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AP 2 🫀🫁 > Thyroid > Flashcards

Thyroid Flashcards

1
Q

Inferior Thyroid Artery

A

Provide profusion to thyroid gland. Connect to left subclavian.

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2
Q

Superior Thyroid Artery

A

Provide profusion to thyroid gland. Connect to external carotid.

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3
Q

Right recurrent laryngeal nerve

A

Branch of the vagus nerve. Wrap around subclavian artery and aorta. “coming back”. Control ability to speak. Enlarged thyroid gland can compress nerve.

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4
Q

Left recurrent laryngeal never

A

Branch of the vagus nerve. Wrap around subclavian artery and aorta. “coming back”. Control ability to speak. Enlarged thyroid gland can compress nerve.

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5
Q

Goiter

A

a swelling of the neck resulting from enlargement of the thyroid gland. Can compress tracheal ligaments and nerves.

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6
Q

Tracheal ligaments

A
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7
Q

Thyroid Gland

A

Controller of metabolic rate. Anatomy: just below the thyroid cartilage.

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8
Q

Anterior Pituitary Gland

A

Controls thyroid. Controls growth and Sex hormones

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9
Q

Hypothalamus

A

Controls thyroid. The one doing the sensing and deciding. Looks at stress and temperature.

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10
Q

TRH(Thyrotropin-releasing hormone)

A

Release by the hypothalamus. Goes through portal circulation to pituitary
gland. Interacts with TRH receptors at the pituitary.

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11
Q

TSH(Thyroid Stimulating Hormone)

A

Release by pituitary gland in response to TRH. Will interact with receptors in the thyroid gland. Causes the thyroid to release thyroid hormones(T3, T4).

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12
Q

T3(3,5,3-Triiodothyronine)

A

Produced by the the combination of T1 and T2. Circulating Thyroid hormone. Tyrosine(AA) derivatives. Less in circulation 7%. More active intracellularly. 2 benzene rings(thyronine.)

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13
Q

T4(Thyroxine)

A

Main circulatory form. Made from the combination of 2 T2s. Circulating Thyroid hormone. More in circulation 93%. 2 benzene rings(thyronine).

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14
Q

Tyrosine

A

1 benzene ring. Amino Acid. Base or parent compound for thyroid hormone.

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15
Q

Monoiodotyrosine(T1)

A

Tyrosine with one iodine stuck to it

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16
Q

Diiodotyrosine(T2)

A

Tyrosine with two iodine stuck to it.

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17
Q

Thyronine

A

2 benzene rings.

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18
Q

Iodine

A

Needed to produce thyroid hormone. 50mg/year needed.

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19
Q

Peroxidase

A

Uses oxidative stress to turn Iodine into Thyroid hormone

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20
Q

Thyroid Hormone

A

Steroid. Fat Soluble. Gene transcription upregulated(protein production)

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21
Q

Albumin

A

Transport protein from liver

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22
Q

TBG(Thyroxine binding globulin)

A

Main transport protein for thyroid hormone. Made in liver

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23
Q

Thyroxine binding pre-albumin

A

Transport protein from liver

24
Q

Mitochondria

A

Elevated thyroid causes Up-regulation of mitochondria, they increase in number and size. Enhanced ability to produce ATP. Increase Na+ permeability=Na/K pump increases cycling rate to get rid of the extra sodium.

25
Q

Hyperthyroidism effects

A

Increase in amount of glucose taken up by the cell. Increase uptake of glucose from GI. Increase ability to have gluconeogenesis(from fats). Increase rate of glycolysis. Increase circulating insulin. Increase activity of entire endocrine system.

26
Q

Hyperthyroidism effects-CV

A

CV: Increase in resting HR, stroke volume, map does NOT increase. pulse pressure elevated. systolic blood pressure(elevated SV). Decreased diastolic pressure(increase metabolism at the tissue), Circulating cholesterol(energy compound-increased use and excretion via GI system), Triglycerides.

27
Q

Hypothyroidism

A

Prolonged elevated cholesterol and triglycerides.

28
Q

Hyperthyroidism-Neuro effects

A

Nuero: more alert, more difficult to sleep, increase neuromuscular transmission. Muscle tremor. Motor dysfunction.

29
Q

How many days for thyroxine to take effect?

30
Q

Exophthalmos

A

protruding eyes

31
Q

Hyperthyroidism disorders

A

1.Tumor
2. Overactive Immune: Grave’s Disease
3. Prescription drugs?

32
Q

Graves’s Disease

A

TSH receptor stimulating antibodies. Levels of circulating thyroid hormone will be increase. Binding to things and turning them on. Reduction in both TRH and TSH.

33
Q

Hyperthyroidism Tx

A
  1. Surgery-cut out
  2. Shrink-radioactive iodine(destroys tissue)
  3. Drugs. Thyocyanate-looks like iodide. High dose(100x) of dietary iodine.
34
Q

Thyocyanate
Propylthiouracil

A

Drug to treat hyperthyroidism. Competitor for iodine pump.

35
Q

Amiodarone

A

35% mass iodine. Chronic use can cause hyperthyroidism or hypothyroidism.

36
Q

Hypothyroidism causes

A
  1. Iodine deficiency
  2. Immune Can target and destroy thyroid gland(Hashimoto’s thyroiditis)
  3. Mutations in peroxidase enzyme
  4. Stunted growth and cognition issues in children-Cretinism(lack of thyroid hormone)
  5. Idiopathic-5%
  6. Mutations in iodine uptake pump-genetic
37
Q

Hypothyroidism Tx:

A

1.Iodine
2. Steroids
3. plamsapharesis
4. Synthetic hormone-synthroid(levothyoxine)

38
Q

Hypothyroidism
in the OR

A
  1. Take longer to wake up
  2. More sensitive to NMB
39
Q

Blood work for Thyroid issues

A
  1. Circulating T4
  2. TH and TRH levels
40
Q

Primary Thyroxine Secreting Tumor

A

Reduction in both TRH and TSH d/t to negative feedback

41
Q

TRH Challenge

A

Look at TSH and T4 response

42
Q

Iodine Deficiency

A

High TRH, TSH. Low T4

43
Q

Thyroxine

A

Shuts down pituitary gland

44
Q

Thyroid Storm

A

Increase HR, oxygen requirements, elevated ventilation, temp.

45
Q

Anterior Pituitary Gland

A

Prolactin(lactation), Lutenizing-LH(ovaries), Follicle stimulating(ovaries), Corticotropin-related to blood steroids(talk to adrenal cortex(cortisol), indirectly affect insulin(pancreas)

46
Q

Thyroglobulin

A

Production and storage Protein in Thyroid Gland.
Tyrosine combining with Iodines. T3 and T4 are produced within. Body can dissolve storage capsule to release T3 and T4. 60-70 T3 and T4s are stored within.

47
Q

Cricothyroid ligament

A

Used for invasive airway. Covered thyroid gland.

48
Q

Portal venous drainage system

A

Connects the hypothalamus
to the anterior pituitary. 2cm. Blood vessel that transports hormones.

49
Q

Iodinase activity

A

15% of T3 supplied from thyroid gland.
85% produced at the cellular by iodinase acting on T4.

50
Q

Increase in pulse pressure in hyperthyroidism

A

Increase in systolic blood pressure cause by an increase in SV.
Decrease in diastolic blood pressure due to the increase metabolism which dilates the vessels.

51
Q

Drugs for Hyperthyroidism

A
  1. Prevent absorption of iodine
  2. Overwhelm Perioxidase
  3. Overwhelm Iodine receptor with dietary iodine
52
Q

Hashimoto’s thyroiditis

A

Body produces antibodies that are reactive to the thyroid gland

53
Q

TSH secreting pituitary tumor

A

Elevated TSH and T4 levels, decrease TRH levels

54
Q

Things that can increase thyroid hormone

A
  1. Stress
  2. Moving to Alaska
  3. Surgery
55
Q

Posterior Pituitary controls…

AP 2 🫀🫁 (10 decks)

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