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Presentation on theme: "GOITER."— Presentation transcript:


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 Benign Toxic 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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