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Functional Anatomy of the Thyroid & Parathyroid Glands Innervation of the Pharynx & Larynx Dr James Peerless June 2011.

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Presentation on theme: "Functional Anatomy of the Thyroid & Parathyroid Glands Innervation of the Pharynx & Larynx Dr James Peerless June 2011."— Presentation transcript:

1 Functional Anatomy of the Thyroid & Parathyroid Glands Innervation of the Pharynx & Larynx Dr James Peerless June 2011

2 Objectives The Thyroid Gland – Anatomy – Endocrine function The Parathyroid Gland – Anatomy – Ca 2+ metabolism Pharynx & Larynx – Innervation

3 The Thyroid Gland Largest endocrine gland in the body Origin – Originates from the floor of pharynx – Thyroglossal duct sometimes persists in adults

4 The Thyroid Gland Relations – Deep to sternothyroid and sternohyoid muscles – Level of C5 –T1 – Bilobular; joined by the isthmus – Anterolateral to the larynx and trachea (2 nd & 3 rd rings) – Bound by a loose connective tissue capsule which is anchored to the cricoid cartilage and tracheal rings

5 Highly vascular Supplied by superior and inferior thyroid arteries Drainage via superior, middle and inferior thyroid veins

6 The Thyroid Gland Nerve Supply – Derived from superior, middle and inferior cervical sympathetic ganglia (from the sympathetic trunk) – Fibres are vasomotor – No secretomotor parasympathetic innervation: the gland is hormonally regulated

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8 Functional Anatomy of Thyroid Follicular structure lined by epithelial cells – Alter shape depending on amount of activity – Contain colloid Parafollicular ‘C’ cells – Secrete calcitonin

9 Thyroglobulin Colloid Follicular Cells Parafollicular Cells

10 Thyroid Hormone Synthesis

11 The Parathyroid Glands Four disc-like glands, embedded in the thyroid gland (dorsal surface) Contain two cell types: Chief cells producing PTH Oxyphil cells: function unknown

12 Sites of aberrant parathyroid glandular tissue

13 Parathyroid Hormone Polypeptide produced in the chief cells Preprohormone  Prehormone  PTH Increases Ca 2+ via three main actions: – Resorption – Reabsorption – Absorption

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15 The Pharynx

16 Nerve Supply Pharyngeal plexus provides motor and most of sensory – Motor: All muscles – fibres from nucleus ambiguus of the accessory nerve carried via the vagus nerve Stylopharyngeus – CN IX Tensor veli palatini - CN V 3 Lower pharynx also receives some motor fibres from recurrent laryngeal nerve – Sensory: Glossopharyngeal (CN IX) – most of mucosa Maxillary (CN V 2 ) – anterior nasopharynx Vagus (CN X) – Branches from the cervical sympathetic chain

17 The Larynx Muscles (6+3) – Intrinsic Cricothyroid Posterior cricoarytenoid Lateral cricoarytenoid Transverse arytenoid Aryepiglottic Thyroarytenoid – All paired except the tranverse arytenoid – Extrinsic Sternothyroid Thyrohyoid Inferior Constrictor

18 The Larynx Innervation – Mucous membranes Above cords: internal laryngeal nerve Below cords: recurrent laryngeal nerve – Muscles of the larynx Cricothyroid: superior/external laryngeal nerve All others: recurrent laryngeal nerve

19 Objectives The Thyroid Gland – Anatomy – Endocrine function The Parathyroid Gland – Anatomy – Ca 2+ metabolism Pharynx & Larynx – Innervation

20 Questions

21 Reference Smith T, Pinnock C, Lin T (2009). Fundamentals of Anaesthesia, 3 rd Edition. Cambridge: Cambridge University Press Moore K, Dalley A (1999). Clinically Oriented Anatomy, 4 th Edition. Philadelphia: Lippincott Williams & Wilkins


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