Thyroid and Parathyroid Glands

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THYROID AND PARATHYROID GLANDS
THYROID GLAND
This is the largest endocrine gland located in the body. It is locate low down at the front of the neck
opposite to C5 to T1.anterior and lateral to the larynx and trachea
The lobes are cone shaped.
Apex extends to the oblique line of thyroid cartilage.
It is highly vascular.
It is H shaped. Contains two lobes joined together by a horizontal isthmus.
Pyramidal lobe may be present. ----present in about 30% of the population
It is not palpable (cannot be touched).
Isthmus crosses the trachea between the 2nd to the 4/5th tracheal ring.
Weighs between 20-30 grams
Lobes related posteriorly to:
 Esophagus
 Common carotid artery
 Inferior thyroid artery
 Longus cervicalis muscle
Muscular relations
SCM (lateral)
Longus colli (posterior)
Anterior strap muscles
Performs the following functions
 Regulate the basal metabolic rate in all cells—triiodothyronine T3

 Stimulate the psychosomatic growth of the body—tetraiodothyronine T4 commonly called
thyroxine
 Play an important role in calcium metabolism--calcitonin
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The thyroid gland is enclosed by a capsule. In addition to this capsule it’s enclosed by an envelope of the
pretracheal fascia.
It is supplied by the following arteries
 Superior thyroid artery—first anterior branch of external carotid artery….supplies the upper 1/3
of the lobe and upper ½ of the isthmus (2)
 Inferior thyroid artery—branch of thyrocervical trunk from the first part of the subclavian
artery…supplies the lower 2/3 of the lobe and lower ½ of the isthmus (2)
 Thyroidea ima artery
 Accessory thyroid arteries—arising from tracheal and esophageal arteries
Superior thyroid artery travels together with the superior laryngeal nerve. The inferior thyroid artery
also travels together with the recurrent laryngeal nerve. Thus much care should be put in place
when litigating.
It is drained by the following veins
 Superior thyroid vein
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 Inferior thyroid vein

 Middle thyroid vein
 Thyroid vein (of Kocher)..(sometimes)
Lymph from thyroid is drained by two groups of lymphatics i.e.
 Upper group
 Lower group
Nerve supply
From the autonomic nervous system
Parasympathetic—derived from vagus nerve
Sympathetic—derived from superior, (middle) and inferior cervical ganglia. Cervical portion of
sympathetic trunk.
Clinical relevance
Goiter—enlargement of the thyroid gland except during lactation and mensturation. This is due to
insufficient iodine. Gland appears nodular. Treatment is through administration of iodine in the diet.
 Pretracheal fascia is dense anteriorly and thin posteriorly thus if it overgrows it most likely will
do so posteriorly. This will lead to difficulty in swallowing and problems in phonation.
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 Thyroid cyst
 Branchial cleft cyst
 Simple cyst
 Metastasis of thyroid cancer can invade the structures around it.
 Thyroglossal cyst
 Adenoma---growth within substance of the thyroid gland. Result in swellings
 50% of thyroid cancers are papillary adenocarcinomas
PARATHYROID GLAND
These are two pairs of inferior and superior glands located within the capsule of the thyroid gland
posteriorly. May be embedded within the thyroid gland
Function
 Secrete parathormone which maintains calcium levels by mobilizing calcium from the bones.
Works contrary to the calcitonin secreted by the thyroid gland.
 Regulate calcium and phosphate levels.
 Increasing the reabsorption of calcium by proximal renal tubules
 Promoting the absorption of dietary calcium from small intestine
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The glands are supplied by the superior and inferior parathyroid arteries—respectively by name.
The parathyroid glands are supplied by the sympathetic fibres, derived from the superior and middle
cervical sympathetic ganglia
Clinical relevance
 Hypoparathrodism—from removal of parathyroid gland during thyroidectomy.

 Hyperparathyrodism. PTH increases blood calcium level. Acts on bones, kidneys, small intestine.
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start of the beginning

THYROID AND PARATHYROID GLANDS

The lobes are cone shaped.

Apex extends to the oblique line of thyroid cartilage.

It is H shaped. Contains two lobes joined together by a horizontal isthmus.

Pyramidal lobe may be present. ----present in about 30% of the population

It is not palpable (cannot be touched).

Weighs between 20-30 grams

Lobes related posteriorly to:

Longus colli (posterior)

Anterior strap muscles

Performs the following functions

 Regulate the basal metabolic rate in all cells—triiodothyronine T3

It is supplied by the following arteries

It is drained by the following veins

 Superior thyroid vein

 Inferior thyroid vein

Lymph from thyroid is drained by two groups of lymphatics i.e.

From the autonomic nervous system

Parasympathetic—derived from vagus nerve

 Hypoparathrodism—from removal of parathyroid gland during thyroidectomy.

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