyperthyroidism usually unilateral or bilateral?

A

bilateral

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11
Q

what are the functions of thyroid hormone?

A

increase metabolic rate
increase catabolism of fat/muscle
increase body temperature
increase sympathetic drive
acts of emetic centre and cardiac muscle

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12
Q

what are the clinical signs of hyerparathyroidism?

A

weight loss and polyphagia
behavioural change - restless/aggression
PUPD
vomiting and diarrhoea
cardiac signs (murmur, tachycardia)

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13
Q

what are the classical finding on biochemistry of cats with hyperparathyroidism?

A

increased liver enzymes
decreased creatinine
decreased potassium
increased phosphate

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14
Q

what is the diagnostic test used for hyperparathyroidism?

A

total T4 (increased)

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15
Q

what are the possible treatment options for hyperparathyroidism?

A

medical - antithyroid drugs, radioiodine
surgical - thyroidectomy

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16
Q

what are the two anti-thyroid medications available?

A

carbimazole
methimazole

17
Q

how do anti-thyroid medications work?

A

block thyroid hormone synthesis by blocking oxidation of iodide in the thyroid gland

18
Q

how many treatments of radioactive iodine is needed for hyperparathyroidism?

A

one is usually curative

19
Q

what are the disadvantages of radioactive iodine for treating hyperparathyroidism?

A

requires 2 week hospitalisation
specialist procedure (few centres do it)

20
Q

what are the advantages of radioactive iodine for treating hyperparathyroidism?

A

curative and minimal side effects
minimal cat/owner compliance needed
targets ectopic thyroid tissue

21
Q

what must be done before thyroidectomy?

A

get cat in euthyroid state by using anti-thyroid drugs
control cardiac murmur/tachycardia if present
treat hypertension
ensure cat in normokalaemic

22
Q

how are patients positioned for thyroidectomy?

A

dorsal recumbency (thoraci limbs pulled caudally)

23
Q

what are the steps of the cervical approach for thyroidectomy?

A

incision from larynx to manubrium
sternohyoid and sternothyroid muscles bluntly separated to reveal trachea
paratracheal fascia bluntly dissected to expose thyroid

24
Q

what is the appearance of normal thyroid glands?

A

pale tan and flat

25
Q

what is the appearance of thyroid glands with thyroid adenomatous hyperplasia?

A

brown/red and plump

26
Q

what are the advantages of a bilateral thyroidectomy?

A

single surgery and cheaper

27
Q

what is the main disadvantage of bilateral thyroidectomy?

A

risk of hypoparathyroidism

28
Q

what is a staged thyroidectomy?

A

largest gland removed and then second removed 4 weeks later

29
Q

what are the two types of thyroidectomy?

A

modified intracapsular (external parathyroid gland preserved)
modified extracapsular

30
Q

what is the modified intracapsular thyroidectomy?

A

incise into thyroid capsule and bluntly direct it out, then cut most of the capsular tissue away leaving the external parathyroid gland

31
Q

what is the modified extracapsular thyroidectomy?

A

make an incision around the external parathyroid to preserve it and then remove the thyroid within its capsule

32
Q

what are the main complications of thyroidectomy?

A

haemorrhage
laryngeal paralysis
horners syndrome
hypothyroidism
hypoparathyroidism
recurrence

33
Q

why is iatrogenic hypoparathyroidism commonly seen after thyroidectomy?

A

very likely to remove at least one of the parathyroid glands so the other take a bit of time to undergo hyperplasia
its usually very mild

34
Q

what are the most common canine thyroid gland tumours?

A

carcinoma

35
Q

why is cross-matching prior to thyroidectomy highly recommended?

A

large risk of severe haemorrhage

36
Q

should the parathyroid be preserved in canine thyroidectomy of a mass?

A

no - risk of leaving neoplastic cells

Small animal (fourth year) (26 decks)

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