thyroid and parathyroid gland Flashcards
where is the thyroid gland?
- anterior neck — spans the C5-T1 vertebrae
- located within the visceral compartment of the neck (along with the trachea, oesophagus and pharynx)
- wrapped around the cricoid cartilage and superior rings of the trachea
what does the thyroid gland consist of in its structure?
two lobes (left and right), which are connected by a central isthmus anteriorly – this produces a butterfly-shape appearance
what is the visceral compartment of the neck bounded by?
pretracheal fascia
In the embryo, the thyroid gland begins development near the base of the tongue – in an area known as the___________. It descends during development and reaches its destination in the anterior neck by week ___.
- foramen cecum
- 7
what does the descend of the developing thyroid gland form? describe
the thyroglossal duct – an epithelialised tract that connects the gland to its origin at the foramen cecum
what happens/can happen to the thyroglossal duct?
It usually regresses by the 10th week of gestation, but can persist in some individuals. If it fails to regress, the duct can give rise to cysts or fistulae.
A thyroglossal cyst results from a build-up of secretions within the duct. It typically presents as a midline lump in the anterior neck which rises on tongue protrusion. If left untreated, this cyst can become infected, and form a cutaneous fistula – discharging out onto the skin of the anterior neck.
Thyroglossal cysts and fistulae are usually treated with complete excision. Recurrence is quoted at approximately 2.5%
anterior relations of thryoid gland
infrahyoid muscles, namely the sternothyroid, superior belly of the omohyoid and sternohyoid
lateral relations of thyroid gland
carotid sheath, containing the common carotid artey, internal jugular vein and vagus nerve
medial relations of the thyroid gland
Organs – larynx, pharynx, trachea and oesophagus
Nerves – external laryngeal and recurrent laryngeal
the thyroid gland gets its arterial supply from what 2 main arteries?
superior and inferior thyroid arteries
describe the superior thyroid artery
arises as the first branch of the external carotid artery.
what does the superior thyroid artery lie in close proximity to?
the external branch of the superior laryngeal nerve (innervates the larynx)
what does the inferior thyroid artery arise from?
the thyrocervical trunk (a branch of the subclavian artery)
what does the inferior thyroid artery lie in close proximity to?
the recurrent laryngeal nerve (innervates the larynx)
In a small proportion of people (around 10%) there is an additional artery present for the thyroid gland – describe
the thyroid ima artery
- it arises from the brachiocephalic trunk and supplies the anterior surface and isthmus of the thyroid gland
venous drainage of the thyroid gland
superior, middle, and inferior thyroid veins, which form a venous plexus around the thyroid gland
The superior and middle thyroid veins drain into the ______ and the inferior empties into the __________.
- IJV
- brachiocephalic vein
thyroid gland innervation
innervated by branches derived from the sympathetic trunk.
These nerves do not control the secretory function of the gland – the release of thyroid hormones is regulated by the pituitary gland.
lymphatic drainage of thyroid gland
to the paratracheal and deep cervical nodes
The left and right ________ laryngeal nerves lie in close proximity to the thyroid gland and care must be taken not to damage them during thyroid surgery.
They branch from their respective _____ nerve within the chest and hook around the right _______ artery (right RL nerve), or the _________ (left RL nerve).
The recurrent laryngeal nerve then travels back up the neck, running between the ____ and ____ in the ___________________. It then passes underneath the thyroid gland to innervate the ______.
- recurrent
- vagus
- subclavian
- arch of the aorta
- trachea
- oesophagus
- tracheoeosophageal groove
- larynx
the parathyroid glands are responsible for the production of _______ which acts to do what?
- parathyroid hormone (PTH)
- increase the level of serum calcium
where are the parathyroid glands?
- posterior aspect of thyroid gland
- external to the thyroid gland itself but within the pretracheal fascia
how many PT glands do most people have?
4 — 2 superior and 2 inferior
what are the parathyroid glands derived from?
2 x superior — from fourth pharyngeal pouch
2 x inferior — from third pharyngeal pouch