Thyroid Gland

THYROID GLAND
• Is a brownish red, highly, vascular organ.

• Situated anteriorly at the level of the 5th, 6th and

7th cervical and the 1st thoracic vertebrae.
• Related to the pretracheal fascia, that binds it to
the larynx.

• Possesses its own true fibrous capsule, which is

continuous with the stroma of the gland.
• Consists of a pair of
lateral lobes which are
joined across the
median line by the
ISTHMUS.
 The Lobes:
• Conical in shape

• Extends from the middle of the thyroid cartilage to

the 6th tracheal ring.

• Its apex points upward.

 PYRAMIDAL LOBE
• A triangular projection, extending upward
usually from the left side of the upper border of
the isthmus.
• Each lobe is about 5cm long; its greatest transverse
and anteroposterior diameter dimensions being
about 3cm and 2cm.
• The posteromedial aspect of each lobe is attached
to the side of the cricoid cartilage by a ligamentous
band, called the LATERAL LIGAMENT of the thyroid
gland.
•Medial surface of the Thyroid gland is related to
the following structures:
• 2 tubes ( esophagus and trachea)
• 2 nerves (recurrent and external laryngeal)
• 2 muscles (inferior constrictor and cricothyroid)
•The lobe is related posteriorly to:
• Common carotid
• Inferior thyroid arteries
• Longus cervicis muscle
•Superficially, it is covered by:
• Sternohyoid
• Omohyoid
• Sternothyroid

• Note: These muscles are overlapped by the

Sternocleidomastoid muscle.
 ARTERIES
• SUPERIOR THYROID ARTERY, is the first branch
of the external carotid.

• Supplies the infrahyoid, laryngeal and

sternocleidomastoid branches in the carotid
triangle.
 ARTERIES
• INFERIOR THYROID ARTERY, is a branch of the
thyrocervical trunk which arises from the first
part of the subclavian.
• Supplies the larynx, the pharynx, the trachea,
the esophagus and the surrounding muscles.
• Unlike the superior thyroid artery the inferior
thyroid does not follow a direct course towards
the lower pole of the thyroid gland.
• It travels upward along the medial border of the
scalenus anterior muscle.
• At the 6th cervical vertebra it turns medially
behind the vagus nerve and the common carotid.
• Passes in front of the vertebral vessels.
• Then continues downward, reaching the posterior
border of the gland to which it is finally
distributed.
 THYROIDEA IMA
• Is a branch from the inominate or the aortic
arch.
• It varies in size from a tiny arteriole to a vessel as
large as the inferior thyroid, which it may
replace.
• It passes upward over the anterior surface of
the trachea, under cover of the thymus, and
reaches the inferior border of the isthmus.
 VEINS
• Form a rich plexus situated in front of the gland.

• As they leave the gland, they form 3 main trunks.

 1. SUPERIOR THYROID VEIN
• is the only venous trunk that accompanies the
artery of the same name.
• It leaves the upper part of the gland, taking as its
guide the outer border of the omohyoid muscle,
crosses the common carotid artery and ends in
the internal jugular vein.
 2. MIDDLE THYROID VEIN
• has no accompanying artery.
• It leaves the gland about its midportion, follows
the inner border of the omohyoid, crosses the
common carotid artery and ends in the internal
jugular vein.
 3. INFERIOR THYROID VEIN
• commences at the lower pole of the gland and
at the lower border of the isthmus.
• They pass downward in front of the trachea and
may be connected by several transverse
branches and end in the left inominate vein.
 NERVES
•Two nerves are related to the thyroid gland:
• Superior laryngeal
• Recurrent laryngeal
 SUPERIOR LARYNGEAL NERVE
• arises from the inferior ganglion (nodosum).
• Passes downward and medially and crosses
behind the internal carotid artery.
• It divides into the internal and the external
laryngeal nerves.
 Internal Laryngeal Nerve
•Larger of the two branches.
•Accompanied by the superior laryngeal
branch of the superior thyroid artery.
•It is purely sensory and supplies fiber to the
floor of the piriform fossa and the mucous
membrane of the larynx above the vocal
cord.
 External Laryngeal Nerve
• Accompanies the superior thyroid artery but is
placed on a deeper plane.
• Supplies the cricothyroid and inferior
constrictor muscles.
• Ligation of this nerve would cause temporary
weakness or huskiness of the voice.
 RECURRENT LARYNGEAL NERVE
• is a structure of vital importance in thyroid
surgery.

• Considerable variation in its position may take

place.
 RECURRENT LARYNGEAL NERVE
• Normally it is located in the tracheo-esophageal
groove.

• It always passes posterior to the joint that exists

between the inferior cornu of the thyroid and
the cricoid.
•It is both sensory and motor.
•It supplies all the intrinsic muscles of the
larynx with the exception of the
cricothyroid.
 THYROIDECTOMY COMPLICATIONS
• Postoperative seroma • Thyrotoxic storm
• Postoperative bleeding • Superior Laryngeal Nerve
• Recurrent Laryngeal Nerve Injury
Injury (results to vocal- • Infection
fold paresis or paralysis) • Hypothyroidism
• Hypoparathyroidism
(direct trauma,
devascularization, or
removal)