PRACTICE TRANSLATION AND PRACTICE FROM THE TRAILER VILLAGE
Please try to translate some of the following paragraphs to both review your knowledge and learn more vocabulary about thyroid surgery.
Instructions: Self-translate English into Vietnamese, then click on translate to display the translation and compare with your translation.
The thyroid gland is a single midline endocrine organ in the anterior neck responsible for thyroid hormone production which lies in the visceral space completely enveloped by the pretracheal fascia (middle-layer of the deep cervical fascia).
The thyroid is a solitary mid-line endocrine organ in the anterior neck that is responsible for the production of thyroid hormones, located in the visceral cavity completely surrounded by the anterior trachea (the middle layer of the deep neck.).
2. Gross anatomy – major anatomy
• The thyroid extends from c5 to t1 and lies anterior to the thyroid and cricoid cartilages of the larynx and the first five or six tracheal rings.
The thyroid gland extends from c5 to t1 and lies anterior to the thyroid cartilage, the laryngeal cartilage and the first five or six loops of tracheal cartilage.
• The thyroid is butterfly or “h” -shaped and is composed of two lobes, each with a superior and inferior pole. Usually, the superior pole is narrower than the inferior pole giving a pear-like shape to each lateral lobe. The lateral lobes are connected in the midline by a narrow isthmus which is adherent to the 2nd-4th tracheal rings. Each lobe measures approximately 4 cm in length. Average weight is 25 g; this is slightly higher in females and may increase during menstruation and pregnancy
The thyroid gland has a butterfly or “h” shape and is composed of two lobes, each with an upper and lower poles. Usually, the upper pole is narrower than the lower pole giving a pear-like appearance to each lateral lobe. The lateral lobes are joined in the midline by a strait, (female) attached to the 2nd to 4th tracheal cartilage rings. Each lobe is about 4 cm long. Average weight is 25 g; This weight is slightly higher in women and can increase during menstruation and pregnancy.
• The parathyroid glands lie posteromedially and are sometimes intracapsular.
The parathyroid glands lie behind the center and sometimes in the sac.
• The ligament of Berry is a posterior extension of the thyroid capsule which attaches to the cricoid cartilage and the upper tracheal rings. It encloses a short segment of the recurrent laryngeal nerve as it ascends in the tracheo-esophageal groove. As such it is an important surgical landmark during thyroidectomies to avoid damaging the nerve.
Berry ligament is a posterior extension of the sheath attached to the ring cartilage and the upper tracheal cartilage rings. It surrounds a short segment of the laryngeal nerve that reverses as it travels up into the tracheal-esophageal furrow. Therefore, this is an important surgical milestone in the thyroidectomy to avoid nerve damage.
3. Relations (related)
• Anteriorly: strap muscles / infrahyoid muscles
Front: suspenders / muscles below the nail
• Posteriorly: thyroid cartilage, cricoid cartilage, trachea
Post: thyroid cartilage, ring cartilage, trachea
• Posteromedially: tracheo-esophageal groove (containing lymph nodes, recurrent laryngeal nerve, parathyroid glands)
Middle posterior: trachea-esophageal furrow (contains lymph nodes, inverted laryngeal nerve, parathyroid glands)
• Posterolaterally: carotid space
Rear side: scene compartment
4. Arterial supply – the artery
• Superior thyroid artery (from the external carotid artery)
Upper thyroid artery (from the external carotid artery)
• Inferior thyroid artery (from the thyrocervical trunk)
Lower thyroid artery (from the cervical body of the inferior artery)
• If the inferior thyroid artery arises from the subclavian artery it is referred to as an accessory inferior thyroid artery
If the lower thyroid artery separates from the subclavic artery, it is called the subarachnoid artery
5. Venous drainage – intravenous drainage
• Superior thyroid vein (drains to the internal jugular vein)
Upper thyroid vein (drains to the inner carotid vein)
• Middle thyroid vein (drains to the internal jugular vein)
Median veins (drains to the inner carotid vein)
• Inferior thyroid vein (drains via plexus to the brachiocephalic vein)
Lower thyroid vein (drains through the plexus to the first arm vein)
6. Lymphatic drainage – lymph drainage
Lymphatic drainage is multidirectional and initial lymph drainage is to perithyroid lymph nodes then onto prelaryngeal, pretracheal and paratracheal nodes (level 6 lymph nodes).
Lymph drainage is omnidirectional (multidirectional) and lymph drainage is initially to parathyroid glands, then to the anterior laryngeal, tracheal, and tracheal nodes (group 6).
7. Innervation – nerve dominant
Sympathetic supply is provided by superior, middle and inferior cervical ganglia.
Sympathetic domination is provided by the upper, mid, and lower cervical lymph nodes.
8. Variant anatomy – anatomical variation
• Lobar hemiagenesis
1 lobe thyroid gland
• Pyramidal lobe
Superiorly-projecting thyroid tissue from the isthmus
The thyroid tissue protrudes (convex) upwards from the waistline
• Thyroglossal duct cyst
• Ectopic thyroid tissue
The thyroid is out of place
Thyroid at the base of the tongue
• Zuckerkandl’s tubercle: the projections of normal thyroid tissue from the posterior or posteromedial margin of the thyroid gland that extend posterior to the tracheoesophageal groove
Zuckerkandl’s tubercle: protrusion of normal (protruding) thyroid tissue from the posterior or medial margins of the thyroid gland extending backwards to the airway-esophagus)
• The gland may be supplied by a thyroidea ima artery, which may replace the inferior thyroid artery (3%)
The gland can be supplied by the medial thyroid artery, which can replace the lower thyroid artery (3%).
The thyroidea ima artery is an uncommon variant of the blood supply to the inferior aspect of the thyroid gland. It is often associated with absent inferior thyroid arteries. It is reported in ~ 7.5% (range 1.5-12.2%) of individuals and can arise from:
The medial thyroid artery is an uncommon variant of the blood supply to the lower part of the thyroid gland. It is often related to the absence of the lower thyroid arteries. It is reported that around ~ 7.5% (between 1.5-12.2%) individuals and can be derived from:
Brachiocephalic trunk (most common: 1.9-6.0%)
first arm torso (most common: 1.9-6.0%)
Right common carotid artery
right common carotid artery
Internal thoracic artery
inner chest artery
BS. Vo Thi Thanh Huong
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Reference source: https://radiopaedia.org/articles/thyroid-gland?lang=us