thyroid function

The thyroid gland is formedfrom the diverticulum of the floor of the pharynx
Twolobes connected by isthmus may contain remnants in the
thyrogbssal duct
The gland is in closeproximity with the parathyroidgland andrecurrent
laryngeal nerve Noteforsurgery
Thyroidhormones
Thyroxine Tae Triodsthyromine 73 Ccells in the parafollicular regions release
calcitonin
a what is the relevance of iodine in the thyroid
gland
Thyroid hormones are iodine containing modified a a Tg contains 4 isdives
Iodine veg
in comes from iodide fromthe soil
a iodide uptakefrom the blood intothe follicular cell
b Iodide oxidation Iodide Iodine activeforms This iodinates
the thyroxine residues
mumem
formation of T Tz anycombood T t Ta tomake 13 74
d colloidresorption
prom.momma
mm man
e Proteolysis attackedby proteases
8 Recycling 73 t 74 re enter bloodstream and rest is recycled

Radioactive b dine injected goesto 9activitypartsof the thyroid Tumours which are
overactive adenoma
High dose of iodine treatstumours producingprimaryhyperthyroidism
Biodination conversion of Ty 73 occurs in the liver Ty is a prohormone take off
one is ohne 73
This is controlled by thesympathetic nervous system is inhibited by
stress
TSH Thyroidstimulating hormone controls iodide uptake oxidation
iodination

Thyroid hormones in the blood bound to plasma proteins albumin pre

albumin thyroxinebinding globulin 7 Ba
TBG has a high affinity to 13 t 74
I Only 0 OJ1 of Ty is free O J t of Tz is free c Large storage
The freeportion of hormone can diffuse into the tissue Total plasma csn c
depends on conc og binding protein
t in liver kidney disease
In pregnancy TB a 9 in liver 9 conc of Ty

What is the action ofthyroidhormone

via intracellularreceptors t DNA raises basalmetabolic rate 902utilisation
9ATP production
Increases number of adrenergic B receptors intissues 9 SNS function
In the fetus responsible formaturation of bones lungs 1 brain

Hyperthyroidism
Hyperthyroidism
signs symptoms
lose weight sweating high heart rate SBP 9 DB Pt mean BP isnormal
diarrhoea
exopthalmus eyes pushed forward in Graves disease is not
caused by thyroidhormones
causes
a raves Disease gland diffusely enlarged uniformdensity prodantibody
that mimics TSH
goitre swelling of thyroid gland
Toxic modules glandnodules show up hot spots humour adenoma within
the gland E TSH
Treatment
surgery remove thyroid or part of thyroid 1 give replacement Ty never
give Tz Toomuch cardiac issues
Radio idine Highdose plusreplacement Ty
Anti thyroid drugsplus replacement Ty Methimazole

Hypothyroidism Myxoedema
cold intolerant 1 metabolism low heart rate constipation doughy texture
to skins lethargic put on weight

Beta bdinases in the pituitary are different to the rest of the body whenplasma
13 is low Biodination in the liver is low but pituitary 73 is not reduced
how 73 syndrome plasma 73 is low but pituitary TSH secretion is not
increased