This document provides an overview of the clinical examination of the thyroid gland. It discusses the surgical anatomy, development, blood supply, nerve supply, physiology and investigations of the thyroid gland. It then outlines the process of gathering equipment, taking a patient history, and performing a physical examination including inspection, palpation, percussion and auscultation of the thyroid. The examination aims to determine if the swelling is benign or malignant, localized or diffuse, mobile or fixed, and assess for any pressure effects or toxic manifestations. Differential diagnoses are also considered.
The document provides information about examining the thyroid gland, including:
1) The anatomy, physiology, common conditions like goiter, and presenting complaints are outlined.
2) The examination involves inspection of the neck, hands, eyes, and face, as well as palpation of the thyroid gland and lymph nodes, percussion of the sternum, and auscultation of the thyroid.
3) Special tests like assessing reflexes and proximal muscle strength are also described. A checklist is provided to ensure all relevant assessment steps are completed systematically.
- Thyroid approach regarding history and physical examination mainly from BROWSE.
- Done by: Dr. Anas Aljundi ( Medical school at Al-Quds University ).
Gas Under Diaphragm - Final Year MB BS LectureMr Adeel Abbas
This document discusses gas found under the diaphragm on chest x-rays. It notes that gas in this location is not always dangerous, as it can sometimes be present physiologically in the stomach or large intestine. However, if enteric contents are also leaking, this indicates a perforation which can be deadly. The document lists some potential causes of free air under the diaphragm and notes that upright chest x-rays are best for detecting it. Management principles include resuscitation, cleaning the peritoneal cavity, and repairing or diverting any perforation.
Goiter refers to an enlargement of the thyroid gland. It can be caused by various factors including iodine deficiency, autoimmune thyroid conditions, drugs, radiation exposure, and unusual dietary habits. Goiters are classified as toxic or non-toxic and can be diffuse, multinodular, or nodular. Clinical examination involves inspection of the neck to evaluate size, shape, surface, borders, and movement with swallowing. Palpation is used to assess temperature, consistency, mobility, and presence of thyroid toxicity. Investigations may include blood tests, imaging, and fine needle aspiration biopsy to diagnose the cause of the goiter. Treatment options depend on the underlying pathology but may involve surgery, medication, or radioactive
This document discusses obstructive jaundice, including a case study of an 82-year-old male patient presenting with progressive jaundice, itching, weight loss, and other symptoms. It reviews the causes, pathophysiology, investigations, and management of obstructive jaundice. Common causes include gallstones, pancreatic cancer, and cholangiocarcinoma. Investigations may include blood tests, ultrasound, CT, MRCP, and ERCP. Management depends on the underlying cause but may involve surgical procedures like cholecystectomy, Whipple procedure, or stenting to relieve the obstruction.
This document outlines a seminar on gall bladder and biliary pathologies. It begins with an overview of gall bladder anatomy and functions. It then discusses common pathologies like cholelithiasis, cholecystitis, cholangitis, and sclerosing cholangitis. Congenital abnormalities like biliary atresia and choledochal cyst are described. Finally, it covers tumors of the bile duct, distinguishing between benign and malignant types.
This presentation gives general overview about different aspects of PILONIDAL DISEASE including pathophysiology, etiology, clinical Presentation, different treatment options available etc
The document provides information about examining the thyroid gland, including:
1) The anatomy, physiology, common conditions like goiter, and presenting complaints are outlined.
2) The examination involves inspection of the neck, hands, eyes, and face, as well as palpation of the thyroid gland and lymph nodes, percussion of the sternum, and auscultation of the thyroid.
3) Special tests like assessing reflexes and proximal muscle strength are also described. A checklist is provided to ensure all relevant assessment steps are completed systematically.
- Thyroid approach regarding history and physical examination mainly from BROWSE.
- Done by: Dr. Anas Aljundi ( Medical school at Al-Quds University ).
Gas Under Diaphragm - Final Year MB BS LectureMr Adeel Abbas
This document discusses gas found under the diaphragm on chest x-rays. It notes that gas in this location is not always dangerous, as it can sometimes be present physiologically in the stomach or large intestine. However, if enteric contents are also leaking, this indicates a perforation which can be deadly. The document lists some potential causes of free air under the diaphragm and notes that upright chest x-rays are best for detecting it. Management principles include resuscitation, cleaning the peritoneal cavity, and repairing or diverting any perforation.
Goiter refers to an enlargement of the thyroid gland. It can be caused by various factors including iodine deficiency, autoimmune thyroid conditions, drugs, radiation exposure, and unusual dietary habits. Goiters are classified as toxic or non-toxic and can be diffuse, multinodular, or nodular. Clinical examination involves inspection of the neck to evaluate size, shape, surface, borders, and movement with swallowing. Palpation is used to assess temperature, consistency, mobility, and presence of thyroid toxicity. Investigations may include blood tests, imaging, and fine needle aspiration biopsy to diagnose the cause of the goiter. Treatment options depend on the underlying pathology but may involve surgery, medication, or radioactive
This document discusses obstructive jaundice, including a case study of an 82-year-old male patient presenting with progressive jaundice, itching, weight loss, and other symptoms. It reviews the causes, pathophysiology, investigations, and management of obstructive jaundice. Common causes include gallstones, pancreatic cancer, and cholangiocarcinoma. Investigations may include blood tests, ultrasound, CT, MRCP, and ERCP. Management depends on the underlying cause but may involve surgical procedures like cholecystectomy, Whipple procedure, or stenting to relieve the obstruction.
This document outlines a seminar on gall bladder and biliary pathologies. It begins with an overview of gall bladder anatomy and functions. It then discusses common pathologies like cholelithiasis, cholecystitis, cholangitis, and sclerosing cholangitis. Congenital abnormalities like biliary atresia and choledochal cyst are described. Finally, it covers tumors of the bile duct, distinguishing between benign and malignant types.
This presentation gives general overview about different aspects of PILONIDAL DISEASE including pathophysiology, etiology, clinical Presentation, different treatment options available etc
The document discusses thyroidectomy, including:
- Types of thyroidectomy such as hemithyroidectomy, subtotal thyroidectomy, and total thyroidectomy.
- Surgical anatomy of the thyroid gland and related structures like the recurrent laryngeal nerve.
- Preoperative preparation, the surgical procedure, and postoperative management of complications like hemorrhage and recurrent laryngeal nerve injury.
1. Acute appendicitis is caused by obstruction of the appendix lumen, leading to increased intraluminal pressure, edema, and bacterial invasion.
2. The classic presentation includes initially vague periumbilical pain that later localizes to the right lower quadrant, accompanied by anorexia, nausea, and low-grade fever.
3. On examination, tenderness is elicited over McBurney's point with guarding and rebound tenderness. Diagnosis is suggested by clinical scoring systems and confirmed by ultrasound or CT scan showing a thick-walled, inflamed appendix.
This document discusses various branchial remnants and their characteristics. It describes:
- First branchial cleft cysts which can be parallel to the external auditory canal or connect to the malleus or incus.
- Second branchial cleft cysts, the most common type, which present as painless neck masses behind the sternocleidomastoid muscle.
- Preauricular pits and sinuses which can lead to interconnected cysts in front of the tragus.
- Skin tags which are usually benign but may be associated with other conditions.
- Branchial fistulas which have openings in the tonsillar fossa.
- Surgical excision is usually required to treat infected or
Made by Ranjith R Thampi. A surgery powerpoint I made during internship for Management of Varicose Veins. Tried to cover as much as possible on the topic. Kindly comment before you download. Thanks!
This document provides information on umbilical, paraumbilical, and incisional hernias. It discusses the anatomy, classification, features, and treatment options for each type of hernia. Umbilical hernias are common in newborns and infants and can be congenital or acquired. Paraumbilical hernias typically present as swellings in adults, especially females. Incisional hernias occur through weak surgical scars from prior abdominal operations. All three types are generally treated with surgical repair or mesh placement, depending on hernia size and characteristics.
The document discusses an integrated approach to diagnosing splenomegaly. It begins by defining splenomegaly and examining the spleen. A step-wise approach is then outlined involving taking a thorough history, conducting a physical exam, ordering lab and imaging tests, and performing specialized testing to investigate for possible etiologies of splenomegaly such as infection, infiltration, congestion, and hyperplasia. The goal is to determine the underlying cause and provide appropriate treatment.
1) Solitary thyroid nodules are common and usually detected by palpation or ultrasound. Evaluation is needed to rule out malignancy given the risk of cancer in solitary nodules.
2) Ultrasound and fine needle aspiration biopsy are important diagnostic tools, with ultrasound assessing features suggestive of malignancy and FNAB providing cytology results.
3) Treatment depends on FNAB and risk factor results, ranging from observation for benign nodules to surgery for malignant or suspicious nodules. Surgery type depends on cancer risk and includes lobectomy or total thyroidectomy.
Thyroid Examination - General Surgery Sana Rasheed
The document provides instructions for examining the thyroid gland. It begins with introducing oneself to the patient and obtaining consent. It describes the anatomy of the thyroid gland and its location. The examination involves inspection of the thyroid from the front and back while palpating and feeling for nodules or irregularities. Signs of hyperthyroidism like eye signs, tremors, and moist skin are also checked. The examination is concluded by checking reflexes and the heart before thanking the patient.
1. The document discusses various potential causes of a mass in the right iliac fossa, including appendicitis, appendicular abscess, carcinoid tumors of the appendix, mucoceles, adenocarcinoma, tuberculosis, Crohn's disease, carcinoma of the caecum, actinomycosis, amoebiasis, mesenteric cysts, intussusception, iliopsoas abscess, retroperitoneal tumors, aneurysms, and more rare causes.
2. Diagnostic tools mentioned include ultrasound, CT, colonoscopy, and biopsy. Treatment depends on the underlying cause but may include antibiotics, surgery, chemotherapy, and ATT.
3
This document provides information on various surgical specimens including:
- A specimen of an inflamed appendix showing characteristics of appendicitis.
- Specimens of gallstones found in the gallbladder and risk factors for gallstone formation.
- A specimen of a hydatid cyst found in the liver as well as details on the lifecycle and characteristics of the Echinococcus parasite.
- A specimen of Meckel's diverticulum arising from the ileum and details on types of intestinal diverticula.
- A specimen showing an ileoileal intussusception in the small intestine.
Hematuria, or blood in the urine, can be caused by diseases of the urinary system or other systemic disorders. It is classified as microscopic or gross based on visibility, and as early, terminal, or diffuse based on timing during urination. Common causes include glomerular diseases, infections, cancers, trauma, and stones. Diagnosis involves urinalysis, microscopy, imaging, and sometimes kidney biopsy. Treatment focuses on the underlying condition causing the hematuria. Prognosis depends on associated clinical or laboratory abnormalities, with isolated microscopic hematuria generally having a good prognosis.
Fournier's gangrene is a necrotizing fasciitis of the genital region that is usually polymicrobial in nature. It is more common in males ages 30-60 and risk factors include diabetes, alcoholism, malignancy, and immunosuppression. The infection spreads rapidly in fascial planes due to bacterial enzymes and can cause tissue death. Treatment involves aggressive surgical debridement and broad spectrum antibiotics. Complications can include organ failure, shock, and death if not treated promptly.
approach to a patient with thyroid swelling (EMCH)Al Tarique
The document provides information on evaluating and treating a patient presenting with a thyroid swelling:
- It describes the anatomy and histology of the thyroid gland and differential diagnoses for anterior midline neck swellings. Common causes of thyroid swelling include diffuse goiter, multinodular goiter, and solitary nodules.
- Evaluation involves taking a medical history, examining the swelling, and performing tests like ultrasound and thyroid function tests. Physical exam assesses features of the swelling and checks for signs of hyperthyroidism or hypothyroidism.
- Treatment depends on the underlying cause but may include medications, radioactive iodine therapy, or surgery to manage conditions like toxic multinodular goiter, thyroid
This document discusses the management of appendicular lumps. It notes that appendicular lumps are inflammatory tumors consisting of the inflamed appendix and surrounding tissues. Treatment options include emergency surgery, conservative management followed by interval surgery, or totally conservative management without interval surgery. Conservative treatment is associated with a risk of missing hidden pathologies. Emergency surgery carries a high risk of complications while interval surgery risks appendicular abscess or perforation during the waiting period. Randomized controlled trials have found that conservative treatment without interval surgery appears to be the best approach for appendicular masses and abscesses. The document examines factors to consider in decision making and presents cases studies from a tertiary care center.
This document provides information on the management of inguinal hernias. It discusses the historical development of hernia repair techniques from the 15th century to modern methods. Investigation methods such as ultrasound, CT, MRI, and herniography are outlined. Surgical techniques for hernia repair including herniotomy, herniorrhaphy, hernioplasty, and laparoscopic repair are described in detail. Post-operative complications of open and laparoscopic hernia repair are also reviewed. The conclusion states that laparoscopic and Lichtenstein open mesh repairs have good long-term results and low recurrence rates compared to other open hernia repair techniques.
This document discusses various energy sources used in surgery including radiofrequency electro-surgery, ultrasonic energy systems, lasers, and argon beam coagulation. It provides details on how each system generates energy and its corresponding tissue effects. Monopolar and bipolar electro-surgery are compared in terms of advantages and disadvantages. Harmonic scalpels are noted to have reduced thermal spread and overall procedure time compared to other devices. Risks such as burns and device interference are also reviewed.
The document outlines the steps for examining the thyroid gland which includes inspection of the hands, pulse, eyes, face and thyroid as well as palpation. Inspection evaluates features like dry skin, sweating, tremors and examines the eyes, face and thyroid for signs like exopthalmos, lid lag and masses. Palpation assesses the thyroid gland for size, symmetry, consistency and thrills. Additional tests like thyroid function tests, FNAC and imaging may also be used.
The document provides an overview of the surgical anatomy, development, blood supply, lymphatic drainage, and examination of the thyroid gland. It discusses the thyroid gland's location in the lower neck, its lobes and isthmus, and that each lobule contains follicles. It also reviews aspects of examining a patient such as gathering demographic details, symptoms, and performing physical exams including inspection, palpation, percussion, and auscultation of the thyroid. Common investigations and treatments are also summarized.
Surgical management of benign multinodular goitreCHRIS ALUMONA
According to the WHO about 200 million people are living with goitres worldwide. Of the benign cases, endemic goitres make up the bulk in iodine deficiency belts. Goitres may be simple or toxic. The aetiopathogenesis and surgical management of this condition is detailed in a practical sense in this presentation.
The document discusses thyroidectomy, including:
- Types of thyroidectomy such as hemithyroidectomy, subtotal thyroidectomy, and total thyroidectomy.
- Surgical anatomy of the thyroid gland and related structures like the recurrent laryngeal nerve.
- Preoperative preparation, the surgical procedure, and postoperative management of complications like hemorrhage and recurrent laryngeal nerve injury.
1. Acute appendicitis is caused by obstruction of the appendix lumen, leading to increased intraluminal pressure, edema, and bacterial invasion.
2. The classic presentation includes initially vague periumbilical pain that later localizes to the right lower quadrant, accompanied by anorexia, nausea, and low-grade fever.
3. On examination, tenderness is elicited over McBurney's point with guarding and rebound tenderness. Diagnosis is suggested by clinical scoring systems and confirmed by ultrasound or CT scan showing a thick-walled, inflamed appendix.
This document discusses various branchial remnants and their characteristics. It describes:
- First branchial cleft cysts which can be parallel to the external auditory canal or connect to the malleus or incus.
- Second branchial cleft cysts, the most common type, which present as painless neck masses behind the sternocleidomastoid muscle.
- Preauricular pits and sinuses which can lead to interconnected cysts in front of the tragus.
- Skin tags which are usually benign but may be associated with other conditions.
- Branchial fistulas which have openings in the tonsillar fossa.
- Surgical excision is usually required to treat infected or
Made by Ranjith R Thampi. A surgery powerpoint I made during internship for Management of Varicose Veins. Tried to cover as much as possible on the topic. Kindly comment before you download. Thanks!
This document provides information on umbilical, paraumbilical, and incisional hernias. It discusses the anatomy, classification, features, and treatment options for each type of hernia. Umbilical hernias are common in newborns and infants and can be congenital or acquired. Paraumbilical hernias typically present as swellings in adults, especially females. Incisional hernias occur through weak surgical scars from prior abdominal operations. All three types are generally treated with surgical repair or mesh placement, depending on hernia size and characteristics.
The document discusses an integrated approach to diagnosing splenomegaly. It begins by defining splenomegaly and examining the spleen. A step-wise approach is then outlined involving taking a thorough history, conducting a physical exam, ordering lab and imaging tests, and performing specialized testing to investigate for possible etiologies of splenomegaly such as infection, infiltration, congestion, and hyperplasia. The goal is to determine the underlying cause and provide appropriate treatment.
1) Solitary thyroid nodules are common and usually detected by palpation or ultrasound. Evaluation is needed to rule out malignancy given the risk of cancer in solitary nodules.
2) Ultrasound and fine needle aspiration biopsy are important diagnostic tools, with ultrasound assessing features suggestive of malignancy and FNAB providing cytology results.
3) Treatment depends on FNAB and risk factor results, ranging from observation for benign nodules to surgery for malignant or suspicious nodules. Surgery type depends on cancer risk and includes lobectomy or total thyroidectomy.
Thyroid Examination - General Surgery Sana Rasheed
The document provides instructions for examining the thyroid gland. It begins with introducing oneself to the patient and obtaining consent. It describes the anatomy of the thyroid gland and its location. The examination involves inspection of the thyroid from the front and back while palpating and feeling for nodules or irregularities. Signs of hyperthyroidism like eye signs, tremors, and moist skin are also checked. The examination is concluded by checking reflexes and the heart before thanking the patient.
1. The document discusses various potential causes of a mass in the right iliac fossa, including appendicitis, appendicular abscess, carcinoid tumors of the appendix, mucoceles, adenocarcinoma, tuberculosis, Crohn's disease, carcinoma of the caecum, actinomycosis, amoebiasis, mesenteric cysts, intussusception, iliopsoas abscess, retroperitoneal tumors, aneurysms, and more rare causes.
2. Diagnostic tools mentioned include ultrasound, CT, colonoscopy, and biopsy. Treatment depends on the underlying cause but may include antibiotics, surgery, chemotherapy, and ATT.
3
This document provides information on various surgical specimens including:
- A specimen of an inflamed appendix showing characteristics of appendicitis.
- Specimens of gallstones found in the gallbladder and risk factors for gallstone formation.
- A specimen of a hydatid cyst found in the liver as well as details on the lifecycle and characteristics of the Echinococcus parasite.
- A specimen of Meckel's diverticulum arising from the ileum and details on types of intestinal diverticula.
- A specimen showing an ileoileal intussusception in the small intestine.
Hematuria, or blood in the urine, can be caused by diseases of the urinary system or other systemic disorders. It is classified as microscopic or gross based on visibility, and as early, terminal, or diffuse based on timing during urination. Common causes include glomerular diseases, infections, cancers, trauma, and stones. Diagnosis involves urinalysis, microscopy, imaging, and sometimes kidney biopsy. Treatment focuses on the underlying condition causing the hematuria. Prognosis depends on associated clinical or laboratory abnormalities, with isolated microscopic hematuria generally having a good prognosis.
Fournier's gangrene is a necrotizing fasciitis of the genital region that is usually polymicrobial in nature. It is more common in males ages 30-60 and risk factors include diabetes, alcoholism, malignancy, and immunosuppression. The infection spreads rapidly in fascial planes due to bacterial enzymes and can cause tissue death. Treatment involves aggressive surgical debridement and broad spectrum antibiotics. Complications can include organ failure, shock, and death if not treated promptly.
approach to a patient with thyroid swelling (EMCH)Al Tarique
The document provides information on evaluating and treating a patient presenting with a thyroid swelling:
- It describes the anatomy and histology of the thyroid gland and differential diagnoses for anterior midline neck swellings. Common causes of thyroid swelling include diffuse goiter, multinodular goiter, and solitary nodules.
- Evaluation involves taking a medical history, examining the swelling, and performing tests like ultrasound and thyroid function tests. Physical exam assesses features of the swelling and checks for signs of hyperthyroidism or hypothyroidism.
- Treatment depends on the underlying cause but may include medications, radioactive iodine therapy, or surgery to manage conditions like toxic multinodular goiter, thyroid
This document discusses the management of appendicular lumps. It notes that appendicular lumps are inflammatory tumors consisting of the inflamed appendix and surrounding tissues. Treatment options include emergency surgery, conservative management followed by interval surgery, or totally conservative management without interval surgery. Conservative treatment is associated with a risk of missing hidden pathologies. Emergency surgery carries a high risk of complications while interval surgery risks appendicular abscess or perforation during the waiting period. Randomized controlled trials have found that conservative treatment without interval surgery appears to be the best approach for appendicular masses and abscesses. The document examines factors to consider in decision making and presents cases studies from a tertiary care center.
This document provides information on the management of inguinal hernias. It discusses the historical development of hernia repair techniques from the 15th century to modern methods. Investigation methods such as ultrasound, CT, MRI, and herniography are outlined. Surgical techniques for hernia repair including herniotomy, herniorrhaphy, hernioplasty, and laparoscopic repair are described in detail. Post-operative complications of open and laparoscopic hernia repair are also reviewed. The conclusion states that laparoscopic and Lichtenstein open mesh repairs have good long-term results and low recurrence rates compared to other open hernia repair techniques.
This document discusses various energy sources used in surgery including radiofrequency electro-surgery, ultrasonic energy systems, lasers, and argon beam coagulation. It provides details on how each system generates energy and its corresponding tissue effects. Monopolar and bipolar electro-surgery are compared in terms of advantages and disadvantages. Harmonic scalpels are noted to have reduced thermal spread and overall procedure time compared to other devices. Risks such as burns and device interference are also reviewed.
The document outlines the steps for examining the thyroid gland which includes inspection of the hands, pulse, eyes, face and thyroid as well as palpation. Inspection evaluates features like dry skin, sweating, tremors and examines the eyes, face and thyroid for signs like exopthalmos, lid lag and masses. Palpation assesses the thyroid gland for size, symmetry, consistency and thrills. Additional tests like thyroid function tests, FNAC and imaging may also be used.
The document provides an overview of the surgical anatomy, development, blood supply, lymphatic drainage, and examination of the thyroid gland. It discusses the thyroid gland's location in the lower neck, its lobes and isthmus, and that each lobule contains follicles. It also reviews aspects of examining a patient such as gathering demographic details, symptoms, and performing physical exams including inspection, palpation, percussion, and auscultation of the thyroid. Common investigations and treatments are also summarized.
Surgical management of benign multinodular goitreCHRIS ALUMONA
According to the WHO about 200 million people are living with goitres worldwide. Of the benign cases, endemic goitres make up the bulk in iodine deficiency belts. Goitres may be simple or toxic. The aetiopathogenesis and surgical management of this condition is detailed in a practical sense in this presentation.
This document provides an overview of neck masses and thyroid disorders. It begins with the anatomy of the thyroid gland and approaches to examining neck masses. Specific conditions covered include thyroglossal duct cyst, solitary thyroid nodule, Graves' disease, thyroid cancer including papillary, follicular, anaplastic and medullary carcinomas. Diagnostic tests and treatments for these conditions such as medication, radioactive iodine therapy, surgery and its complications are summarized.
This document provides information on various neck masses and thyroid conditions. It begins with the anatomy of the thyroid gland and approaches to evaluating neck masses. It then discusses specific conditions like thyroglossal duct cyst, solitary thyroid nodule, Graves' disease, and different types of thyroid cancer including papillary carcinoma, follicular carcinoma, anaplastic carcinoma, and medullary carcinoma. For each condition, it covers topics like pathogenesis, clinical presentation, diagnosis, treatment and complications.
This document provides an overview of benign and malignant disorders of the thyroid gland and their management. It begins with the anatomy, physiology, and embryology of the thyroid. It then discusses various benign conditions such as goiter, thyroid nodules, Graves' disease, and Hashimoto's thyroiditis. Malignant disorders covered include differentiated thyroid cancers, anaplastic thyroid cancer, thyroid lymphoma, and medullary thyroid cancer. The document concludes with a discussion of papillary carcinoma, the most common type of thyroid cancer.
The document provides information about the thyroid gland, including its anatomy, blood supply, nerves, lymphatic system, and physiology. It discusses thyroid disorders like hyperthyroidism and hypothyroidism. Graves' disease is described as the most common cause of hyperthyroidism, caused by autoimmune stimulation of the thyroid-stimulating hormone receptor by antibodies. Clinical features, diagnostic tests, and treatment options including antithyroid drugs, radioactive iodine therapy, and surgery are outlined for Graves' disease. Toxic multinodular goiter is also briefly mentioned.
This simplified lecture gives an account of how to approach a patient with a neck mass. Moreover, it shows hoe master thyroid gland history taking and examination and general examination.
Additionally, the lecture is supported by many real-life scenarios to cover the topics from a clinical point of view.
The document discusses the embryology, anatomy, physiology, imaging, and clinical presentation of thyroid disorders. It covers the development of the thyroid gland and associated structures from the pharyngeal pouches. It describes the surgical anatomy of the thyroid and recurrent laryngeal nerve. The physiology section addresses the production and regulation of thyroid hormones. Imaging modalities for evaluating the thyroid are also summarized.
The thyroid gland is located in the neck and produces hormones that regulate metabolism. It can be imaged using ultrasound, radioactive iodine scans, or technetium scans. Ultrasound is often used to evaluate thyroid nodules for signs of malignancy such as microcalcifications or irregular margins. Radioactive iodine uptake tests measure how much radioiodine is absorbed by the thyroid and can help distinguish hyperthyroidism from hypothyroidism. Diseases like Graves' disease, Hashimoto's thyroiditis, thyroid cancer and nodules can be identified and monitored using thyroid imaging techniques.
general Examination in paediatric medicine Sujit Balodiya
This 22 month old boy presents with pallor. His mother notes no other symptoms but was concerned due to comments from relatives. On exam, he appears pale but is otherwise healthy and active. Lab work shows microcytic anemia. The cause is likely iron deficiency due to a diet high in milk and low in iron-rich foods. Counseling is provided on an iron-rich diet.
This document provides information on benign thyroid swellings. It begins with the surgical anatomy of the thyroid gland including its location, parts, coverings, arterial supply, venous drainage, and nerve supply. It then discusses the physiology of the thyroid gland including hormone production and regulation. Various types of thyroid enlargements are described such as simple goiter, clinically discrete swellings, hyperthyroidism, and thyroiditis. Diagnostic tests and treatments are also summarized.
The document provides information on the thyroid gland, including its anatomy, histology, physiology, pathology, and disorders. Some key points:
- The thyroid is one of the earliest endocrine organs to develop. It is located in the neck and weighs 15-25 grams.
- Graves' disease is the most common cause of hyperthyroidism. It is characterized by the triad of thyrotoxicosis, ophthalmopathy, and dermopathy due to autoantibodies that mimic TSH.
- Hypothyroidism is most commonly caused by Hashimoto's thyroiditis, an autoimmune disorder characterized by lymphocytic infiltration and antibody production. Clinical manifestations range from mild to
Thyroid swelling and management. In detail case discussion of thyroid swelling and its management. Details of examination as well included in the slide.
Examination of the endocrine system.pptxHiraFarooq23
Examination of the endocrine system includes questioning the patient about symptoms, examining the neck area, palpating the thyroid gland, and measuring the neck circumference. Questioning focuses on complaints related to the thyroid, pituitary, adrenal and other endocrine glands. Examination of the neck looks for enlargement of the thyroid and specific facial features of hyperthyroidism. Palpation assesses the size, consistency and mobility of the thyroid gland. Diseases of the endocrine system can cause hormonal imbalances and symptoms affecting multiple organ systems. Acute endocrine emergencies like hyperthyroid crisis and myxoedema coma require prompt treatment to prevent mortality.
This is a clinical case presentation of Nodular Thyroid in a 40 year old woman. Detailed Anatomy, Physiology of Neck region including thyroid with their pahophysiology. Possible investigations and modalities of treatment have also been discussed in this presentation.
The document summarizes key information about the thyroid gland including its embryology, anatomy, blood supply, innervation, functions, clinical examination, and important laboratory investigations for thyroid disorders. It describes the thyroid's development from pharyngeal pouches, typical location and lobes in the neck, and nerves and vessels involved. Examination techniques like inspection, palpation, and auscultation are outlined. Common blood tests for thyroid function like TSH, T3, T4, calcitonin, radioactive iodine uptake, and thyroid antibodies are also summarized.
The document provides information on thyroid diseases, including:
- The anatomy and physiology of the thyroid gland, including its blood supply, nervous supply, lymphatic drainage, and relations to surrounding structures.
- Embryology of the thyroid gland, which develops in the pharynx and migrates to its permanent site in the neck.
- Common thyroid diseases such as hyperthyroidism (Graves' disease, toxic nodular goiter), hypothyroidism, thyroid cancer (papillary, follicular, medullary, anaplastic), thyroid cysts and swellings.
- Investigations for thyroid diseases including blood tests, imaging, and biopsy. Surgical and medical treatments are
This document discusses various endocrine problems involving the pituitary gland and thyroid. It summarizes pituitary control of growth hormone and describes symptoms of growth hormone excess such as enlarged hands, feet, and tongue. It also discusses diagnostic studies and treatment for growth hormone excess. Transient diabetes insipidus and syndrome of inappropriate antidiuretic hormone are described as potential postoperative complications. Diabetes insipidus, its causes and goals of treatment are summarized. Hyperthyroidism, hypothyroidism, thyroid storm, thyroiditis, thyroid cancer, and thyroidectomy are briefly described. Cushing's syndrome, Addison's disease, hyperparathyroidism, and pheochromocytoma are also mentioned.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...rightmanforbloodline
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Versio
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
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Exam of thyrod gland
1. CLINICAL DISCUSSION ON
EXAMINATION OF THYROID
GLAND
PRESENTED BY
DR.SHIVAKUMAR B.
FINAL YEAR IN-SERVICE PG SCHOLAR
DEPT OF SHALYA TANTRA
GAMC BENGALORE
UNDER THE GUIDANCE OF
DR.SHRIDHAR RAO S.M.
HOD DEPT OF SHALYA TANTRA
GAMC BENGALORE
2. CONTENTS
• Surgical Anatomy of Thyroid Gland
• Development
• Blood Supply, Nerve supply, Lymphatic drainage
• Physiology
• Gather equipment's
• History taking
• Physical examination
• Local examination
• Investigations
• Treatment
• Ayurvedic aspects
3. Surgical Anatomy of Thyroid Gland
• Endocrine gland ,situated in lower part
of the front and sides on neck. It
weighs about 20gms, highly vascular
organ opposite to the 5th,6th,7th cervical
and 1st thoracic vertebrae
• Consists of right and left lobes, joined
by isthmus.it is ensheathed by pretracheal
layer of deep cervical fascia each lobe is
5*3*1.5cms in size lobe is conical in shape
• Lobule is functional unit, supplied by an
arteriole.
• Each lobule consists of 25-40 follicles,
lined by cuboidal epithelium
4. Development :
•The thyroid gland arises initially as a midline diverticulum in
the floor of the pharynx.
•Endodermal in Origin
•Situation and Extent :
• Each lobe extends from middle of thyroid cartilage to
fourth or fifth tracheal ring.
• Isthmus extends from second to fourth tracheal ring
5. Blood Supply :
Supplied by Superior and Inferior Thyroid Arteries.
Drained by Superior, Middle and Inferior Thyroid Veins.
In some individuals, Fourth thyroid vein (of Kocher) may
emerge between middle and inferior thyroid veins.
6. NERVE SUPPLY
•Derived from sympathetic and parasympathetic
nerve
•Recurent Laryngeal nerve it is branch of Vagus
nerve
•Superior Laryngeal nerve divides into internal
and external laryngeal nerve
7. Lymphatic Drainage :
• Subcapsular Plexus drains
principally to the central
compartment juxtathyroid
'Delphian' and paratracheal nodes,
and also on nodes on superior and
inferior thyroid veins.
• From there it passes to deep
cervical
nodes and mediastinal group of
nodes.
10. History Taking
• Socio-Demographic Details
• Gender
Majority of thyroid disorders are commoner in females.
( Example : Simple Goitres, Thyrotoxicosis and Thyroid carcinomas )
• Thyrotoxicosis is eight times commoner in females than in males
• Every thyroid carcinomas are more often seen in female in the ratio of
3:1
11. AGE
• Pubertal Girls : Simple Goitre
• Young Age : Primary Toxic Goitre , Papillary Carcinoma
• Women in 20s - 30s : Solitary Nodular, Multinodular Goitre and
Colloid Goitre
• Middle aged Women : Follicular Carcinoma , Hashimoto Disease
• Old aged Women : Anaplastic Carcinoma
12. • Occupation : Thyrotoxicosis is common in patients working under
stress and strain
• Residence : Places endemic to goitre due to iodine deficiency.
Eg – Areas near rocky mountains like Himalayas, vindhyas and
satpura ranges. More common in southern India than northern India,
Great Britain-Mendips ,Derbyshire,Yorkshire
13. Swelling
• Onset – Duration – Progression – association with pain
• Simple goitre grows slowly
• Multinodular or solitary nodular colloid goitre increases size though
extremely slowly per year
• Fast growing swelling is seen in anaplastic carcinoma
• Slow growing swelling is associated with papillary and follicular
carcinoma
• History of sleepless nights (primary thyrotoxicosis)
14. PAIN
• Goitre - painless
• Inflammatory conditions – painful
• Malignancies – painless to start , painful in late
stages(infiltration of surrounding structures,nerves to cause
pain )
16. Symptoms of primary thyrotoxicosis
• Loss of weight inspite good appetite
• Preference for cold ,heat intolerance and excessive sweating.
• Nervous excitability ,irritability insomnia, tremor of hands, muscle
weakness
• Staring eyes, protruding eyes, difficulty in closing eyelids, double
vision ,oedema or swelling of conjunctiva(chemosis)
• Palpitation, tachycardia, dyspnoea (Less marked)
17. Symptoms of secondary
thyrotoxicosis
• Palpitations
• Ectopic beats
• Cardiac arrhythmias
• Dyspnoea on exhaustion
• Chest pain
• CCF(late stage with swelling around ankles)
18. Symptoms of Hypothyroidism(myxoedema)
• Increase in weight in spite of poor appetite
• Fat accumulates at the back of the neck and shoulders
• Cold intolerance/preference of warm climate
• Muscle fatigue, lethargy, loss of memory, mild hoarseness of voice,
constipation, oligomenorrhea
19. • Past history :
Drug history for goitrogens:which have low iodine content
(PAS, Thyocyanate, sulphonilurea, antithyroid drugs) Past
response to treatment
• Personal history: Consumption of vegetables of brassica
family i.e cabbage, turnips, cauliflower, sprout (goitrogens)
• Family history :Enzyme deficiencies, primary
thyrotoxicosis,and thyroid cancers
20. Physical Examination
• General survey
• Build and state of nutrition
• Lean and thin – thyrotoxicosis
• Obese – hypothyroidism
• Anaemia and Cachexia - Ca thyroid Facies
• Excitement, tension, nervousness,
exophthalmos (Hyperthyroidism)
Puffy face without expression(mask like face) - hypothyroidism
21. • Mental state and intelligence
• Dull with low intelligence – In hypothyroidism
• Pulse -
Irregular in thyrotoxicosis ,irregularity is more of a feature of secondary
thyrotoxicosis
In hypothyroidism pulse become slow(bradycardia)
• Skin
Moist – primary thyrotoxicosis
Dry and inelastic - hypothyroidism
22. Primary toxic manifestations (To be assessed
during general examination)
• Eye signs
-Lid retraction- by over activity
of involuntary part of the levator
palpebrae superioris muscle
,when the upper eyelid is higher
than normal lower eye lid is in its
normal position
23. - Exophthalmos-when eye ball is pushed forwards
do to increased fat in the retro orbital space
24. Von Graefe’s Sign (lid lag) –the upper eye lid lags
behind the eye ball as the patient is asked to took
downwards
25. Joffroy’s Sign -Absence of wrinkling on forehead
when patient is asked to look up with face inclined
downwards
29. Ophthalmoplegia
Patient can’t look upwards and outwards
Chemosis
Edema of conjunctiva : Venous and lymphatic drainage of
conjunctiva is obstructed due to increased retro orbital pressure
30. • Tachycardia
• Tremor of the hands (fine tremors are observed on outstretched hand
or tongue keep in this position for at least half min)
• Moist skin
• Thyroid bruit
• Search for metastasis
• Bony(skull, spine, pelvis) and lungs.
31. Local examination
Inspection
– Normal gland is not visible
– Pizzillo’s method
• Patient’s hands behind the head, and is asked to push against clasped
hands on the occiput.
• Uniform enlargement of whole gland – physiological goitre, colloid
goitre, Hashimoto’s disease
• Isolated nodules of different sizes – nodular goitre
• Swelling lateral to thyroid – aberrant gland or lymph node from Ca
32. Movement with deglutition :
• Thyroid moves on deglutition (thyroglossal cyst, sub hyoid
bursitis, pretracheal/prelarynngeal lymph nodes) greatly limited
when it is fixed by inflammation and malignant infiltration.
• Look for lower border of the gland,
not possible to see in retrosternal enlargement
– Pemberton’s test
Raising hands above head, with arms touching ears
Facial distress due to thoracic inlet obstruction
• Tongue protrusion test
Differentiate between thyroglossal cyst
and thyroid swelling(in ectopic thyroid gland)
33. Palpation
Position
• Patient is sitting, physician
stands behind/in front of the
patient
• Neck slightly flexed, thumb
behind the neck, other four
fingers on each lobes and the
gland palpated in its entirely.
34. • Lahey’s method
Examiner stands in front of the
patient
Gland is pushed to one side, ideal
for palpating margins
• Crile’s method
Thumb on the gland, patient is
asked to swallow (To look for
nodularity)
35. Points to be assessed during palpation
Whether the whole gland is enlarged ?
– If yes
• Surface – smooth (primary thyrotoxicosis ,colloid goitre and
bosselated (multinodular goitre)
• Consistency –
• Firm - primary thyrotoxicosis or Hashimoto’s disease
• Soft – colloid goitre
• Hard – Riedel’s thyroiditis
• Variable – carcinoma
36. • Is the enlargement localized?
Position, size, shape, extent, consistency
• Is the gland mobile?
To be checked in all directions
Fixed – Carcinomas or Chronic conditions
Can you get below the gland?
Are there any pressure effects?
Kocher’s test – Pushing lateral lobes of gland will cause
stridor(whistling sound), positive in multinodular goitre and carcinoma
thyroid. Position of trachea should be noted. Confirmed by X-ray.
37. • Carotid pulsations for involvement of carotid sheath
• Sympathetic trunk – Horner's syndrome(enophthalmos(posterior
displacement of eye ball), pseudoptosis(musculoskeletaldefect of eye
ball), miosis(contraction of pupil), anhidrosis(decreased sweating)
• Venous obstruction – Pemberton’s sign
• Are there any toxic manifestations?
• Are there any evidence
• Is the swelling benign or malignant?
• Are there any pulsations or thrill?
• Are there cervical lymph nodes palpable?
– Early lymphatic metastasis in papillary carcinoma of thyroid “aberrant
thyroid” of hypothyroidism?
38. Percussion
• Over manubrium sterni to look for retrosternal extension
Auscultation
• Primary toxic goitre – systolic bruit(vascular murmur )over the gland
Measurement of neck circumference to monitor growth of
the swelling
39. DIFFERENTIAL DIAGNOSIS OF THYROID SWELLING
• The word goitre denotes any enlargement of thyroid glands irrespective of
pathology , it is classified into
1. Simple goiter (non-toxic)
a) Diffused hyperplastic goitre- Seen in endemic area affecting children and
adolescent uniform enlargement due to increased TSH stimulation in response
to low level of circulating thyroid hormone.
Symptoms- swelling of the neck, pressure effect trachea and esophagus.
Sign- Diffuse swelling thyroid gland which Moves on deglutition and soft
b) Nodular- usually female late 30s,40s common site in junction of isthmus and one
lateral lobe. same as above signs and symptoms nodule may be palpable.
c) Colloidal-above 25yrs age accumulation of thick colloid material in the gland
after physiological hyperplasia have be subsided same as the above sign and
symptoms.
d) Multi nodular – Cut surface of multi nodular goitre reviles hemorrhagic and
necrotic areas separated by normal tissue which contain normal active
follicles.6:1 female than male.
40. 2. Toxic goitres
a) primary toxic goiter (graves disease)
b) Secondary toxic goitre
3. Neoplastic goiter
a) Benign
b) Malignant
41. 4. Thyroiditis
a) Auto immune (Hashimoto’s thyroiditis)-this is most common form
of thyroiditis four auto antigens has be detected-
thyroglobuline,thyroid cell microsomes , nuclear components and
non thyroglobulin colloid, the thyroid is symmetrically enlarged soft
rubbery and firm in consistency in 80% of cases. More related to
hypothyroid state .
b) Sub acute or granulomatous (De quervain’s) thyroiditis- viral in
origin female around 40yrs of age ,firm and irregular enlargement
,adhesion,fever malaise and pain.
c) Reidels thyroiditis-
• its rare chronic inflammatory process involving one or both lobes
firmly attached to trachea and surrounding tissues.
• difficulty in swallowing, hoarseness of voice
42. 5. Retrosternal goitre – more than 50% is below suprasternal notch
a) Sub sternal –common lower border of gland is behind the sternum
b) Intra thoracic – no thyroid is seen the neck
c) Plunging –patient is asked to cough thyroid plunges out , lower
border is seen in neck
6. Thyroglossal cyst- it appears from cystic degeneration of part of
thyroglossal track it is always on midline below the hyoid bone
7. Thyroglossal fistula-due to infection of thyroglossal cyst from just
above the hyoid bone to isthmus
43. TUMOUR
Benign tumour are rare and it can be either papillary adenoma
or follicular adenoma
Classification of malignant thyroid
tumours as follows
A)Follicular cell origin
a)Differentiated
I. Papillary carcinoma (60%)
II. Follicular carcinoma (15%)
III. Mixed carcinoma
b)Undifferentiated
• Anaplastic carcinoma (13%)
B) Parafollicular cell origin
Medullary carcinoma (6%)
C)Non thyroid cell origin
I. Malignant lymphoma (4%)
II. Sarcoma
III. Metastatic carcinoma
44. Carcinoma is again classified into
a) Papilliferous (young)
b) Follicular (middle aged)
c) Anaplastic (elderly):Rapid growing, surface is irregular,hard
45. Investigations
• Thyroid function test (TSH and T3,T4 )
• Euthyroid (Normal TSH,T3 and T4)
Normal serum value
TSH-0.3 to 5 mIU/ltr, Free T3 – 3.5 to 6 umol/ltr
T3-100 to 160 ng/100ml , Free T4-10 to 30nml/ltr
T4-4.5 to 11 micro gram/100ml
• Thyrotoxic (↓TSH, ↑T3 and T4)
• Myxoedema ( ↑TSH, ↓T3 and T4 )
• Thyroid autoantibodies (Antibodies against Thyroperoxidase and
Thyroglobulin )
• >25 units/mL for TPO(thyroidperoxidase) and titre of greater than
1:100 for antithyroglobulin are considered significant Ca
• Serum Calcitonin / CEA (carcinoembryonic antigen)as screening test
for medullary carcinoma
46. •Thyroid Imaging
• Chest and Thoracic Inlet X-Rays : Retrosternal Goitre, and
clinically significant tracheal deviation and compression.
• Ultrasound Scanning (High frequency)- inexpensive ,easy ,
Important in identification of nodes involved in thyroid cancers.
(May reveal clinically irrelevant swellings )
• CT,MRI and PET: Reserved for assessment of known malignancy,
and status of extent of retrosternal goitre
• Isotope Scanning : Routine isotope scanning not indicated.
Investigation of Choice in toxic patient with nodule or nodularity
of gland.
FNAC :
• Investigation of Choice in Discrete Thyroid Swellings(MNG).
• Detect malignancy ,
47. TREATMENT
Selection of Thyroid Procedure:
• Diagnosis (If known pre-operatively)
• Risk of thyroid failure
• Risk of recurrent laryngeal nerve injury
• Risk of recurrence
• Grave's disease
• Multinodular goitre
• Differentiated thyroid cancer
• Risk of Hypoparathyroidism
48. Treatment for hypothyroidism
1)Non nodular goitre –thyroxin 0.3mg/day for month
Partial thyroidectomy
2)Multi nodular gotre-thyroxin 120 to a 80mg /day(if nodularity
persists)
Post op 0.1 mg of levothyroxine
3)Colloid goitre –partial thyroidectomy(for cosmetic reason)
4)Retrosternal goitre – resection
49. Treatment of Hyper Thyroidism
Aim :
• To restore patient to euthyroid state
• To reduce the functioning thyroid mass
• To minimize complications
Drugs :
• Potassium perchlorate 200mg to 400mg /day
• Propyl thiouracil 200mg TID ( In pregnancy)
• Beta blockers (propranolol 20-40mg)
• Carbimazole(thiourea derivatives) – 10mg 6th hourly ( it blocks oxidation of idodide to
iodine)
• Cortico-steroids (reserve drug in uncontrol hyperthyroidism)
50. Thyroid Operations
• All thyroid operations can be assembled by three basic elements
• Total lobectomy (Removal of one lobe&entire isthamus)
• Isthmectomy
• Subtotal lobectomy
•Total Thyroidectomy = 2*total lobectomy +Isthmectomy, choice today no
chances of recurrence,avoid resurgery
•Sub-Total thyroidectomy = 2*su
btotal lobectomy + Isthmectomy(leaving thyroid tissue as tip of small finger
in both side)
•Near Total Thyroidectomy = Total Lobectomy + Isthmectomy+Subtotal on
other side (Dunhill Procedure)
•Lobectomy = Total lobectomy + Isthmectomy
51. MOST COMMON FOR THYROID GLAND
Most surgical disease of thyroid gland is solitary thyroid nodule
Most common site is at junction of isthamus&lobe
Common drug for thyrotoxicosis is Carbimazole
Common investigation is USG
Common surgery of carcinoma is total thyroidectomy
Common Ca in children is papillary carcinoma
Thyrotoxicosis factitia:over dose of thyroxine at puberty goitre
Jod Basedow thyrotoxicosis:iodine induced thyrotoxicosis in hyperplastic
endemic goitre
Pendred”s syndrome:congenital deafness since infancy in diffuse
hyperplastic goitre
52. गलगण्ड
Nirukti
गलस्य पार्श्वे गलगण्ड एकः ch chi 12/79
Ast hrd utt 21/53
Samprapti
वातः कफर्श्चैव गले [१] प्रवृद्धौ मन्ये तु संसृत्य तथैव मेदः |
कु ववन्न्त गण्डं क्रमशः स्वललङगैः समन्न्वतं तं गलगण्डमाहुः ||२२||
Su Ni 11/22
Dalhana commentary
वातेन कफे न च गलगण्डो भवतत न पपत्तेन, स्वभावेन पपत्तजस्य गलगण्डस्या
भावात्