文档介绍：颈部疾病
甲状腺疾病
原发性甲状旁腺功能亢进
Primary hyperparathyroidism
颈淋巴结结核
lymphoid tuberculosis
颈部肿块
mass of neck
中国最早的颈部肿物照片,于1909年由一位英国植物探险家在黄河流域拍摄。个人认为很像甲状腺肿。
1. Position
Deep to sternothyroid and sternohyoid m.
Superior terminal is at the level of the midpoint of thyroid cartilage.
Inferior terminal is at the level of 6th tracheal ring.
Isthmus of the thyroid passes transversely through the anterior to the 2nd-4th tracheal rings.
2. Relations
anteriorly—
skin,
superficial fascia, enveloping fascia,
infrahyoid mm.
pretracheal fascia,
posteromedially- larynx, trachea, pharynx, esophagus and recurrent laryngeal n.
posterolaterally—carotid sheath and contents in the sheath
3. Feature
right and left lobes
isthmus
pyramidal lobe
4. Covers
Capsule of the thyroid gland (fibrous-capsule,covering the outer surface of the gland )
Thyroid sheath(belonging to pretracheal fascia, suspensory lig. attached to the thyroid cartilage, cricoid cartilage and tracheal cartilage rings)
The blood vessels, nn. and parathyroid glands in the space between the covers of the gland
5. Blood vessels
1) arteries
(1).superior thyroid a. from external carotid a.
(2). inferior thyroid a. from thyrocervical trunk
** lowest thyroid a.
2) veins
(1). superior thyroid v.
(2). middle thyroid v.
(shorter and larger)
Above vv. drain the blood into the internal jugular v.
(3). inferior thyroid the blood of inferior poles into the left brachiocephalic v.
Thyroid anatomy-vagus
甲状腺生理概要
1 合成T4(90%)T3(10%),结合甲状腺球蛋白
2 T4、T3作用:①耗氧、产热
②蛋白质、碳水化合物及脂肪的分解
③促进生长发育和组织分化(脑、骨骼)
3 生理调节:
①下丘脑(TRH)→垂体(TSH) →甲状腺(T3、T4)轴
②甲状腺内:高碘→甲状腺摄碘↑,T3、T4合成↑
→甲状腺摄碘↓,T3 、T4合成↓
负反馈:①甲状腺素需要量↑(活动,妊娠,生长发育,寒冷)
②甲状腺素合成障碍
③缺碘
病因
1 摄入碘缺乏:地方性~
2 甲状腺激素需要量增加:生理性~
3 甲状腺激素生物合成和分泌障碍
病因分类
1 地方性~endemicity
2 生理性~physiogenic
3 先天性~congenital
单纯性甲状腺肿(Simple Goiter )
发病机理 pathogenesy
1 地方性:缺碘→ T3、T4合成↓→TSH ↑→甲状腺增生、
T3、T4 ↑
2 3 生理性: T3、T4合成相对↓→TSH ↑
4 先天性: T3、T4合成↓→TSH ↑
单纯性甲状腺肿(Simple Goiter )
病理生理 Pathophysiology
甲状