DOCSLIB.ORG

Incessant Bilobed Thymus in an Old Male Cadaver Case Report

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Incessant Bilobed Thymus in an Old Male Cadaver Case Report Incessant Bilobed Thymus in an CASE REPORT Old Male Cadaver KC Sudikshya*1, Shah Aashish Kumar1, Khaling Rai Dipa2 1 Department of Anatomy, National Medical College, Birgunj, Nepal 2 Department of Medical Surgical Nursing, National Medical College, Birgunj, Nepal ABSTRACT INTRODUCTION Thymus is bilobed primary lymphoid organ Thymus is one of the primary lymphoid organs. situated in superior and anterior mediastinum. It is a soft, capsulated, bilobed gland which The appearance of thymus varies considerably belongs to endocrine system1responsible for the with age. It reaches maximum size at puberty and provision of thymus-processed lymphocytes (T eventually undergoes “fibro fatty involution”, lymphocytes) to the entire body, and provides but it may persist actively to old age. Therefore, a unique microenvironment in which T-cell normal appearance and size of thymus have precursors (thymocytes) undergo development, been elusive. Embryologically, it develops, as differentiation and clonal expansion. It’s lobes lie two separate organs from the endoderm of third close together side by side, joined in the midline pharyngeal pouches of embryo in common by connective tissue that merges with the capsule with inferior parathyroid glands and fuse in the of the organ. The greater part of the thymus lies midline. in the superior and anterior inferior mediastinum behind the manubrium. Superiorly, it extends The study was carried on 10 embalmed cadavers commonly into the neck and may reaches the of known sex in Anatomy Department of National inferior poles of the thyroid gland or even Medical College, Birgunj, Nepal. higher. Inferiorly, the lower border of the thymus reaches the level of the fourth costal cartilages. We found a large bilobed thymus in about 65 year Anterior to the gland in the neck are sternohyoid old male cadaver. This fact is clinically important and sternothyroid muscles and fascia; in the to make differential diagnosis of radiological thorax the gland is covered anteriorly by the review in cases of mediastinal mass. A thorough manubrium, the internal thoracic vessels, the knowledge of its anatomical and embryological upper three costal cartilages and laterally by the features of the thymus, it’s normal variations, pleura. Posteriorly, it is in contact with the vessels incessant in adults is necessary before doing any of the superior mediastinum, especially the left therapeutic, diagnostic and invasive procedures. brachiocephalic vein, the thoracic trachea and the upper part of the anterior surface of the heart. Keywords: Diagnostic, Fibrofatty Involution, The thymus is supplied mainly from branches of Incessant, Invasive procedures, Lymphoid organ the internal thoracic and inferior thyroid arteries. Thymic veins drain to the left brachiocephalic, *Corresponding Author: Dr. Sudikshya KC, internal thoracic and inferior thyroid veins. The Department of Anatomy, National Medical College, thymus has no afferent lymphatics. The thymus Birgunj, Nepal, Email- [email protected]. is innervated from the sympathetic chain via the cervicothoracic (stellate) ganglion or from the ansa subclavia and the vagus.2 MED PHOENIX : An Official Journal of NMC, Birgunj, Nepal, Volume (2), Issue (1) July 2017, 67-70 67 KC Sudikshya et al. The gland develops from the epithelial cells CASE REPORT derived from the endoderm of the third pair of During routine dissection of thorax in National pharyngeal pouches and from mesenchyme Medical College, Birgunj, Nepal, a bilobed into which epithelial tubes grow. Thymus incessant thymus gland was found in about 65 development also depends on direct interaction years old male cadaver. The dissection was of mesenchymal derivatives of the neural crest done as follows- A vertical incision over the with pharyngeal epithelium. Some cells of skin of thorax was given extending from the the epithelial cords become arranged around suprasternal notch to the xiphoid process and a central point, forming small groups of cells another horizontal incision from jugular notch the thymic corpuscles (Hassall corpuscles). along the clavicle to the acromion. The skin was The mesenchyme between the epithelial cords reflected following which the pectoral muscles forms thin incomplete septa between the lobules. were exposed. The pectoralis major and minor Lymphocytes soon appear and fill the interstices muscles were reflected. The thoracic cavity was between the epithelial cells. The lymphocytes are exposed cutting at the sternoclavicular joints derived from hematopoietic stem cells. Growth and ribs at midaxillary lines on either sides and development of the thymus are not complete respectively extending from 2nd to 10th ribs and the at birth. It is a relatively large organ during the anterior thoracic wall was reflected downwards. prenatal period and may extend through the The fascia over the anterior mediastinum was superior thoracic aperture at the root of the neck dissected carefully and a bilobed thymus gland and plays an essential role in the development of was found at the region of manubrium below the immune system. Subsequently, it descends with thyroid gland.6 pericardium from the neck into the thorax.3 Observations were noted as follows: Ectopic thymic tissue is sometimes found. Small . An uneven length bilobed thymus gland with accessory nodules may occur in the neck. They half or more soft-tissue parenchyma along represent portions that have become detached with partial fibrofatty tissue. during their early descent.2 As both lobes develop . The gland was extending from root of the independently; each lobe has its own separate neck below the thyroid gland, to the superior blood supply, lymphatic drainage and nerve and anterior mediastinum. supply.3 . The gland was flat and two lobes were connected by fat and fibrous connective It weighs about 10-15 gm at birth and it tissue. progressively increases in size and weighs to about 20-30 gm till puberty. Then it undergoes The gland showed following relations: fibrofatty involution.1 By adulthood, it is often Superiorly – Thyroid gland scarcely recognizable because of fat infiltrating the Anteriorly – Manubrium of sternum cortex of the gland; however, it is still functional Posteriorly – Aortic arch, pericardium and heart and important for the maintenance of health. In Laterally – Cervical pleura covering right and addition to secreting thymic hormones, the adult left lobes of lung thymus primes thymocytes (T-cell precursors) before releasing them to the periphery.3 Inferiorly - Pericardium. Two thymic veins were found on posterior Acute shrinkage of thymus also occurs in surface draining into the right brachiocephalic conditions such as stress, infection, pregnancy, trunk separately. malnutrition, surgery, chemotherapy and . The gland was not of uniform length, malignancy.4 breadth and thickness and hence maximum measurements were considered. Thymic dysfunction leads to diseases such as myasthenia gravis, tumors, growth disorders, After measurements a small section was sent rheumatic disease etc.5 in pathology laboratory for histological slide 68 MED PHOENIX : An Official Journal of NMC, Birgunj, Nepal, Volume (2), Issue (1) July 2017, 67-70 Bilobed Thymus preparation. Slide revealed only fibrous tissue. of thymus during bodily stress. During recovery Probably the reason may be due to delayed period, it grows back to its original or even larger preservation of body in formalin after death. size. This phenomenon is known as thymic rebound hyperplasia. Rebound hyperplasia is 1. Right thymus commonly seen in children but also occurs in adults. These anatomic variations and dynamic 2. Left Thymus changes appears as main source of confusion. 3. Thyroid Gland These misinterpretations with pathological 4. Right Lung covered by Pleura condition lead to prolonged chemotherapy or 5. Left Lung covered by Pleura radiotherapy or unnecessary biopsy. Thus it sets a major confusion for radiologist.4 6. Pericardium covering Heart and Great Blood Vessels A study by Krishna Murthy JV, et al. shows 7. Thyroid cartilage thymus in adult life may be normal or abnormal. The prepubertal thymic glands were pyramidal in shape, pinkish grey to brown in color while post pubertal thymus were flattened, varied from greyish white to yellow.7 As described by Sushmita Bhatnagar, et al. posterior mediastinal accessory thymus was reported. Surgeons dealing with mediastinal structures should have a better knowledge about these variatons.8 Studies of Yasumasa Monden, et al. proposed that 63% (44% males and 19% females) of myasthenia gravis patients have thymomas. Scientist believed that thymus gland may give incorrect instructions to developing immune cells, ultimately resulting in autoimmunity and the production of acetylcholine receptor antibodies. Thymectomy performed in myasthenia gravis patients has great prognosis.9 Figure 1: Anterior view of Bilobed Thymus of Prevalence of large anterior mediastinal thymus Cadaver in situ. is also reported in 65 year old male cadaver.1 Table 1: Measurements of the Gland A study by Tetsuro Araki, et al. suggested Thymus Right side Left side Cigarette smoking and high BMI are associated Maximum Length (upper pole to 5 cm 3.2 cm lower pole) with advanced fat degeneration of the thymic Maximum Breadth (at superior 1.4 cm 2 cm gland. Cigarette may facilitate fatty degeneration mediastinum) of the thymus. However, the effect of smoking on Maximum Thickness 0.4 cm 0.4 cm 10 Weight including connective tissue 4.9 gm 2.6 gm the adult thymus has not been understood. DISCUSSION
Load more

Recommended publications
  • Downhill Varices Resulting from Giant Intrathoracic Goiter
    E40 UCTN – Unusual cases and technical notes Downhill varices resulting from giant intrathoracic goiter Fig. 2 Sagittal com- puted tomography of the chest. The goiter was immense, reaching the aortic arch, sur- rounding the trachea and partially compres- sing the upper esopha- gus. The esophagus was additionally com- pressed by anterior spinal spondylophytes. Fig. 1 Multiple submucosal veins in the upper esophagus, consistent with downhill varices. An 82-year-old man was admitted to the hospital because of substernal chest pain, dyspnea, and occasional dysphagia to sol- ids. His past medical history was remark- geal varices are called “downhill varices”, References able for diabetes mellitus type II, hyper- as they are located in the upper esophagus 1 Kotfila R, Trudeau W. Extraesophageal vari- – lipidemia, and Parkinson’s disease. On and project downwards. Downhill varices ces. Dig Dis 1998; 16: 232 241 2 Basaranoglu M, Ozdemir S, Celik AF et al. A occur as a result of shunting in cases of up- physical examination he appeared frail case of fibrosing mediastinitis with obstruc- but with no apparent distress. Examina- per systemic venous obstruction from tion of superior vena cava and downhill tion of the neck showed no masses, stri- space-occupying lesions in the medias- esophageal varices: a rare cause of upper dor or jugular venous distension. Heart tinum [2,3]. Downhill varices as a result of gastrointestinal hemorrhage. J Clin Gastro- – examination disclosed a regular rate and mediastinal processes are reported to enterol 1999; 28: 268 270 3 Calderwood AH, Mishkin DS. Downhill rhythm; however a 2/6 systolic ejection occur in up to 50% of patients [3,4].
    [Show full text]
  • Selective Venous Sampling for Primary Hyperparathyroidism: How to Perform an Examination and Interpret the Results with Reference to Thyroid Vein Anatomy
    Jpn J Radiol DOI 10.1007/s11604-017-0658-3 INVITED REVIEW Selective venous sampling for primary hyperparathyroidism: how to perform an examination and interpret the results with reference to thyroid vein anatomy Takayuki Yamada1 · Masaya Ikuno1 · Yasumoto Shinjo1 · Atsushi Hiroishi1 · Shoichiro Matsushita1 · Tsuyoshi Morimoto1 · Reiko Kumano1 · Kunihiro Yagihashi1 · Takuyuki Katabami2 Received: 11 April 2017 / Accepted: 28 May 2017 © Japan Radiological Society 2017 Abstract Primary hyperparathyroidism (pHPT) causes and brachiocephalic veins for catheterization of the thyroid hypercalcemia. The treatment for pHPT is surgical dis- veins and venous anastomoses. section of the hyperfunctioning parathyroid gland. Lower rates of hypocalcemia and recurrent laryngeal nerve injury Keywords Primary hyperparathyroidism · Localization · imply that minimally invasive parathyroidectomy (MIP) is Thyroid vein · Venous sampling safer than bilateral neck resection. Current trends in MIP use can be inferred only by reference to preoperative locali- zation studies. Noninvasive imaging studies (typically pre- Introduction operative localization studies) show good detection rates of hyperfunctioning glands; however, there have also been Primary hyperparathyroidism (pHPT) is a common endocrine cases of nonlocalization or discordant results. Selective disease. Most patients have one adenoma, but double adeno- venous sampling (SVS) is an invasive localization method mas have been reported in up to 15% of cases [1]. Approxi- for detecting elevated intact parathyroid
    [Show full text]
  • Anatomy & Embryology of Thyroid & Parathyroid
    ANATOMY & EMBRYOLOGY OF THYROID & PARATHYROID By Prof . Saeed Abuel Makarem & Associate Prof. Sanaa Alshaarawy 1 OBJECTIVES Ò By the end of the lecture, the student should be able to: Ò Describe the shape, position, relations and structure of the thyroid gland. Ò List the blood supply & lymphatic drainage of the thyroid gland. Ò List the nerves endanger with thyroidectomy operation. Ò Describe the shape, position, blood supply & lymphatic drainage of the parathyroid glands. Ò Describe the development of the thyroid & parathyroid glands. Ò Describe the most common congenital anomalies of the thyroid gland. 2 Before we go to the thyroid What are the parts of the deep fascia or deep cervical fascia of the neck? It is divided mainly into 3 layers: 1- Investing layer. 2- Pretracheal layer. 3- Prevertebral layer. 3 Ò Endocrine, butterfly Thyroid gland shaped gland. Ò Consists of right & left lobes. Ò The 2 lobes are connected to each other by a narrow isthmus, which overlies the 2nd ,3rd & 4th tracheal rings. Ò It is surrounded by a facial sheath derived from the pretracheal layer of the deep cervical fascia. 4 Thyroid gland Ò Each lobe is pear- shaped, with its apex reaches up to the oblique line of thyroid cartilage. Ò Its base lies at the level of 4th or 5th tracheal rings. Ò Inside the pretracheal facial capsule, there is another C.T capsule. Ò So, it s surrounded by 2 membranes. 5 Each lobe is pear shape, with its apex directed upward as far as the Anterior oblique line of the thyroid cartilage; its base lies at the 4th or 5th tracheal ring.
    [Show full text]
  • SŁOWNIK ANATOMICZNY (ANGIELSKO–Łacinsłownik Anatomiczny (Angielsko-Łacińsko-Polski)´ SKO–POLSKI)
    ANATOMY WORDS (ENGLISH–LATIN–POLISH) SŁOWNIK ANATOMICZNY (ANGIELSKO–ŁACINSłownik anatomiczny (angielsko-łacińsko-polski)´ SKO–POLSKI) English – Je˛zyk angielski Latin – Łacina Polish – Je˛zyk polski Arteries – Te˛tnice accessory obturator artery arteria obturatoria accessoria tętnica zasłonowa dodatkowa acetabular branch ramus acetabularis gałąź panewkowa anterior basal segmental artery arteria segmentalis basalis anterior pulmonis tętnica segmentowa podstawna przednia (dextri et sinistri) płuca (prawego i lewego) anterior cecal artery arteria caecalis anterior tętnica kątnicza przednia anterior cerebral artery arteria cerebri anterior tętnica przednia mózgu anterior choroidal artery arteria choroidea anterior tętnica naczyniówkowa przednia anterior ciliary arteries arteriae ciliares anteriores tętnice rzęskowe przednie anterior circumflex humeral artery arteria circumflexa humeri anterior tętnica okalająca ramię przednia anterior communicating artery arteria communicans anterior tętnica łącząca przednia anterior conjunctival artery arteria conjunctivalis anterior tętnica spojówkowa przednia anterior ethmoidal artery arteria ethmoidalis anterior tętnica sitowa przednia anterior inferior cerebellar artery arteria anterior inferior cerebelli tętnica dolna przednia móżdżku anterior interosseous artery arteria interossea anterior tętnica międzykostna przednia anterior labial branches of deep external rami labiales anteriores arteriae pudendae gałęzie wargowe przednie tętnicy sromowej pudendal artery externae profundae zewnętrznej głębokiej
    [Show full text]
  • An Unusual Origin and Course of the Thyroidea Ima Artery, with Absence of Inferior Thyroid Artery Bilaterally
    Surgical and Radiologic Anatomy (2019) 41:235–237 https://doi.org/10.1007/s00276-018-2122-1 ANATOMIC VARIATIONS An unusual origin and course of the thyroidea ima artery, with absence of inferior thyroid artery bilaterally Doris George Yohannan1 · Rajeev Rajan1 · Akhil Bhuvanendran Chandran1 · Renuka Krishnapillai1 Received: 31 May 2018 / Accepted: 21 October 2018 / Published online: 25 October 2018 © Springer-Verlag France SAS, part of Springer Nature 2018 Abstract We report an unusual origin and course of the thyroidea ima artery in a male cadaver. The ima artery originated from the right subclavian artery very close to origin of the right vertebral artery. The artery coursed anteriorly between the common carotid artery medially and internal jugular vein laterally. It then coursed obliquely, from below upwards, from lateral to medial superficial to common carotid artery, to reach the inferior pole of the right lobe of thyroid and branched repeatedly to supply the anteroinferior and posteroinferior aspects of both the thyroid lobes and isthmus. The superior thyroid arteries were normal. Both the inferior thyroid arteries were absent. The unusual feature of this thyroidea ima artery is its origin from the subclavian artery close to vertebral artery origin, the location being remarkably far-off from the usual near midline position, and the oblique and relatively superficial course. This report is a caveat to neck surgeons to consider such a superficially running vessel to be a thyroidea ima artery. Keywords Thyroid vascular anatomy · Thyroidea ima artery · Artery of Neubauer · Blood supply of thyroid · Variations Introduction (1.1%), transverse scapular (1.1%), or pericardiophrenic or thyrocervical trunk [8, 10].
    [Show full text]
  • Anatomy of the Woodchuck (Marmota Monax)
    QL737 .R68B49 2005 Anatomy of the Woodchuck (Marmota monax) A. J. Bezuidenhout and H. E. Evans SPECIAL PUBLICATION NO. 13 AMERICAN SOCIETY OF MAMMALOGISTS LIBRARY OF THE /XT FOR THE ^> ^ PEOPLE ^ ^* <£ FOR _ EDVCATION O <£ FOR ^J O, SCIENCE j< Anatomy of the Woodchuck (Marmota monax) by A. J. Bezuidenhout and H. E. Evans SPECIAL PUBLICATION NO. 13 American Society of Mammalogists Published 21 February 2005 Price $45.00 includes postage and handling. American Society of Mammalogists P.O. Box 7060 Lawrence, KS 66044-1897 ISBN: 1-891276-43-3 Library of Congress Control Number: 2005921107 Printed at Allen Press, Inc., Lawrence, Kansas 66044 Issued: 21 February 2005 Copyright © by the American Society of Mammalogists 2005 SPECIAL PUBLICATIONS American Society of Mammalogists This series, published by the American Society of Mammalogists in association with Allen Press, Inc., has been established for peer-reviewed papers of monographic scope concerned with any aspect of the biology of mammals. Copies of Special Publications by the Society may be ordered from: American Society of Mammalogists, % Allen Marketing and Management, P.O. Box 7060, Lawrence, KS 66044-8897, or at www. mammalogy.org. Dr. Joseph F. Merritt Editor for Special Publications Department of Biology United States Air Force Academy 2355 Faculty Drive US Air Force Academy, CO 80840 Dr. David M. Leslie, Jr. Chair, ASM Publications Committee Oklahoma Cooperative Fish and Wildlife Research Unit United States Geological Survey 404 Life Sciences West Oklahoma State University Stillwater, OK 74078-3051 Anatomy of the Woodchuck (Marmota MONAX) A. J. Bezuidenhout and H. E. Evans Published by the American Society of Mammalogists Contents Page Acknowledgments vii Foreword ix Chapter 1.
    [Show full text]
  • Superior and Posterior Mediastina Reading: 1. Gray's Anatomy For
    Dr. Weyrich G07: Superior and Posterior Mediastina Reading: 1. Gray’s Anatomy for Students, chapter 3 Objectives: 1. Subdivisions of mediastinum 2. Structures in Superior mediastinum 3. Structures in Posterior mediastinum Clinical Correlate: 1. Aortic aneurysms Superior Mediastinum (pp.181-199) 27 Review of the Subdivisions of the Mediastinum Superior mediastinum Comprises area within superior thoracic aperture and transverse thoracic plane -Transverse thoracic plane – arbitrary line from the sternal angle anteriorly to the IV disk or T4 and T5 posteriorly Inferior mediastinum Extends from transverse thoracic plane to diaphragm; 3 subdivisions Anterior mediastinum – smallest subdivision of mediastinum -Lies between the body of sternum and transversus thoracis muscles anteriorly and the pericardium posteriorly -Continuous with superior mediastinum at the sternal angle and limited inferiorly by the diaphragm -Consists of sternopericardial ligaments, fat, lymphatic vessels, and branches of internal thoracic vessels. Contains inferior part of thymus in children Middle mediastinum – contains heart Posterior mediastinum Superior Mediastinum Thymus – lies posterior to manubrium and extends into the anterior mediastinum -Important in development of immune system through puberty -Replaced by adipose tissue in adult Arterial blood supply -Anterior intercostals and mediastinal branches of internal thoracic artery Venous blood supply -Veins drain into left brachiocephalic, internal thoracic, and thymic veins 28 Brachiocephalic Veins - Formed by the
    [Show full text]
  • A Syllabus of Core Surgical Anatomy
    A Syllabus of Core Surgical Anatomy Background In February 2010, it was agreed that the Anatomy Committee would undertake to develop a new generic examination for implementation in 2012 to assess anatomy for surgical trainees. Content Anatomical questions relate to: • clinical examination – surface anatomy, inspection, palpation, percussion, auscultation, pelvic examination, testing for peripheral nerve injuries, potential sites of spread of tumours (as determined by anatomy e.g. lymphatic drainage of the breast) • urethral catheterization • vascular access (arterial and venous, peripheral and central) • the airway: maintenance, access • chest drainage • imaging (plain radiographs, CT, MRI, US, contrast studies) • surgical access – open and minimally invasive • endoscopy (GI, arthroscopy etc) • peripheral nerve blocks • percutaneous liver biopsy • trauma (aligned to anatomy in EMST) • common anatomical complications of routine surgical procedures • principles of anatomy: terminology, anatomical position, planes, relationships in regional anatomy, movements, tissues, systems, and anatomical variation. Syllabus Essential (+++) • What an early SET 1 trainee (PGY 2-3 with general experience) should know. • Must recognise, understand and be able to explain. • These structures comprise core basic surgical anatomy and are essential in inter-specialty communication. • Lack of knowledge could jeapordise patient safety. • Includes all common and important anatomical characteristics of the structure: location, constituent parts, relations, blood supply and lymphatic drainage, innervation, course and distribution, when the structure is at risk, effects of injury, and common variants of clinical importance. Desirable (++) • Should be able to describe the basic anatomy/location of the structure, its function, major nerve and blood supply ± lymphatic drainage, and general relations. Non-core (+) • Not considered core knowledge but may be appropriate for specialty-specific anatomy.
    [Show full text]
  • Transcervical Thymectomy
    Original Article Page 1 of 5 Transcervical thymectomy Marcin Zieliński1, Mariusz Rybak1*, Katarzyna Solarczyk-Bombik1, Michal Wilkojc1, Wojciech Czajkowski1, Sylweriusz Kosinski2, Edward Fryzlewicz2, Tomasz Nabialek2, Malgorzata Szolkowska3, Juliusz Pankowski4 1Department of the Thoracic Surgery, 2Department the Anesthesiology and Intensive Care, Pulmonary Hospital, Zakopane, Poland; 3Department of Pathology of the Tuberculosis Institute, Warsaw, Poland; 4Department of Pathology, Pulmonary Hospital, Zakopane, Poland Contributions: (I) Conception and design: M Zieliński; (II) Administrative support: None; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: All authors; (V) Data analysis and interpretation: None; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Marcin Zieliński, MD, PhD. Department of Thoracic Surgery, Pulmonary Hospital, Ul. Gładkie 1, 34 500 Zakopane, Poland. Email: [email protected]. Background: The aim of this article is to describe the technique of minimally invasive extended thymectomy performed through the transcervical video-thoracoscopic (VATS) approach with elevation of the sternum for the thymic tumors with/without myasthenia gravis (MG). Methods: The operation is done through the collar incision in the neck of a length of 4–8 cm. To facilitate an access to the mediastinum a one-tooth hook connected to the Zakopane bar (Aesculap-Chifa, Nowy Tomysl, Poland) is inserted under the sternal notch for elevation of the sternum. Careful anatomical dissection of the structures of the lower neck region is done with preservation from injury of the thyroid gland, the parathyroid glands and both laryngeal recurrent nerves. The thymus gland is resected en-bloc with the surrounding fatty tissue of the lower neck and the anterior superior mediastinum.
    [Show full text]
  • Endocrine Block اي كالم باللون الذهبي مأخوذ من التيم وورك فايل )الي يقال انه اكسترا( EDITING FLIE Anatomy of Pituitary Gland
    PRACTICAL ANATOMY Endocrine Block اي كﻻم باللون الذهبي مأخوذ من التيم وورك فايل )الي يقال انه اكسترا( EDITING FLIE Anatomy Of Pituitary Gland 2 Identify the Pointed areas: 1 1- hypophyseal fossa(Sella turcica). 2-anterior & posterior clinoidal process. The pituitary gland: located in middle cranial fossa and protected in sella turcica (hypophyseal fossa) of body of sphenoid. Relations Of Pituitary Gland Identify the Pointed areas: 1- mamillary bodies (posteriorly). 2 2-optic chiasma (anteriorly). 1 3-Sphenoidal air sinuses (inferior) . 3 4-body of the sphenoid. If Pituitary gland became enlarged (e.g 4 adenoma ) it will cause pressure on optic chiasma and lead to Bilateral temporal eye field blindness Relations Of Pituitary Gland 1 2 Identify the Pointed area : 1- Pituitary gland. 2- Diaphragma sellae (superior). 3-Sphenoidal air sinuses(inferior) . 4-Cavernous sinuses (lateral) . 4 3 Identify the Pointed area : 2 1- Anterior lobe(Adenohypophysis) . 2- optic chiasma 3- infundibulum . 4- Posterior lobe (Neurohypophysis) 3 SUBDIVISIONS OF PITUITARY GLAND 1 Anterior Posterior 4 Lobe(Adenohyp Lobe(Neurohyp ophysis) ophysis) The true gland connected to hypothalamus through hypothalamo- hypophyseal tract synthesizes & Secretes hormones Stores hormones secreted by hypothalamicnuclei receives a nerve supply from some of the hypothalamic nuclei (supraoptic & Hormone-releasing & inhibiting factors paraventricular) The axons of these produced by hypothalamus use nuclei convey their neurosecretion to Hypophyseal Portal System to reach the the Posterior lobe of pituitary gland Anterior lobe of pituitary gland through Hypothalamo-Hypophyseal tract from where it passes into the blood stream. Blood Supply Of Pituitary Gland Identify the Pointed area : 1- Superior hypophyseal artery: supplies infundibulum & forms a capillary network from which vessels pass downward & form sinusoids into the anterior lobe of pituitary gland (hypophyseal portal system).
    [Show full text]
  • Thyroid and Parathyroid Glands
    Thyroid and Parathyroid Glands Lecture (2) . Important . Doctors Notes Please check our Editing File . Notes/Extra explanation هذا العمل مبني بشكل أساسي على عمل دفعة 436 مع المراجعة {ومنْْيتو َ ّكْْع َلْْا ِّْللْفَهُوْْحس بهْ} َ َ َ َ َ َ َ َ َ ُ ُ والتدقيق وإضافة المﻻحظات وﻻ يغني عن المصدر اﻷساسي للمذاكرة . Objectives At the end of the lecture, students should be able to: Describe the shape, position, relations and of the thyroid gland. List the blood supply & lymphatic drainage of the thyroid gland. List the nerves endanger with thyroidectomy operation. Describe the shape, position, blood supply & lymphatic drainage of the parathyroid glands. Parts of the deep cervical fascia of the neck o It is divided mainly into 3 layers (or more) important during surgeries: • Investing layer (covers neck completely) • Pretracheal layer (covers thyroid gland and trachea) • Prevertebral layer (surrounds vertebra & prevretbral muscles). o The carotid sheath is part of the deep cervical fascia of the neck Note: At the 4 the corners of the neck, the investing layer separates to form two layers (anterior and posterior layers) to cover the sternocleidomastoid muscle in the anterolateral corner and trapezius muscle in the posterolateral corner "الغدة الدرقية" Thyroid Gland o Endocrine, butterfly shaped gland, Consists of right & left lobes connected to each other by a narrow isthmus, which overlies the 2nd ,3rd & 4th tracheal rings. o The gland is surrounded by a facial sheath derived from the pretracheal layer of the deep cervical fascia, what is the
    [Show full text]
  • THE VARIATIONS of the INFERIOR THYROID VEIN of the DOMESTIC Clit
    AUTHOR'S ABSTRACT OF THIS PAPER ISSCED BY THE BIBLIOGR.4PHIC SERVICE, FEBRUbRY 24 THE VARIATIONS OF THE INFERIOR THYROID VEIN OF THE DOMESTIC CLiT HARRISON R. HUNT West Virginia Universitv SEVEN FIGURES The inferior thyroid veins of man vary considerably. The following observations, made on thirty-three domestic cats selected at random, show that the same is true of this vein in the cat. Each of the accompanying figures represents, some- what diagrammatically, the conditions in a single animal. These seven animals suffice to give a fairly complete idea of the variations in the remaining twenty-six. Figure 1 shows the inferior thyroid vein (I) communicating anteriorly with the left internal jugular, receiving branches from only the left lobe of the thyroid gland (14), then passing ob- liquely backward across the trachea (13) to join the right innominate vein (10). The veins labeled 2 and 3 in this and the following figures were not homologized with certainty with the human superior and middle thyroid veins. Two other dis- sections resembled figure 1 very closely, except that in one of them the inferior thyroid vein joined the external jugular vein at a. Figure 2 resembles figure 1 in some respects. However, the inferior thyroid vein (1) in figure 2 receives a branch (a) from the right lobe of the thyroid gland (14), empties into the right internal jugular vein (a), but in the dissection did not appear to communicate directly with the left internal jugular. The inferior thyroid vein in a second cat joined the jugulars at m 39 40 HARRISON R.
    [Show full text]