This presentation about thyroid gland : - Anatomy of thyroid gland - Physiology of thyroid gland - Pathology of thyroid gland - Treatment and prevention of thyroid disease

1. ThyThyroid Gland
Prepared by
Kayhan Ahmad
Shko Hamid
Sarkar Ahmad
Hazhir Jaza

2. Key Words
 Brief Introduction of thyroid gland
 Thyroid Gland
 Anatomic Location
 Structure
 Hormones
 Physiology (Action and Function)
 Hyperthyroidism
 Hypothyroidism
 Thyroid Pathology
 Prevention and Treatment

3. Thyroid Gland
The thyroid gland is one of the largest
endocrine gland in the body
Consists of two connected lobe
control metabolic rate, protein synthesis
and control The body’s sensitivity to other
hormone

4. Thyroid Gland
Location of thyroid gland
 Situated in the neck region in front of
larynx and trachea
 Made up of two lobes of thick red
glandular tissue joined together by a
narrow strip or bridge called isthmus

5. Thyroid Gland
isthmus

6. Thyroid Gland
Structure of thyroid gland
• is a butterfly shaped organ
• Usually the right lobe is larger than the left
lobe
• Usually larger in Women

7. Thyroid Gland
Mechanism action of thyroid Gland

8. Thyroid Gland
Mechanism action of thyroid Gland
26 Oct 2018

9. Thyroid Gland
Hormones of thyroid gland
The thyroid gland secrets two main hormones
Thyroxine also called T4
Triiodothyronine called T3

10. Thyroid Gland
Hormones of thyroid gland
• Thyroxine contain 4
atoms of iodine
• triiodothyronine
contain 3 atoms of
iodine

11. Thyroid Gland
Hormones of thyroid gland

12. Thyroid Gland
Hormones of thyroid gland
• Thyroxine T4 is more amount in
blood but less potent
• Trriodothyronine T3 is is less
amount in blood but more potent

13. Thyroid Gland
Formation and secretion
of thyroid hormones
• Approximately 87% of T3 is produced by
monodeiodination of T4
• Small amounts of reverse tri-iodothyronine (R T3)
also found in thyroid venous blood
• (reverse T3 is inactive)

14. Thyroid Gland
Hormonal function
I. Regulation of basal metabolic rate and
intake of oxygen
II. regulation of cellular metabolism
III. Regulation of growth and development
Thyroid hormones have several function

15. Thyroid Gland
Thyroid Hormones Action on the Body
I. Effects of Nervous System
II. Effects on Skeletal Muscle
III.Effects on the Heart

16. Thyroid Gland
Thyroid Hormones Action on the Body
IV.Relation to Catecholamines
V. Effects on Carbohydrate and Cholesterol Metabolism
VI. Effects on Growth and Development

17. Thyroid Gland
Thyroid Hormones Action on the Body
VII. Effects on Endocrine System
VIII. Increased respiration
IX. Increased GI motility

18. Thyroid disorder

19. Thyroid disorder
 Hyperthyroidisim
 Hypothyroidisim

20. Hyperthyroidism
Primary Hyperthyroidism
• Graves disease
• Subacute thyroiditis
Secondary Hyperthyroidism
• TSH secreting tumor
• TRH secreting tumor

21. Graves Disease
• The most common cause of hyperthyroidism
• Strong familial predisposition
• Female preponderance 5:1
• Age 40 and 60 years

22. Graves Disease
Characterized by
• Thyrotoxicosis
• Diffuse goiter
• Extra-thyroidal conditions

23. Graves Disease
Etiology
 Exactly etiology is not known
Possible trigger
 Postpartum state
 Iodine excess
 Lithium therapy
 Bacterial and viral infections
Genetic Factor
HLA-B8
HLADR3
Sensitized T-Helper lymphocyte
 Human leukocyte antigen ( HLA) include

24. Graves Disease
Hallmark of Graves’s disease
Thyroid-stimulating antibodies

25. Graves Disease
associated with other autoimmune
conditions such as
• Type 1 Diabetes mellitus
• Addison’s disease
• Pernicious anemia
• Myasthenia gravis

26. Graves Disease
Clinical Features
• Heat intolerance
• Increased sweating and thirst
• Weight loss despite adequate caloric intake
• Symptoms of increased adrenergic stimulation
• GI Symptoms

27. Graves Disease
Clinical Features
Female patient develop
• Amenorrhea
• Decreased fertility
• Increased incidence of miscarriage

28. Graves Disease
Clinical Features
Eye symptoms
• Spasm of the upper eyelid
• Prominent stare
• Periorbital edema
• Conjunctival sweeling
• Limitaion of upward and lateral
gaze
• blindness

29. Graves Disease

30. Graves Disease
Clinical Features
Skin Problem
Pretibial myxedema

31. Subacute thyroidites
What is thyroiditis?

32. Subacute thyroidites
• Pain and discomfort
• Thyroid gland become inflammed
• Initially make hyperthyroidism
• Change to hypothyroidism

33. Subacute thyroidites
Cause and risk factors
• Viral infection
• Women aged 40 to 50
• Upper respiratory infection (flu and mumps)

34. Subacute thyroidites
Sign and Symptoms
• Pain in the thyroid gland
• Pain spread to neck, ears and jaw
• Swallon of thyroid and tendor to touch
• Pain remain between 1 to 3 months

35. Subacute thyroiditis
Types of subacute thyroiditis
• Subacute granulmatous thyroiditis
• Postpartum thyroidites
• Palpitation thyroiditis
• Subacute lymphocytic thyroiditis

36. Subacute granulmatous
thyroiditis
• Most common types
• Viral infection
• Symptoms of hyperthyroidism
• Change to hypothyroidism
• Commonly make permanent complications

37. Postpartum thyroiditis
• Women one year after giving birth
• Goes away within 18 months
• Autoimmune disease
• Hyperthyroidism changes to hypothyroidism

38. Subacute lymphocytic
thyroiditis
• During postpartum period
• Hyperthyroidism develops earlier
• Three months after birth
• Hypothyroidism stay more for several months

39. Palpation thyroiditis
• Mechanical manipulation
• Repeated thyroid gland examination
• Surgery

40. Hypothyroidism

41. Hypothyroidism
• Disorder of the
endocrine system in
which the thyroid
gland does not
produce enough
thyroid hormone
• Hashimoto’s disease
• Congenital hypothyroidism

42. Hypothyroidism

43. Hypothyroidism

44. Hashimoto’s disease
• Also known as chronic lymphocytic thyroidites ,
is a condition in which your immune system
attacks your thyroid gland
• The most common cause of hypothyroidism in
areas of the world where iodine levels are
sufficient
• Primarily affects middle-aged women

45. Hashimoto’s disease
Causes
 Genes
 Hormones
 Radiation exposure

46. Hashimoto’s disease

47. Hashimoto’s disease
Diagnosis
• A hormone test blood tests can determine the
amount of hormones produced by your thyroid
and pituitary glands
• An antibody test because Hashimoto’s disease is
an autoimmune disorder , the cause involves
production of abnormal antibodies (TPO
antibodies).

48. Cretinism
 Also known as Congenital hypothyroidism
 Is a sever deficiency of thyroid hormone in
newborns , it causes impaired neurological
function , stunted growth, and physical
deformities.

49. Cretinism
Types of Cretinism
Endemic cretinism
Sporadic cretinism

50. Cretinism

51. Cretinism
Signs and symptoms
Early stage
 Short and thickened bones
 Slow movement
 Development of dry skin
 Abnormal physical characteristics
 Short and wide face
 Underdeveloped lower jaw
 Overdeveloped upper jaw
 macroglossia

52. Cretinism

53. Cretinism

54. Cretinism
Diagnosis of cretinism
• Blood Test
• New-born screening test These are the usual
screening tests done by the doctor in first 24 to
72 hours of life to check for metabolic and genetic
disorder
• Ultrasonography the non-radioactive imaging
tests to look for the structural abnormalities in
the thyroid gland

55. Cretinism
Prognosis of cretinism
• Depend on the age of the baby
• When treatment is initiated

56. Prevention and
Treatment

57. Prevention
• According to (ATA) more than
12% of people living in U.S.A
will develop a thyroid condition
at sometime in their lives
• 20 million Americans have
thyroid disease

58. Prevention
I. Ask for a Thyroid Collar for X-Rays
II. Stop Smoking
III. Eat less soy

59. Prevention

60. Prevention
IV.Do the Thyroid Neck Check
V. Discuss Selenium Supplementation with
your doctor
VI. Keep Potassium Iodide on Hand

61. Prevention
VII. Get Celiac Disease Diagnosed and Treated
VIII. Look Out for Perchlorate
IX. Consider Fluoride’s Role

62. Treatment
Treatment of your
thyroid condition
depends on the type
of thyroid problem

63. Treatment
 Hyperthyroidism/Graves Disease
Treatments
I. Anti-thyroid Medications
-
• Include Methimazole
• Propylthiouracil (PTU)
• Carbimazole

64. Treatment
 Hyperthyroidism/Graves Disease
Treatments
II. Radioactive Iodine
III.Surgery

65. Treatment
 Hyperthyroidism/Graves Disease
Treatments

66. Treatment
Most thyroid patients who receive
RAI treatment or have surgery
eventually end up hypothyroid and
are treated with thyroid hormone
replacement drugs
 Hyperthyroidism/Graves
Disease Treatments

67. Treatment
 Hypothyroidism/Hashimoto’s
Disease Treatments
I. Levothyroxine
II. Liothyronine
III.Thyroid extract (NDT) and amour thyroid

68. Treatment
Hypothyroidism/Cretinism
Treatment
I. Oral levothyroxine
II. Clinical evaluation
III.Iodine Supplementation

69. Treatment
 Hypothyroidism/Cretinism
Treatment

70. Thank You

71. Any Questions?

72. Sources
Nature Publishing Group
HealthSoul
Wikipedia
Schwartz’s Principles of Surgery
Tenth Edition