Primary Hyperparathyroidism
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Thyroid Gland Parathyroid Glands
Human Physiology Course Thyroid Gland Parathyroid Glands Assoc. Prof. Mária Pallayová, MD, PhD [email protected] Department of Human Physiology, UPJŠ LF April 13, 2020 (10th week – Summer Semester 2019/2020) Hormones and Functions Thyroid gland Parathyroids Thymus Adrenal glands Endocrine pancreas Ovaries, Testes Pineal Pituitary Hypothalamus-Pituitary Axis GIT, adipose tissue, brain, heart, kidney, ... Hormones and Functions Thyroid gland Parathyroids Thymus Adrenal glands Endocrine pancreas Ovaries, Testes Pineal Pituitary Hypothalamus-Pituitary Axis GIT, adipose tissue, brain, heart, kidney, ... Lecture Outline Functional anatomy of the thyroid gland Synthesis, secretion, and metabolism of the thyroid hormones The mechanism of thyroid action Role of the thyroid hormones in development, growth, and metabolism Thyroid hormone deficiency and excess in adults Physiology of the parathyroids Functional Anatomy of the Thyroid Gland two lobes + isthmus (just below the cricoid cartilage) attached to the trachea by connective tissue A normal THGL in a healthy adult weighs about 15-20 g. Functional Anatomy of the Thyroid Gland arterial blood supply: from a superior and an inferior thyroid a., which arise from the external carotid and subclavian a., respectively. venous blood supply: a series of thyroid veins drain into the ext. jugular and innominate vv. ( a rich blood supply to the thyroid gland w/ a higher rate of blood flow per gram than even that of the kidneys). innervation: adrenergic innervation from the cervical ganglia; cholinergic innervation from the n. vagus (regulation of vasomotor function to increase the delivery of TSH, iodide, and metabolic substrates to the THGL). Functional Anatomy of the Thyroid Gland The colloid (a thick, gel-like substance) is a solution composed primarily of thyroglobulin (10-25% the high viscosity), a large protein that is a storage form of the thyroid hormones. -
Beyond the Fixed Setpoint of the Hypothalamus–Pituitary–Thyroid Axis
E Fliers and others Hypothalamus–pituitary– 171:5 R197–R208 Review thyroid axis MECHANISMS IN ENDOCRINOLOGY Beyond the fixed setpoint of the hypothalamus–pituitary–thyroid axis Eric Fliers1, Andries Kalsbeek1,2 and Anita Boelen1 Correspondence should be addressed 1Department of Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam, 1105 AZ to E Fliers Amsterdam, The Netherlands and 2Hypothalamic Integration Mechanisms, Netherlands Institute for Neuroscience, Email Amsterdam, The Netherlands e.fl[email protected] Abstract The hypothalamus–pituitary–thyroid (HPT) axis represents a classical example of an endocrine feedback loop. This review discusses dynamic changes in HPT axis setpoint regulation, identifying their molecular and cellular determinants, and speculates about their functional role. Hypothalamic thyrotropin-releasing hormone neurons were identified as key components of thyroid hormone (TH) setpoint regulation already in the 1980s, and this was followed by the demonstration of a pivotal role for the thyroid hormone receptor beta in negative feedback of TH on the hypothalamic and pituitary level. Gradually, the concept emerged of the HPT axis setpoint as a fixed entity, aiming at a particular TH serum concentration. However, TH serum concentrations appear to be variable and highly responsive to physiological and pathophysiological environmental factors, including the availability or absence of food, inflammation and clock time. During food deprivation and inflammation, TH serum concentrations decrease without a concomitant rise in serum TSH, reflecting a deviation from negative feedback regulation in the HPT axis. Surprisingly, TH action in peripheral organs in these conditions cannot be simply predicted by decreased serum TH concentrations. Instead, diverse environmental stimuli have differential effects on local TH metabolism, e.g. -
Study Guide Medical Terminology by Thea Liza Batan About the Author
Study Guide Medical Terminology By Thea Liza Batan About the Author Thea Liza Batan earned a Master of Science in Nursing Administration in 2007 from Xavier University in Cincinnati, Ohio. She has worked as a staff nurse, nurse instructor, and level department head. She currently works as a simulation coordinator and a free- lance writer specializing in nursing and healthcare. All terms mentioned in this text that are known to be trademarks or service marks have been appropriately capitalized. Use of a term in this text shouldn’t be regarded as affecting the validity of any trademark or service mark. Copyright © 2017 by Penn Foster, Inc. All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner. Requests for permission to make copies of any part of the work should be mailed to Copyright Permissions, Penn Foster, 925 Oak Street, Scranton, Pennsylvania 18515. Printed in the United States of America CONTENTS INSTRUCTIONS 1 READING ASSIGNMENTS 3 LESSON 1: THE FUNDAMENTALS OF MEDICAL TERMINOLOGY 5 LESSON 2: DIAGNOSIS, INTERVENTION, AND HUMAN BODY TERMS 28 LESSON 3: MUSCULOSKELETAL, CIRCULATORY, AND RESPIRATORY SYSTEM TERMS 44 LESSON 4: DIGESTIVE, URINARY, AND REPRODUCTIVE SYSTEM TERMS 69 LESSON 5: INTEGUMENTARY, NERVOUS, AND ENDOCRINE S YSTEM TERMS 96 SELF-CHECK ANSWERS 134 © PENN FOSTER, INC. 2017 MEDICAL TERMINOLOGY PAGE III Contents INSTRUCTIONS INTRODUCTION Welcome to your course on medical terminology. You’re taking this course because you’re most likely interested in pursuing a health and science career, which entails proficiencyincommunicatingwithhealthcareprofessionalssuchasphysicians,nurses, or dentists. -
The Fine Structure of the Parathyroid Gland*
The Fine Structure of the Parathyroid Gland* BY JERRY STEVEN TRIER, M.D. (From the Department of Anatomy, University of Washington School of Medicine, Seattle) PLATES 3 TO 10 (Received for publication, July 29, 1957) ABSTRACT The fine structure of the parathyroid of the macaque is described, and is cor- related with classical parathyroid cytology as seen in the light microscope. The two parenchymal cell types, the chief cells and the oxyphil cells, have been recognized in electron mierographs. The chief cells contain within their cyto- plasm mitochondria, endoplasmic reticulum, and Golgi bodies similar to those found in other endocrine tissues as well as frequent PAS-positive granules. The juxtanuclear body of the light microscopists is identified with stacks of parallel lamellar elements of the endoplasmic rcticulum of the ergastoplasmic or granular type. Oxyphll cells are characterized by juxtanuclear bodies and by numerous mito- chondria found throughout their cytoplasm. Puzzling lamellar whorls are described in the cytoplasm of some oxyphil cells. The endothelium of parathyroid capillaries is extremely thin in some areas and contains numerous fenestrations as well as an extensive system of vesicles. The possible significance of these structures is discussed. The connective tissue elements found in the perivascular spaces of macaque parathyroid are described. INTRODUCTION Other contributions to the present concepts con cerning the human parathyroid can be found in the It is the purpose of the present paper to report some observations on the fine structure of the reports of Bergstrand (7), Morgan (34), Pappen- parathyroid gland employing the electron micro- heimer and Wilens (45), Castleman and Mallory (10), and Gilmour (20). -
Thyroid and Polycystic Ovary Syndrome
S Gabersˇcˇek and others Thyroid and PCOS 172:1 R9–R21 Review MECHANISMS IN ENDOCRINOLOGY Thyroid and polycystic ovary syndrome Simona Gabersˇcˇek1,2, Katja Zaletel1, Verena Schwetz3, Thomas Pieber3, Barbara Obermayer-Pietsch3 and Elisabeth Lerchbaum3 Correspondence should be addressed to 1Department of Nuclear Medicine, University Medical Centre Ljubljana, Zalosˇka 7, 1525 Ljubljana, Slovenia, B Obermayer-Pietsch 2Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1104 Ljubljana, Slovenia and 3Division of Endocrinology Email and Metabolism, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, barbara.obermayer@ 8036 Graz, Austria medunigraz.at Abstract Thyroid disorders, especially Hashimoto’s thyroiditis (HT), and polycystic ovary syndrome (PCOS) are closely associated, based on a number of studies showing a significantly higher prevalence of HT in women with PCOS than in controls. However, the mechanisms of this association are not as clear. Certainly, genetic susceptibility contributes an important part to the development of HT and PCOS. However, a common genetic background has not yet been established. Polymorphisms of the PCOS-related gene for fibrillin 3 (FBN3) could be involved in the pathogenesis of HT and PCOS. Fibrillins influence the activity of transforming growth factor beta (TGFb). Multifunctional TGFb is also a key regulator of immune tolerance by stimulating regulatory T cells (Tregs), which are known to inhibit excessive immune response. With lower TGFb and Treg levels, the autoimmune processes, well known in HT and assumed in PCOS, might develop. In fact, lower levels of TGFb1 were found in HT as well as in PCOS women carrying allele 8 of D19S884 in the FBN3 gene. -
Thyroid & Parathyroid Glands
THYROID & PARATHYROID GLANDS Objectives: ◧ Editing file • Describe the histological structure of ◧ thyroid & parathyroid glands. Important • Identify and correlate between the different ◧ Doctor notes / Extra endocrine cells in thyroid gland and their functions. • Describe the functional structure of the parathyroid cells. 438 Histology Team Endocrine Block THYROID GLAND STROMA 1- Capsule: dense irregular collagenous C.T. 2- Septa (Interlobular septa) 3- Reticular fibers: Thin C.T. composed mostly of reticular fibers with rich capillary plexus surrounds each thyroid follicle. PARENCHYMA Are the structural and functional units of the thyroid gland. 1- Simple cuboidal epithelium: 2- Colloid: central colloid-filled lumen. a- Follicular (principal) cells b- Parafollicular cells (C cells) (Clear cells) - Pale-stained cells (Clear Cells). (Polygonal/pyramidal cells) N.B. Each follicle is - Simple cuboidal cells. - Found singly or in clusters in between the follicular cells. - Round nucleus with prominent nucleoli. surrounded by thin - Their apices do not reach the lumen of the follicle. L/M: - Basophilic cytoplasm. basal lamina. - Are larger than follicular cells (2-3 times).(larger but less in number) - Apical surface reaches the lumen of the (Acidophilic) - Only 0.1% of the epithelial cells. thyroid follicle. - Have round nucleus - Mitochondria. - RER. (synthesis of thyroglobulin) - Supranuclear Golgi Complex. - Mitochondria. E/M: - Numerous apically-located lysosomes. - RER (moderate). - Numerous dispersed small vesicles - Well-developed Golgi. - The vesicles contain newly formed thyroglobulin. - Numerous apical short microvilli. Function: Synthesis of thyroid hormones (T4 & T3). Secrete calcitonin. 438 Histology Team - Endocrine Block 2 PARATHYROID GLAND They are 4 glands on the posterior of thyroid gland. STROMA 1- Capsule: Each gland has its Thin capsule. -
Thyroid Disease
Thyroid Disease Thyroid disease occurs when the thyroid (a small, butterfly-shaped gland in the front of your neck) does not produce the right amount of thyroid hormone. These hormones control how your body uses energy. If you are feeling fatigued, notice skin or hair changes, or have hoarseness or pain, your doctor may conduct a physical exam and order blood tests. If these tests indicate a problem, your doctor may order thyroid scan and uptake, thyroid biopsy, or imaging tests to help diagnose and evaluate a thyroid condition. Treatment will depend on the specific nature of your thyroid condition and its underlying cause. What is thyroid disease? The thyroid is a small, butterfly-shaped gland in the front of your neck that wraps around your windpipe (trachea). The two halves of the thyroid gland are connected in the middle by a thin layer of tissue known as the isthmus. The thyroid gland uses iodine (mostly absorbed from food) to produce hormones that control how your body uses energy. Nearly every organ in the body is affected by the function of the thyroid gland. The pituitary gland and hypothalamus, an area at the base of the brain, control the rate at which the thyroid produces and releases these hormones. The main function of the thyroid gland is to release a hormone called thyroxine or T4, which is converted into a hormone called T3. Both of these hormones circulate in the bloodstream and help regulate your metabolism. The amount of T4 produced by the thyroid gland is determined by a hormone produced by the pituitary gland called TSH or thyroid-stimulating hormone. -
Hypothyroidism and Pregnancy: What Should I Know?
Fact Sheet From ReproductiveFacts.org The Patient Education Website of the American Society for Reproductive Medicine Hypothyroidism and pregnancy: what should I know? What is hypothyroidism? to protect you against bacterial and viral infections. Sometimes, Hypothyroidism (underactive thyroid) is when the thyroid gland however, the immune system can make antibodies against produces less thyroid hormone than it should. The thyroid gland is your own body—such as against your thyroid. T4 is a hormone found in the lower part of the throat and partially wraps around the produced directly by the thyroid gland. It is typically low in patients upper windpipe (trachea). with hypothyroidism. An autoantibody is an antibody that attacks the cells and tissues of the organism that made it. Thyroid What does the thyroid gland do? autoantibodies are seen in patients with Hashimoto’s (autoimmune) The thyroid gland produces two hormones: triiodothyronine (T3) thyroiditis. and thyroxine (T4). These hormones play an important role in metabolism. Metabolism is the body’s ability to transform food How does hypothyroidism affect my fertility and into energy. The thyroid gland is controlled (regulated) by thyroid- my baby if I become pregnant? stimulating hormone (TSH). TSH is produced by the pituitary gland, Hypothyroidism can prevent the release of the egg from the ovary which is located in the brain. (ovulation). Typically, for women who have periods (menstruate) each month, an egg is released from the ovary each month. What are the symptoms of hypothyroidism? But women who have hypothyroidism may release an egg less When the thyroid gland produces less thyroid hormone than it frequently or not at all. -
Parathyroid Disorders THOMAS C
Parathyroid Disorders THOMAS C. MICHELS, MD, MPH, Madigan Army Medical Center, Tacoma, Washington KEVIN M. KELLY, MD, MBA, Carl R. Darnall Army Community Hospital, Fort Hood, Texas Disorders of the parathyroid glands most commonly present with abnormalities of serum calcium. Patients with primary hyperparathyroidism, the most common cause of hypercalcemia in outpatients, are often asymptomatic or may have bone disease, nephrolithiasis, or neuromuscular symptoms. Patients with chronic kidney disease may develop secondary hyperparathyroidism with resultant chronic kidney disease-mineral and bone disorder. Hypo- parathyroidism most often occurs after neck surgery; it can also be caused by autoimmune destruction of the glands and other less common problems. Evaluation of patients with abnormal serum calcium levels includes a history and physical examination; repeat measurement of serum calcium level; and measurement of creatinine, magne- sium, vitamin D, and parathyroid hormone levels. The treatment for symptomatic primary hyperparathyroidism is parathyroidectomy. Management of asymptomatic primary hyperparathyroidism includes monitoring symptoms; serum calcium and creatinine levels; and bone mineral density. Patients with hypoparathyroidism require close monitoring and vitamin D (e.g., calcitriol) replacement. (Am Fam Physician. 2013;88(4):249-257. Copyright © 2013 American Academy of Family Physicians.) CME This clinical content he four parathyroid glands, located 84-amino acid peptide. PTH increases serum conforms to AAFP criteria posterior to the thyroid gland, reg- calcium levels through direct action on bone for continuing medical education (CME). See CME ulate calcium homeostasis through and the kidneys. It stimulates osteoclasts to Quiz on page 227. release of parathyroid hormone resorb bone and mobilize calcium into the T (PTH). Because most parathyroid disorders blood. -
Endocrine System with Special Reference to Thyroid Gland
Odisha Review December - 2012 Endocrine System With Special Reference to Thyroid Gland Soma Mishra Endocrine system consisting of a group of ductless glands viz. pituitary, thyroid, parathyroid, pineal, thymus, gonads, pancreas, adrenal etc. plays a very vital role in governing human behavior. Thyroid is one of the most important glands that control body’s metabolism and calcium level. It secretes iodothyronines that are (tri-iodo- thyronine, thyroxine) and calcitonin. Its secretion is mainly regulated by TRH (thyrotropin releasing hormone) and TSH (thyroid stimulating hormone). It helps in growth (physical, sexual, mental) – development- metamorphosis and calorigenesis- metabolism. The status of thyroid gland may be Euthyroid or Hypothyroid or Hyperthyroid. Hypothyroidism includes cretinism in children and myxoedema in adults. Common causes of hyperthyroid state are Grave’s disease, multinodular goiter, thyroiditis, etc. Any enlargement of thyroid gland, regardless of cause, is called goiter. Some common investigations for Introduction thyroid diseases are estimation of serum T3, T4 The endocrine system or hormonal system and TSH, cholesterol, radioiodine uptake, thyroid is a complex system composed of a group of imaging, etc. Common drug used in ductless glands known as endocrine glands that hypothyroidism is eltroxin, hyperthyroidism is pour their secretions i.e. hormones directly into carbimazole and iodine supplementation in goiter. blood for passage to different body organs known This paper presents a full picture of thyroid gland, as target organs in order to control their its functioning, disorders, and treatments which is functioning, metabolism, cell permeability, growth, very significant for human survival. differentiation and stress conditions. 54 December - 2012 Odisha Review The endocrine system includes the Diseases of the endocrine system result pituitary gland, thyroid gland, parathyroid glands, from too much or too little hormone secretion or adrenal gland, pancreas, ovaries and testes. -
A Seasonal Study of Pinealocytes in the 13-Lined Ground Squirrel, Spermophilus Tridecemlineatus J
A seasonal study of pinealocytes in the 13-lined ground squirrel, Spermophilus tridecemlineatus J. A. Mcnulty, Teresa A. Dombrowski, Wilma A. Spurrier To cite this version: J. A. Mcnulty, Teresa A. Dombrowski, Wilma A. Spurrier. A seasonal study of pinealocytes in the 13- lined ground squirrel, Spermophilus tridecemlineatus. Reproduction Nutrition Développement, 1980, 20 (3A), pp.665-672. hal-00897671 HAL Id: hal-00897671 https://hal.archives-ouvertes.fr/hal-00897671 Submitted on 1 Jan 1980 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. A seasonal study of pinealocytes in the 13-lined ground squirrel, Spermophilus tridecemlineatus J. A. McNULTY, Teresa A. DOMBROWSKI, Wilma A. SPURRIER Departments of Anatomy and Physiology, Loyola University Stritch School of Medicine, 2160 S. First Avenue, Maywood, Illinois 60153 USA. Summary. A quantitative histological study of pinealocytes in the 13-lined ground squir- rel, Spermophilus tridecemlineatus, was conducted over a period of one year. Consistent and statistically significant seasonal differences were found in nuclear and nucleolar dimensions suggesting a circannual rhythm in the metabolism of these cells. Annual peaks occurred during hibernation, whereas the nadirs occurred during the period of sexual activity. -
Background Information
November 18, 2013 INFORMATION ON THE C-8 (PFOA) MEDICAL MONITORING PROGRAM SCREENING TESTS PREPARED BY THE MEDICAL PANEL FOR THE C-8 CLASS MEMBERS The Medical Panel has made recommendations about medical screening tests that C-8 Class Members could have done to find out if they have any of the Probable Link Conditions identified by the Science Panel. This document is about the Medical Monitoring Program. For each of the Probable Link conditions, the document explains who is eligible to have the screening tests and the possible benefits and risks of the screening tests. The Medical Panel wants you to understand the benefits and risks of the tests, so you can decide whether you want to have the tests done. We encourage you to read about the tests and discuss this information with the doctor who can do the screening tests. Background Information In February 2005, the West Virginia Circuit Court approved a Settlement Agreement in a class action lawsuit entitled Jack Leach et al. v. E.I. du Pont de Nemours and Co., Civil Action No. 01-C-608. The suit was about release of a chemical known as C-8, also known as PFOA, from DuPont's Washington Works facility located in Wood County, West Virginia. “Class Members” are current or former residents of the communities affected by release of C-8. The Settlement had several parts. The Settlement Agreement established a Science Panel to investigate possible links between exposure to C-8 and any diseases. The Panel’s research found that C-8 exposure was probably linked to high cholesterol, thyroid disease, ulcerative colitis, testicular cancer, kidney cancer, and high blood pressure during pregnancy.