Viscera of the neck

2021 ◽  
pp. 231-242
Author(s):  
Daniel R. van Gijn ◽  
Jonathan Dunne
Keyword(s):  
Thyroid Gland ◽  
Thyroid Cartilage ◽  
Oblique Line ◽  
Tracheal Ring ◽  
Inferior Thyroid Artery ◽  
Parathyroid Glands ◽  
Anterior Surface ◽  
Venous Plexus ◽  
Jugular Veins ◽  
Lower Neck

The thyroid gland is a symmetrical H-shaped endocrine structure in the lower neck. It consists of two lobes, each extending from the oblique line of the thyroid cartilage above to the sixth tracheal ring below – united by a median isthmus covered by the anterior jugular veins. The small, (usually) paired and inconsistent parathyroid glands lie behind the lobes of the thyroid gland. They measure 6mm by 4mm by 2mm and are ordinarily four in number – two superior and two inferior. They are involved in the careful regulation of the body’s calcium levels. Both superior and inferior glands are ordinarily supplied by the inferior thyroid artery. Drainage is into the venous plexus on the anterior surface of the thyroid.

scholarly journals KISSING SUPERIOR PARATHYROID GLANDS: A CASE REPORT

2020 ◽  
Vol 8 (4.2) ◽  
pp. 7810-7813
Author(s):  
Romini Niranjan ◽  
◽  
Surangi. G. Yasawardene ◽  
Keyword(s):  
Case Report ◽  
Thyroid Gland ◽  
Parathyroid Gland ◽  
Incidental Finding ◽  
Lateral Lobe ◽  
Tracheal Ring ◽  
Left Lobe ◽  
Parathyroid Glands ◽  
Cervical Region ◽  
Pharyngeal Pouch

Parathyroid glands are responsible for maintaining the calcium level in blood and usually a pair of superior and inferior parathyroid glands are located in the thyroid gland. Parathyroid glands are smaller and have variations in their size, shape, number and location. Thus, it is difficult to identify the parathyroid gland and leads to its accidental removal during thyroidectomy. This case report is an incidental finding of two superior parathyroid glands in the left lobe of thyroid gland in 68-year female cadaver. Both superior parathyroid glands were located at the first tracheal ring, 2 mm in size, circular in shape, tan yellow in colour, covered by a thin capsule and separated from each other in a distance less than 1 mm. They appear similar as a twin pair and seems to kiss each other. Both were confirmed by the histological method as parathyroid tissues. Superior parathyroid gland developed from the dorsal wing of fourth pharyngeal pouch, get detached from its origin and assumed a relatively constant final location either at the cricothyroid junction or at first tracheal ring. In this present case, the dorsal wing of the fourth pharyngeal pouch have undergone earlier embryological division into two separate superior glands during its descent to the cervical region in the left side. Embryological development of thyroid gland is linked with the development of parathyroid, thymus and ultimobranchial body. Thyroid gland developed from two sources. The median one contributes to thyroid isthmus and parts of the lateral lobe of thyroid. Lateral thyroid lobes derived its contributions from the caudal pharyngeal endoderm of the 4th and 5th pharyngeal pouches. The fusion of median and lateral thyroid forms the Zuckerkandl’s tubercle. Superior parathyroid gland might have travelled along the superior border of isthmus and any changes in the development of thyroid might have influence in the development of parathyroid glands. Up to now a very few cases of kissing parathyroid glands are reported in the literature and this will provide an additional anatomical information of kissing superior parathyroid glands. KEY WORDS: Kissing superior parathyroid glands, Complications of thyroidectomy, Parathyroidectomy, Cricothyroid junction, Twin parathyroid.

scholarly journals VIRIATION OF THE EXTERNAL BRANCH OF THE SUPERIOR LARYNGEAL NERVE

2019 ◽  
Vol 21 (1) ◽  
pp. 84-88
Author(s):  
V Y Malyuga ◽  
A A Kuprin
Keyword(s):  
Thyroid Gland ◽  
Thyroid Cartilage ◽  
Oblique Line ◽  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Type I ◽  
Constrictor Muscle ◽  
Point Of Entry ◽  
External Branch ◽  
Inferior Pharyngeal Constrictor

Till now, there is no universal clinical classification about variations of the external branch of the superior laryngeal nerve despite the multiple classifications that was proposed. The aim of this research is identification and systematization of topographic types of the external branch of the superior laryngeal nerve. The study is based on the autopsy material (21 complexes organs of the neck) and on identification of variations of 40 external branches of the superior laryngeal nerve. We identify two permanent landmark that are located at the minimum distance from nerve and on which we made metrical calculations: oblique line of thyroid cartilage, tendinous arch of the inferior pharyngeal constrictor muscle. The “entry” point of the nerve is always located on the inferior pharyngeal constrictor muscle,and not protruding beyond the oblique line of thyroid cartilage superiorly and tendinous arch of the inferior pharyngeal constrictor muscle anteriorly. The proposed topographic classification of the location of the external branch of the superior laryngeal nerve is based on localization of point of pierced of the nerve relating to the length of the oblique line of thyroid cartilage. In 64.2% of cases, the external branch of the superior laryngeal nerve was in close proximity to the upper pole of the thyroid gland, which could lead to its damage during surgery (type I and II). In type III and IV (35.8%) - the point of "entry" in the muscle was located as far as possible from the upper pole of the thyroid gland, and most of the nerve was covered by the fibers of the inferior pharyngeal constrictor muscle.

​Comparative Gross Anatomical and Biometrical Studies on Thyroid Gland of Buffalo, Sheep and Goat

2021 ◽  
Author(s):  
Amit Poonia ◽  
Anuradha Gupta ◽  
Varinder Uppal
Keyword(s):  
Thyroid Gland ◽  
Thyroid Cartilage ◽  
Tracheal Ring ◽  
Left Lobe ◽  
Biologically Active ◽  
Endocrine Gland ◽  
Water Displacement ◽  
Blood Calcium ◽  
Right Lobe ◽  
The Right

Background: The thyroid gland is vital endocrine gland which secretes three hormones i.e. thyroxin (T4), triiodothyronine (T3) and Calcitonin hormones. The thyroxin (T4) and triiodothyronine (T3) hormones are biologically active and are required for maintenance of normal levels of metabolic activity. The thyroid also produces calcitonin from the parafollicular cells which act directly on osteoclast to decrease the bone resorption which lower the blood calcium level. Deficient or excessive production of thyroid hormones may lead to serious pathological states with outward symptoms. Methods: The gross anatomical and biometrical studies were conducted on thyroid gland of buffalo, sheep and goat (n=12) collected immediately after slaughtering from slaughter house and local meat shop. The weight of thyroid gland was measured by weighing balance, volume by water displacement method, length and width of lateral lobes and isthmus by calibrated scale and inelastic thread and thickness of lateral lobes and isthmus was measured by digital vernier calliper. The data was analysed statistically. Result: The lateral lobes were roughly triangular in buffalo and elongated in sheep and oval in goat. The surfaces were granular and rough in buffalo but smooth in sheep and goat. It extended from thyroid cartilage to 2nd tracheal ring in buffalo, 1st to 6th tracheal ring in sheep and 1st to 7th tracheal ring in goat. The left lobe was larger than the right lobe in all the three species studied. The thyroid gland was biggest in buffalo followed by goat and smallest in sheep. The density of isthmus was more than the lobes in sheep and goat but not in buffalo.

scholarly journals Cadaver Study of the Extension of the Lobes of the Thyroid Gland

1970 ◽  
Vol 19 (1) ◽  
pp. 47-50
Author(s):  
ASM Nurunnabi ◽  
S Ara ◽  
R Ahmed ◽  
S Kishwara ◽  
S Mahbub ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Thyroid Cartilage ◽  
Cadaver Study ◽  
Tracheal Ring ◽  
Human Thyroid ◽  
Medical College ◽  
Key Words Thyroid Gland ◽  
Dead Bodies ◽  
The Right ◽  
Inferior Limit

Context: The present study was designed to see the extension i.e. the superior and the inferior limits of the right and the left lobes of the thyroid gland of Bangladeshi people and compare with the previous studies. Study design: Descriptive type of study. Place and period of the study: Department of Anatomy, Dhaka Medical College, Dhaka from January to December 2008. Materials: The present study was performed on 60 post mortem human thyroid gland (39 of male and 21 of female) of unclaimed dead bodies which were in the morgue under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. Methods: The samples were collected from the dead bodies by ‘block dissection' and upper and lower limits of the lobes of the thyroid gland were observed in situ and recorded. Results: The superior limit of the right and left lobes of the thyroid glands reached above the midpoint of the lamina of the thyroid cartilage in 16.67% and 8.33% cases and was found at the level of that midpoint in 41.67% and 43.33% of cases respectively. 41.67% on the right and 48.33% on the left could not reach that midpoint of the thyroid cartilage. The inferior limit of the right and left lobes of the thyroid gland reached up to the 5th tracheal ring in 63.33% and 60% cases respectively and inferiorly up to the 6th tracheal ring in 36.67% and 40% cases respectively. Key words: Thyroid gland; extension of lobes; superior and inferior limit. DOI: 10.3329/jdmc.v19i1.6252 J Dhaka Med Coll. 2010; 19(1) : 47-50.

scholarly journals Postmortem Study of Thyroid Arteries in Bangladeshi People

1970 ◽  
Vol 7 (1) ◽  
pp. 26-33 ◽  
Author(s):  
Kanta Roy Rimi ◽  
Shamim Ara ◽  
Motahar Hossain ◽  
KM Shefyetullah ◽  
Humaira Naushaba ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Carotid Artery ◽  
Thyroid Surgery ◽  
Common Carotid Artery ◽  
Tracheal Ring ◽  
Inferior Thyroid Artery ◽  
External Carotid ◽  
Superior Thyroid Artery ◽  
Medical College ◽  
The Right

Context: Anatomical knowledge of vasculature is essential for successful thyroid surgery. Vascular anatomy of thyroid artery may vary. Study design: Descriptive type of study. Place & Period of study: Department of Anatomy, Dhaka Medical College from July 2003 to December 2004. Materials: Present study was performed on 57 thyroid gland. The samples were collected from unclaimed dead bodies that were under examination in the Department of Forensic Medicine of Dhaka Medical College, Dhaka. Methods: The samples were divided in groups. All samples of thyroid arteries were studied morphologically. Five (5) samples were transferred into aided dissection by common vermilion mixed melted paraffin wax. Result: Superior thyroid artery was most commonly originated from external carotid artery (male- 76.5% both right and left, female-91.3% right, 73.9% left), followed by bifurcation of common carotid artery (maleright 14.7%, left 20.6%, female- left 13%, right 0% and from common carotid artery (male 8.8% right, 2.9% left, female- 8.7% right, 13% left) at the level or above the level of upper border of thyroid cartilage. On the right side in 100% and 94.7% cases superior thyroid artery and inferior thyroid artery were originated as a single artery respectively. On the left side in 94.7% and 87.7% cases superior thyroid artery and inferior thyroid artery were originated as a single artery respectively. On the left side, double superior thyroid artery was present in 5.3% cases, double inferior thyroid artery was present in 1.8% cases. Inferior thyroid artery was found to be absent in 4.3% right side, 9.5% left side in female cases and 5.9% both right and left side in male cases. There was no significant (P>0.05) difference between the length of superior thyroid artery on the right and left side. But the length of inferior thyroid artery showed significant (p<0.001) difference between the right and left side. Inferior thyroid artery was most commonly originated from thyrocervical trunk (right 47%, left 90.2%), followed by subclavian artery (right 13%, left 9.80%). It most commonly originated at the level of 8th-10th tracheal ring in (right 50%, left 52.95%) cases followed by 6th-8th or 10th-14th tracheal ring (right 27.8%, left 27.45%), 10th - 14th tracheal ring (right 22.2%, left 19.6%). Thyroidea ima artery was present in 6 out of 57 cadaver (10.52%), most commonly it was originated from brachiocephalic trunk (50%) but it was also originated from arch of aorta (33.3%) and right common carotid artery (16.7%). Conclusion: It is important to know the arterial pattern of thyroid gland for successful thyroid surgery in our country. This artery can help to understand the arterial pattern of thyroid gland in our country and there by may help to reduce the complication during thyroid surgery. Due to small size of sample in our study, further study with large samples from different zones, especially in endemic zone of the country using polyester resin cast and more sophisticated micro-anatomical technique with multivariant analysis is recommended. Keywords: Thyroid arteries, Postmortem, Bangladeshi.   doi: 10.3329/bja.v7i1.3014 Bangladesh Journal of Anatomy January 2009, Vol. 7 No. 1 pp. 26-33

scholarly journals MORPHOSTRUCTURE OF THE FIELD MOUSE THYROID GLAND IN NORMAL STATE IN THE CONDITIONS OF FOREST-STEPPE NEAR KRASNOYARSK

Ekosistemy ◽  
2021 ◽  
pp. 106-115
Author(s):  
A. A. Lyuto ◽  
A. S. Shishikin
Keyword(s):  
Thyroid Gland ◽  
Thyroid Cartilage ◽  
Parathyroid Glands ◽  
Follicular Epithelium ◽  
Forest Steppe ◽  
Field Mouse ◽  
Normal Morphology ◽  
Reticular Cells ◽  
The Mean ◽  
Field Mice

The regional research of the zonal undisturbed (normal) morphology of the thyroid gland of young field mice was carried out in the conditions of forest-steppe near Krasnoyarsk. The most important indicators of the thyroid gland are identified: macroscopically, the width of each lobe is 2-2. 7 mm, the length is 1.5-2 mm, the height is 1-2 mm. The width of the isthmus is 1.5-2 mm. The color of the gland ranges from red to dark red and it clearly contrasts with the background of the larynx and thyroid cartilage. The thyroid and parathyroid glands are a single organocomplex. The specific features of the structure of the thyroid gland of field mice are the small size of the organ, a thin capsule, the presence of internal accessory parathyroid glands, a compactly organized parenchyma, and a moderately developed vascular network. The stroma of the gland is relatively poorly developed, it contains a thin network of reticular cells, a small number of macrophages. The epithelium of large follicles has a prismatic shape, although middle size follicles have cubic shaped epithelium. The height of thyrocytes is 6.83 microns, the mean area of follicles is 467.9 microns; Brown index is 9.7; follicular-colloid index is 3.72; the sclerosis index is 0.81. The field mouse, due to its ecological and morphological features, is a valuable object of bioindication for assessment of the state of background and anthropogenic landscape in the conditions of the Krasnoyarsk forest-steppe. The size of the gland (taking into account age of a mouse), the Brown index, as well as the height and shape of thyrocytes (follicular epithelium) are significant bioindication criteria to assess the changes in the case of technogenic exposure influenced by pollutants.

An Anatomic Study of the External Laryngeal Framework with Surgical Implications

1992 ◽  
Vol 106 (3) ◽  
pp. 235-240 ◽  
Author(s):  
Lawrence Z. Meiteles ◽  
Pi-Tang Lin ◽  
Eugene J. Wenk
Keyword(s):  
Vocal Fold ◽  
Anterior Commissure ◽  
Thyroid Cartilage ◽  
Oblique Line ◽  
Type I ◽  
Anatomic Study ◽  
True Vocal Cord ◽  
Precise Knowledge ◽  
Human Cadavers ◽  
Superior Border

Precise knowledge of the level of the vocal fold as projected on the external thyroid cartilage is of critical importance for the performance of thyroplasty type I and supraglottic laryngectomy. Measurements of the external laryngeal framework were made on the larynges of 18 human cadavers in order to identify landmarks that will aid the surgeon in determining endolaryngeal anatomy. On the basis of our results, the following guidelines are recommended: (1) Thyroid cartilage incision for supra-glottic laryngectomy should be made on a line joining the juncture of the upper one third and lower two thirds of the midline length and the juncture of the upper one third and lower two thirds of the oblique line. This will ensure a position above the level of the anterior commissure and the true vocal cord; (2) In thyroplasty type I, the superior border of the thyroid cartilage window should be made at a line joining the midpoint of the midline length and the juncture of the upper two thirds and lower one third of the oblique line. Formation of the cartilage window according to this guideline will ensure its placement lateral to the vocalis muscle.

scholarly journals SURGICAL PREVENTION AND TREATMENT OF POSTOPERATIVE HYPOPARATHYROIDISM IN PATIENTS OPERATED ON THYROID GLAND

2020 ◽  
pp. 128-134
Author(s):  
A. Ya. Pasko
Keyword(s):  
Thyroid Gland ◽  
Blood Supply ◽  
Postoperative Period ◽  
Parathyroid Glands ◽  
Antioxidant Therapy ◽  
Fatty Tissue ◽  
Group I ◽  
Postoperative Hypoparathyroidism ◽  
Prevention And Treatment ◽  
Surgical Prevention

Abstract. Thyroid gland (TG) diseases are among the most common and occupy the second place in the structure of endocrine system diseases after diabetes mellitus. The main method of TG disease treatment remains the surgical one. With the increase in the incidence of various forms of TG pathology, the number of surgeries increases including the ones performed at non-specialized in-patient facilities leading to an increase in the frequency of postoperative complications. One of the most common specific complications after surgeries on TG is postoperative hypoparathyroidism (PHPT). It occupies a special place considering the severity of manifestations and the difficulty in prevention. It is usually caused by trauma or parathyroid glands (PTG) removal, their blood supply disturbance, as well as the development of fibrosis at the surgery site in the long term. Therefore, the improvement of existing technologies and the development of new approaches to surgeries in case of TG diseases are relevant today. The most common method of postoperative hypoparathyroidism (PHPT) surgical prevention is precision nature of surgical manipulations with careful adhering to tactical and technical requirements for the operator: identify parathyroid glands (PTG) timely, mobilize gently, and keep their blood supply. However, it is often impossible to keep PTG intact structurally and without ischemia due to the small sizes of PTG and their vessels, anatomical and embryological features of these organs localization, the consistency and color similarity with fatty tissue, lymph nodes. The objective of the research was to develop and evaluate the algorithm of prevention and treatment of postoperative hypoparathyroidism (PHPT) based on determining parathyroid glands (PTG) viability and the use of antihypoxant-antioxidant therapy in the postoperative period. The research was based on the results of a comprehensive examination and treatment of 60 patients who were operated for thyroid gland diseases. The patients underwent inpatient treatment at the surgical department of Ivano-Frankivsk Central City Clinical Hospital and Ivano-Frankivsk Regional Oncology Center from 2017 to 2020. We proposed an algorithm for surgical prevention and treatment of PHPT during thyroid gland surgeries which consisted in the following. We performed a visual assessment of PTG intraoperatively and evaluated each gland from 0 to 3 points according to the degree of its viability affection. If the gland was evaluated at 0-2 points, we left it, since there was a high probability of maintaining its function. If it was evaluated at 3 points, its autotransplantation was performed. Cytoflavin drug was applied in a dose of 10 ml per 200 0.9% NaCl intravenously once a day during 7 days in the postoperative period for the purpose of antihypoxant-antioxidant therapy. 2 groups of patients were formed in order to evaluate the effectiveness of the algorithm. Each group consisted of 30 people. Patients of Group I underwent surgery on thyroid gland according to generally accepted rules. Patients of Group II underwent interventions according to the above-mentioned algorithm. The use of our proposed algorithm (intraoperative assessment of PTG viability and antihypoxant-antioxidant therapy in the postoperative period) significantly reduces the frequency of permanent PHP justifying indications to its application.

scholarly journals From thyroid cartilage to thyroid gland

2015 ◽  
Author(s):  
Konstantinos Laios ◽  
Efstathia Lagiou ◽  
Vasiliki Konofaou ◽  
Maria Piagkou ◽  
Marianna Karamanou
Keyword(s):  
Thyroid Gland ◽  
Thyroid Cartilage

scholarly journals Anatomical landmarks of the external branch of the superior laryngeal nerve

2019 ◽  
Vol 12 (4) ◽  
pp. 161-177
Author(s):  
Viktor Y. Malyuga ◽  
Aleksandr A. Kuprin
Keyword(s):  
Thyroid Cartilage ◽  
Oblique Line ◽  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Constrictor Muscle ◽  
External Branch ◽  
Close Proximity ◽  
Inferior Pharyngeal Constrictor ◽  
Line Type

Background. The external branch of the superior laryngeal nerve innervates a cricothyroid muscle, which provides tension in vocal cords and formation of high-frequency sounds. When the nerve is damaged during surgery, patients may notice hoarseness, inability to utter high pitched sounds, “rapid fatigue” of the voice, and dysphagia. According to literature, paresis of an external branch of the superior laryngeal nerve reaches up to 58% after thyroid surgery. Aim: to identify permanent landmarks and topographic variations of the external branch of the superior laryngeal nerve. Materials and methods. The study is based on the autopsy material (21 complexes organs of the neck) and on identification of variations of 40 external branches of the superior laryngeal nerve. We identified two permanent landmarks that are located at the minimum distance from nerve and we made metrical calculations relative to them: oblique line of thyroid cartilage and tendinous arch of the inferior pharyngeal constrictor muscle. Results. The piercing point of the nerve is always located at the inferior pharyngeal constrictor muscle without protruding beyond the oblique line of thyroid cartilage superiorly and tendinous arch of the inferior pharyngeal constrictor muscle anteriorly. The nerve had the parallel direction in 92.8% of cases (angel less than 30 degrees) relative to the oblique line and in 85.7% cases it was in close proximity to this line (at distance up to 4 mm). The proposed topographic classification of the location of the external branch of the superior laryngeal nerve is based on localization of the piercing point of the nerve relative to the length of the oblique line of thyroid cartilage and the risk of nerve damage. In 14.2% of cases, the piercing point was in the front third of the line (type I), and in 50% it was in the middle third of this line (type II). These variations of the external branch of the superior laryngeal nerve was in close proximity to the upper pole of the thyroid gland, which could have lead to its damage during surgery. In type III and IV (35.8%) – the piercing point in the muscle was located as far as possible from the upper pole of the thyroid gland and the greater part of the nerve was covered with the fibers of inferior pharyngeal constrictor muscle. Conclusion. We identified the main orienteers for the search and proposed anatomical classification of the location of the external branch on the superior laryngeal nerve.

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