thyroid: clinical Flashcards
when can goitre occur?
in non-neoplastic and non-inflammatory conditions e.g. iodine deficiency, pregnancy, hyPERthyroidism
what can a goitre cause?
swelling in the neck which can compress trachea, oesophagus, recurrent laryngeal nerves (hoarseness of voice)
where does goitre enlarge? (direction)
anteriorly, posterior (weak ‘capsule’ fascia), inferior, laterally
but NOT superior (sternothyroid (infrahyoid) muscle attachment at oblique (inferior) line of thyroid cartilage)
what can a post-operative haemorrhage during thyroidectomy cause?
compression of trachea as blood collects in fibrous capsule of gland, making breathing v. difficult
which part of the thyroid is commonly preserved during thyroidectomy? why?
posterior part of each lobe
to protect recurrent + superior laryngeal nerves and to spare parathyroid glands
what is the remnant of thyroglossal duct? course of travel?
pyramidal thyroid lobe
extends superiorly from isthmus, develops from remnants of epithelium and CT of thyroglossal duct
what is the thyroid cartilage attached to? by what?
superiorly: hyoid bone by thyrohyoid membrane
inferiorly: cricoid cartilage by cricothyroid membrane
where can the thyroid cartilage be palpated?
anteriorly
what should be carried out in acute laryngeal obstruction?
thyroid cartilage can be punctured to enable patient to breath
