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GOITER

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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GOITER

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  1. GOITER

  2. 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

  3. 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

  4. Anatomy

  5. Physiology of thyroid gland T3 – triiodothyronine (thyronine) T4 – tetraiodothyronine (thyroxin) Thyrocalcitonin ( calcitonin )

  6. Physiology of thyroid gland Functions of thyroid hormones 1. Bone growth 2. CNS maturation 3. Beta-adrenergic effects

  7. Physiology of thyroid gland 1. Increase cardiac output 2. Increase basal metabolic rate 3. Increase glycogenolysis, gluconeogenesis, lipolysis

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

  9. Pathogenesis of diffuse nontoxic goiter • Iodine deficiency results in hypothyroidism • Increasing TSH causes hypertrophy of thyroid

  10. Pathogenesis of multinodular goiter • Follicles may become autonomous; certain follicles will have greater intrinsic growth and functional capability

  11. Pathogenesis of toxic multinodular goiter • Follicles continue to grow and function despite decreasing TSH

  12. Classification • Benign Nontoxic Conditions • Diffuse and Nodular Goiter • Benign Toxic Conditions • Toxic Multinodular Goiter • Graves’ Disease • Toxic Adenoma

  13. Classification • Sporadic goiter • Endemic goiter

  14. Classification • Hyperthyroid goiter • Euthyroid goiter • Hypothyroid goiter

  15. Clinical features enlargement compressive symptoms thyrotoxicosis

  16. 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

  17. Treatment • Suppressive Therapy • Antithyroid Medications • I-131 • Surgery

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