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GOITER. Anatomy. The largest gland of the endocrine system The isthmus of the thyroid connects the right and left lobes The gland lies over the trachea down to cricoid cartilage. Anatomy. Arterial supply : superior thyroid artery from external carotid artery

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Presentation Transcript
anatomy
Anatomy
  • The largest gland of the endocrine system
  • The isthmus of the thyroid connects the right and left lobes
  • The gland lies over the trachea down to cricoid cartilage
anatomy1
Anatomy

Arterial supply :

superior thyroid artery from external carotid artery

inferior thyroid artery from subclavian artery

Venous drainage :

to the internal jugular veins

to the left brachiocephalic vein

Lymphatic drainage:

to the deep cervical nodes

physiology of thyroid gland
Physiology of thyroid gland

T3 – triiodothyronine (thyronine)

T4 – tetraiodothyronine (thyroxin)

Thyrocalcitonin ( calcitonin )

physiology of thyroid gland1
Physiology of thyroid gland

Functions of thyroid hormones

1. Bone growth

2. CNS maturation

3. Beta-adrenergic effects

physiology of thyroid gland2
Physiology of thyroid gland

1. Increase cardiac output

2. Increase basal metabolic rate

3. Increase glycogenolysis, gluconeogenesis, lipolysis

definition
Definition

Goiter – the enlargement of the thyroid gland (local or diffuse) based on hyperplasia or degeneration

pathogenesis of diffuse nontoxic goiter
Pathogenesis of diffuse nontoxic goiter
  • Iodine deficiency results in hypothyroidism
  • Increasing TSH causes hypertrophy of thyroid
pathogenesis of multinodular goiter
Pathogenesis of multinodular goiter
  • Follicles may become autonomous; certain follicles will have greater intrinsic growth and functional capability
pathogenesis of toxic multinodular goiter
Pathogenesis of toxic multinodular goiter
  • Follicles continue to grow and function despite decreasing TSH
classification
Classification
  • Benign Nontoxic Conditions
    • Diffuse and Nodular Goiter
  • Benign Toxic Conditions
    • Toxic Multinodular Goiter
    • Graves’ Disease
    • Toxic Adenoma
classification1
Classification
  • Sporadic goiter
  • Endemic goiter
classification2
Classification
  • Hyperthyroid goiter
  • Euthyroid goiter
  • Hypothyroid goiter
clinical features
Clinical features

enlargement

compressive symptoms

thyrotoxicosis

enlargement
Enlargement
  • 0 – the gland is not palpated
  • I – some part of the gland can be palpated
  • II- the gland can be seen although the neck is in a normal shape
  • III – shape of the neck is being changed
  • IV – configuration of the neck is being changed
  • V – an giant goiter with complications
treatment
Treatment
  • Suppressive Therapy
  • Antithyroid Medications
  • I-131
  • Surgery