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Summer 2014 - High Resolution ✔️ > Thyroid & Parathyroid Glands > Flashcards

Thyroid & Parathyroid Glands Flashcards

(111 cards)

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0
Q

what is the thyroid’ job

A

maintains metabolism, growth, and development

synthesizes, stores, and secretes hormones through tissue/blood not ducts

function - control BMR (basil metabolic rate)

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1
Q

the thyroid/parathyroid are in what system of the body

A

largest endocrine gland in the body

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2
Q

the thyroid is located in the ___________ neck at the level of the thyroid cartilage

A

anteroinferior

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3
Q

how many lobes does the thyroid have

A

2 - left and right

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4
Q

what connects the 2 lobes of the thyroid

A

the isthmus

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5
Q

the thyroid straddles the ________ anteriorly

A

trachea

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6
Q

the thyroid is bounded laterally by the _______ arteries and _______ veins

A

carotid arteries

jugular veins

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7
Q

_______ _______ arises from the isthmus

A

pyramidal lobe

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8
Q

the thyroid develops prenatally in the _____ week

A

3rd

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9
Q

_________ duct connects thyroid to the tongue

A

thyroglossal

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10
Q

thyroglossal duct atrophies by the _____ week

A

8th

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11
Q

if thyroglossal duct persists what might form

A

cyts, fistulas, accessory pyramidal lobe** (15-30%)

extends superiorly from isthmus

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12
Q

can be considered ______ tissue

A

ectopic

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13
Q

what is the shape of the thyroid

A

U or H shape

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14
Q

thryroid varies with what 3 things

A

age, gender, and body surface

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15
Q

what lobe is usually larger, right or left

A

right lobe

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16
Q

do females or males have larger thyroids

A

females

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17
Q

lobes = ______

A

size

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18
Q

what is the normal size of an adult thyroid

A

4-6 cm long x 1.3-1.8 cm AP x 1.5-2 cm wide

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19
Q

what is the normal size of the isthmus

A

2-6 mm

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20
Q

what is anterior to the thyroid

A

strap muscles

sternocleidomastoid muscle

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21
Q

what is posterolateral to the thyroid

important

A

CCA
IJV
longus colli muscle

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22
Q

what is medial to the thyroid

A

larynx
trachea
esophagus

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23
Q

what are the 3 strap muscles

A

sternohyoid
omohyoid
sternothyroid

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24
the thyroid is _____ vascular
highly
25
2 _____ _____ arteries from ECA descend to upper poles
superior thyroid
26
2 ______ ______ arteries from subclavian and ascend to lower poles
inferior thyroid
27
corresponding veins drain into the ______ vein
IJV (internal jugular vein)
28
what is the first branch off the ECA
superior thyroid
29
______ is processed by follicular cells to manufacture, store, and secrete thyroid hormones
iodine
30
the thyroid gland traps iodine from _____ and through a series of _____ reactions
blood chemical
31
trapping iodine produces which thyroid homones
T3 (triiodothyronine) and T4 (thyroxine)
32
when thyroid hormone is needs by the body, it is released into the bloodstream by action of thyrotropin, or ______-______ hormone, produced by pituitary gland
thyroid - stimulating hormone (TSH)
33
_______ decreases concentration of calcium in blood by first acting on bone to inhibit its breakdown
calcitonin
34
calcitonin helps to maintain what
homeostasis of blood calcium secreted by C-cells or parafollicular cells
35
what is the most potent hormone
T3 - triiodothyronine 10%
36
thyroid produces 90% of which hormone
T4 - thyroxine
37
hormones are stored in the _____
colloid
38
the pituitary produces what hormone
TSH
39
secreation of TSH is controlled by what....what produces with hormone
TRH hypothalmus
40
what is euthyroid
the correct amount of hormone production
41
what is hyperthyroidism
increased amount of hormone production
42
what is hypothyroidism
decreased amount of hormone production
43
describe hypothyroidism
``` undersecretion of hormones low intake of iodine inability of thyroid to produce thyroid hormones chronic autoimmune thyroiditis pituitary gland or hypothalamus disease ```
44
some clinical signs of hypothyroidism
``` weight gain hair loss increased tissue around eyes lethargy cold intolerance dry skin bradycardia ```
45
sonographic appearance of hypothyroidism
``` diffusely abnormal decreased heterogeneous echogenicity normal enlarged with irregular surface small calcifications ```
46
describe hyperthyroidism
oversecretion of thyroid hormones entire gland out of control Graves' disease toxic adenomas
47
clinical signs of hyperthyroidism
``` dramatic increase in metabolic rate weight loss with increased appetite nervous energy tremors excessive sweating tachycardia exopthalmos - bulging eyes & retraction of eyelids ```
48
sonographic appearance of hyperthyroidism
normal sized or enlarged gland inhomogeneous hypervascularity - key sign for Graves' disease
49
describe thyroid functioning tests
nuc med | blood tests to measure T3 & T4
50
describe "hot" nodules on nuc med tests
hyperfunctioning nodule | 5-10% of all nodules - usually benign
51
describe "cold" nodules on nud med tests
nonfunctioning | 80-85% of all nodules - 10-15% of these are malignant
52
what is an important part to do before scanning the thyroid
get patient's history
53
how should a patient lay for a thyroid scan
supine positioning with pillow under shoulders for hyperextension of neck
54
what tranducer is used to scan a thyroid
high frequency linear
55
each lobe is imaged in ______ and ______ planes make sure you also image the ______
long and trans isthmus
56
transverse sono landmarks
CCA IJV trachea
57
Longitudinal sono landmarks
should extend lateral to include region of CCA
58
the thyroid has what kind of echotexture
fine homogeneous
59
vessels will be seen as ______ tubular structures
anechoic
60
muscles with appear as _______
hypoechoic
61
what should be documented during a thyroid scan
define texture (solid, cystic, or complex) single/multiple location evaluate adjacent lymph adenopathy
62
US is also used for _________ procedures of the thyroid
interventional
63
what is the most common cause of thyroid disorders world wide
iodine deficiency
64
what does iodine deficiency lead to
goiter formation hypothyroidism
65
_________ processes responsible where iodine is not deficent
autoimmune
66
autoimmune processes can lead to what
hypothyroidism hyperthroidism
67
describe a goiter
``` diffused enlargement of thyroid peak age 35-50 yrs females 3:1 80% is caused by hyperplasia of the gland hampers hormone secretion may become very large endemic goiter ```
68
what are the types of goiters
nodular hyperplasia multinodular goiter adenomatous hyperplasia simple/non-toxic - no functional disturbance/happens in puberty multinodular/toxic - increased/decreased function
69
causes of goiters
``` iodine deficiency thyroid hormone deficiency Graves' disease thyroiditis neoplasm cyst ```
70
describe non-toxic (simple) goiter
diffuse uniform enlargement iodine deficiency dietary shortage or gland malfunction may lag behind = hypothyroidism
71
describe toxic multinodular goiter
``` may be spontaneous may be end stage of simple goiter enlarged heterogeneous focal scarring, ischemia, necrosis, cyst formation, calcifications asymmetry ```
72
describe Graves' disease
female > 30 autoimmune most frequent cause of hyperthyroidism
73
what is the Graves' disease triad
triad - diffuse toxic goiter, exopthalmos, dermis thickening
74
Graves' disease sonographically
hypoechoic diffuse homogeneous enlargement increased color flow
75
what is the to go word for Graves' disease **important**
"thyroid inferno" due to increased color flow
76
describe thyroiditis
swelling and tenderness | infection or autoimmune
77
what are the 2 types of thyroiditis
De Quervain's - viral infection Hashimoto's - destructive autoimmune disorder
78
describe De Quervain's
``` subacute granulomatous thyroiditis fever enlarged gland pain on palpation pain may radiate to ear or jaw ```
79
describe Hashimoto's
``` chronic autoimmune lymphocytic painless onset diffusely enlarged gland young to middle aged females heterogeneous as progresses & tenderness eventual severe gland damage = hypothyroidism - MOST COMMON ```
80
Hashimoto's sonographically
``` hypoechoic coarse homogeneous thickened fibrous strands - chronic sign increased color flow - in acute stage over time - fibrotic, ill defined, heterogeneous increased risk for malignancy ```
81
what is the most common cause for US
palpable nodule
82
what is degeneration of follicular adenoma, may have debris
cysts
83
what are neoplasmic, complete fibrous encapsulation, females > males, many appearances commonly have peripheral halo, may cause hyperfunction
adenoma
84
describe cysts
10-15% of solitary nodules common - colloid or degeneration or necrosis of adenomatous nodules benign if < 4 cm
85
describe an adenoma
``` true benign neoplasm encapsulated solitary well defined females 7:1 most common thyroid neoplasm "cold" nuc med nodule ```
86
types of adenomas
``` embryonal fetal colloid follifular hyperplasic ```
87
describe carcinoma of the thyroid
rare most common 40-60 yrs risk of malignancy decreases with multiple nodules sonographically - variable **calcifications present 50-80% of all types female 2:1 suspicious if single nodule seen & under 14 or over 65 yrs
88
describe papillary carcinoma
``` MOST COMMON - 75-90% 3rd & 7th decade of life female predominant thyroid cancer in children 25 % laminate calcifications 20% metastatic cervical adenopathy least aggressive ```
89
papillary carcinoma sonographically
hypoechoic microcalcifications 90% hypervascularity 90% cervical lymph node metastasis 20%
90
describe follicular carcinoma
MORE AGGRESSIVE than papillary females solid nodule metastases to lung, bone, and other distant sites
91
follicular carcinoma sonographically
irregular firm nodular enlargement
92
describe medullary carcinoma
5% thyroid cancers | hard bulky mass, enlargement
93
medullary carcinoma sonographically
bright echogenic foci within solid mass
94
what is medullary carcinoma associated with
elevated serum calcitonin multiple endocrine neoplasm (MEN) type II
95
describe anaplastic carcinoma
rare occurs after 50 MOST LETHAL hard fixed mass with rapid growth invades neck structures, causing death by compression & asphyxiation 6 mos - 1 yr lift expectancy
96
describe lymphoma
``` primarily non-hodgkin's type older females < 4% of all thyroid malignancies rapidly growing neck mass preexisting chronic lymphocytic thyroiditis - Hashimoto's ```
97
lymphoma sonographically
nonvascular hypoechoic mass | adjacent thyroid heterogeneous
98
what is the parathyroid anatomy
4 paired glands - (3-5) not uncommon 2 posterior superior poles, 2 posterior inferior poles may be in neck/mediastinum flat and disc shaped
99
parathyroid sonographic findings
``` not usually seen isoechoic to thyroid normal < 4 mm > 5 mm is enlarged, hypoechoic elongated masses between posterior longus colli & anterior thyroid ```
100
parathyroid physiology
calcium-sensing organs produces PTH (parathyroid hormone) when serum calcium decreased, PTH increased PTH acts on bone, kidney, & intestine to enhance calcium absorption unexplained hypercalcemia = US
101
describe primary hyperparathyroidism
increased function of the parathyroid glands females increased PTH from an adenoma, hyperplasia, or carcinoma primary hyperplasia - hyperfunction with no apparent cause
102
describe secondary hyperparathyroidism
chronic hypocalcemia from renal failure, vit D def, malabsorption syndromes compensatory reaction leads to PTH stimulation includes all 4 glands primary hyperplasia - parathyroid
103
describe parathyroid adenoma
MOST COMMON cause of primary hyperparathyroidism 80% can not discern adenoma from cancer
104
parathyroid adenoma sonographically
hypoechoic solid encapulated discrete borders
105
neck masses: describe thyroglossal duct cyst
CONGENITAL anomaly midline & anterior to trachea remnant of tubular development oval or spherical masses rarely larger than 2-3 cm
106
thyroglossal duct cyst sonographically
cystic mass anterior to trachea
107
neck masses: describe branchial cleft cysts
remnant of embryologic development tract from pharyngeal cavity to auricle results in cystic formation lateral to thyroid gland may present with solid components, especially if infected
108
neck masses: describe abcesses
can be anywhere in neck wide range of appearances MOST COMMON low level echogenicity and irregular walls
109
describe adenopathy
``` shape of node should be oval homogeneous with central core echo complex more round - ? malignancy echo free node - ? inflammatory process fine needle aspiration to confirm ```
110
describe abn lymph nodes
``` loss of fatty hilum irregular margins cystic areas of degeneration calcifications round > 7 mm width or AP ```

Summer 2014 - High Resolution ✔️ (7 decks)

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