Thyroid Anatomy and Function Quiz
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Questions and Answers

What is the general location of the thyroid gland in the human body?

  • In front of the cricoid cartilage
  • Adjacent to the trachea
  • Above the hyoid bone
  • Below the thyroid cartilage (correct)

Which of the following best describes the structure of the thyroid gland?

  • Divided into four distinct sections
  • Comprises two lobes joined by an isthmus (correct)
  • A spherical structure without lobes
  • A single lobe with no isthmus

What additional structure may be present in about 50% of adults related to the thyroid gland?

  • Lateral lobe
  • Submandibular gland
  • Parathyroid glands
  • Pyramidal lobe (correct)

Which cartilage is located directly above the thyroid gland?

<p>Thyroid cartilage (C)</p> Signup and view all the answers

What anatomical feature is immediately below the thyroid gland?

<p>Cricoid cartilage (C)</p> Signup and view all the answers

What is the primary role of the sodium-iodide symporter in iodide trapping?

<p>It facilitates the active transport of iodide into thyroid follicular cells. (C)</p> Signup and view all the answers

Which enzyme is responsible for the conversion of iodide (I-) to iodine (I2)?

<p>Thyroid peroxidase (B)</p> Signup and view all the answers

What is a potential effect of the inhibitory anion perchlorate (ClO4-) on iodide uptake?

<p>It inhibits iodide uptake. (C)</p> Signup and view all the answers

What types of iodination can occur with tyrosines in the synthesis of thyroid hormones?

<p>Monoiodinated (MIT) and diiodinated (DIT) (B)</p> Signup and view all the answers

What is the clinical significance of Pendred syndrome regarding thyroid function?

<p>It leads to congenital hypothyroidism. (C)</p> Signup and view all the answers

What is the role of the thyroid hormone receptor (TR) in gene expression?

<p>It binds to the thyroid response element of DNA, stimulating transcription. (B)</p> Signup and view all the answers

Which of the following is NOT a metabolic effect of thyroid hormone?

<p>Decreased Na+/K+ ATPase activity (B)</p> Signup and view all the answers

What happens to fat metabolism when thyroid hormones are elevated?

<p>Increased mobilization of lipids and decreased fat stores. (A)</p> Signup and view all the answers

How does thyroid hormone affect oxygen consumption in the body?

<p>It increases oxygen consumption and mitochondrial number. (A)</p> Signup and view all the answers

What is one systemic effect of thyroid hormones on the cardiovascular system?

<p>Increased heart strength and cardiac output with higher oxygen demand. (C)</p> Signup and view all the answers

What effect does increased gluconeogenesis have at high levels?

<p>Degrades proteins (A)</p> Signup and view all the answers

Which of the following is NOT considered a benefit of adequate hormone levels for the central nervous system?

<p>Inhibits memory and learning capacity (D)</p> Signup and view all the answers

Which action is specifically related to the development of the skeletal system?

<p>Promotes calcification of bones (A)</p> Signup and view all the answers

How does effective hormone action impact intermediary metabolism?

<p>Stimulates both synthetic and degradative pathways (C)</p> Signup and view all the answers

Which effect does growth hormone have on muscle contraction?

<p>Increases rate and force of contraction (D)</p> Signup and view all the answers

What happens if the thyroglossal duct does not obliterate during embryonic development?

<p>A thyroglossal duct cyst may manifest clinically. (C)</p> Signup and view all the answers

At what gestational week does the thyroid gland typically take its mature shape?

<p>By the 7th to 8th week. (B)</p> Signup and view all the answers

Which thyroid hormone is considered biologically inactive?

<p>Reverse T3 (rT3) (A)</p> Signup and view all the answers

Where are cystic masses commonly found in cases of thyroglossal duct cyst?

<p>Just below the level of the hyoid bone. (B)</p> Signup and view all the answers

Which element is essential for the synthesis of thyroid hormones?

<p>Iodide (I-) (B)</p> Signup and view all the answers

In which condition would one expect to see elevated Thyrotropin (TSH) levels?

<p>Hypothyroidism (A)</p> Signup and view all the answers

What is the likely consequence of ectopic thyroid tissue during development?

<p>Hypothyroidism (C)</p> Signup and view all the answers

What is the role of thyroglobulin in thyroid hormone synthesis?

<p>It contains tyrosine residues necessary for hormone synthesis. (B)</p> Signup and view all the answers

What is the main product of T4 conversion in peripheral tissues?

<p>T3 (B)</p> Signup and view all the answers

How is most of the circulating T3 produced?

<p>Conversion of T4 in peripheral tissues (B)</p> Signup and view all the answers

What role does T4 serve in relation to T3?

<p>It acts as a prohormone. (D)</p> Signup and view all the answers

Which enzyme converts T4 to inactive rT3?

<p>Inner-ring monodeiodinase (A)</p> Signup and view all the answers

What physiological effect does increased thyroid hormones have on TSH release?

<p>Decreases TSH release (A)</p> Signup and view all the answers

What triggers a decrease in TSH levels?

<p>In increased thyroid hormone levels (A)</p> Signup and view all the answers

What is the outcome of excessive TSH levels?

<p>Thyroid gland hypertrophy (D)</p> Signup and view all the answers

What happens to T4 when the cell has sufficient T3?

<p>It is converted to rT3. (A)</p> Signup and view all the answers

Which gland is primarily responsible for TSH synthesis?

<p>Anterior pituitary gland (A)</p> Signup and view all the answers

What effect does TRH have on the anterior pituitary gland?

<p>Stimulates TSH release (B)</p> Signup and view all the answers

What is one significant role of growth hormone in the central nervous system?

<p>Enhancing peripheral nerve reflex amplitude (B), Inhibiting the replication of nerve cells (D)</p> Signup and view all the answers

Which of the following actions is enhanced by growth hormone in relation to skeletal muscle?

<p>Increased force and rate of contraction (A)</p> Signup and view all the answers

How does growth hormone impact intermediary metabolism?

<p>It regulates both synthetic and degradative metabolic pathways (A)</p> Signup and view all the answers

What role does growth hormone play in the development of the skeletal system?

<p>Stimulating the expression of growth factors in bone cells (A)</p> Signup and view all the answers

What specific effect does growth hormone have on general body growth during childhood?

<p>It stimulates growth and maturation of various body tissues (A)</p> Signup and view all the answers

What is the primary reason thyroid hormones require carrier proteins in the bloodstream?

<p>They are hydrophobic and need aid to travel in circulation. (B)</p> Signup and view all the answers

Which serum protein has the highest affinity for binding thyroid hormones?

<p>Thyroxine binding globulin (D)</p> Signup and view all the answers

What percentage of circulating T4 is typically found in a protein-free form?

<p>0.04% (A)</p> Signup and view all the answers

Which of the following statements regarding T3 and T4 is true?

<p>T4 is secreted in greater amounts than T3. (C)</p> Signup and view all the answers

What is the typical half-life of T3 in circulation?

<p>1-3 days (C)</p> Signup and view all the answers

What is the primary role of the sodium-iodide symporter in the thyroid follicular endothelial cells?

<p>It actively transports iodide from the bloodstream into the cells. (A)</p> Signup and view all the answers

Which of the following describes the effect of TSH on iodide transport?

<p>TSH enhances the uptake of iodide into the thyroid cells. (C)</p> Signup and view all the answers

Which condition is linked to Pendred syndrome?

<p>Congenital hypothyroidism due to defective iodide efflux. (A)</p> Signup and view all the answers

What is the chemical process occurring with iodide in presence of H2O2 during thyroid hormone synthesis?

<p>Iodide is oxidized to iodine (I2). (D)</p> Signup and view all the answers

How are tyrosine residues of thyroglobulin modified during iodination?

<p>They can be either monoiodinated or diiodinated. (A)</p> Signup and view all the answers

What occurs if the thyroglossal duct does not fully obliterate during the development of the thyroid gland?

<p>Formation of a thyroglossal duct cyst (B)</p> Signup and view all the answers

What does the presence of ectopic thyroid tissue along the thyroglossal duct commonly indicate?

<p>Incomplete descent of the thyroid gland (B)</p> Signup and view all the answers

In a clinical assessment, what is the likely consequence for a child with hypothyroidism indicated by high Thyrotropin (TSH) levels?

<p>Slowed growth and development (A)</p> Signup and view all the answers

What role does thyroglobulin play in thyroid hormone synthesis?

<p>Acts as a storage form for T3 and T4 (D)</p> Signup and view all the answers

What is the primary element necessary for the synthesis of thyroid hormones?

<p>Iodide (C)</p> Signup and view all the answers

What typically occurs when there is an excess of TSH in serum?

<p>Increased production of T3 and T4 (B)</p> Signup and view all the answers

Which structure is primarily responsible for the production of calcitonin in the thyroid gland?

<p>C-Cells (Parafollicular Cells) (A)</p> Signup and view all the answers

What is the significance of the thyroglossal duct during the development of the thyroid gland?

<p>It connects the thyroid to the tongue. (A)</p> Signup and view all the answers

Which artery provides the primary blood supply to the thyroid gland?

<p>Superior thyroid artery (A)</p> Signup and view all the answers

Which physiological impact could result from damage to the recurrent laryngeal nerve during thyroid surgery?

<p>Vocal cord paralysis (A)</p> Signup and view all the answers

What is the embryological origin of the thyroid gland?

<p>First pharyngeal arch (D)</p> Signup and view all the answers

What role do capillaries play in the function of the thyroid gland?

<p>Deliver nutrients and transport hormones (B)</p> Signup and view all the answers

Which type of thyroid hormonal secretion is influenced by sympathetic innervation?

<p>Hormone synthesis/secretion (B)</p> Signup and view all the answers

In which direction does the thyroid gland descend during embryonic development?

<p>Anteriorly to the pharyngeal gut (B)</p> Signup and view all the answers

What is the primary role of T4 in the body?

<p>Acts as a precursor to T3 (C)</p> Signup and view all the answers

What happens to T3 levels when there is sufficient T3 in the cell?

<p>The cell switches to the inner-ring enzyme and produces rT3 (B)</p> Signup and view all the answers

What effect does excessive TSH levels have on the thyroid gland?

<p>Increased size and activity of thyroid cells (C)</p> Signup and view all the answers

What enzyme is responsible for converting T4 to inactive rT3?

<p>Inner-ring monodeiodinase (B)</p> Signup and view all the answers

How does increased thyroid hormone levels impact TSH release from the pituitary gland?

<p>It causes TSH levels to decrease to nearly zero (D)</p> Signup and view all the answers

What is the predominant source of circulating T3 in the body?

<p>Conversion of T4 in peripheral tissues (D)</p> Signup and view all the answers

How does TRH affect the anterior pituitary gland?

<p>Stimulates TSH synthesis and release (D)</p> Signup and view all the answers

What is the overall impact of iodine deficiency on thyroid hormone levels?

<p>Increased TSH and decreased T4 (A)</p> Signup and view all the answers

What triggers the secretion of TSH from the anterior pituitary gland?

<p>Low levels of thyroid hormones (A)</p> Signup and view all the answers

How does increased cAMP and Ca2+ affect the thyroid gland?

<p>Enhances colloid uptake and hormone secretion (D)</p> Signup and view all the answers

Flashcards

Where is the thyroid gland located?

The thyroid gland is located in the neck, below the thyroid cartilage, behind the strap muscles.

What is the structure of the thyroid gland?

The thyroid gland has two lobes, joined by an isthmus (a connecting bridge), and sits below the cricoid cartilage.

What are the main components of the thyroid gland?

The thyroid gland is composed of two lobes, each consisting of follicles, which are spherical structures surrounded by a single layer of follicular cells that produce thyroid hormone.

What is the thyroid cartilage and where is it located?

The thyroid cartilage (also known as the Adam's apple) is a prominent cartilage in the neck that forms the front part of the larynx, or voice box.

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What is the cricoid cartilage and where is it located?

The cricoid cartilage is a ring-shaped cartilage in the neck that forms the lower part of the larynx, below the thyroid cartilage.

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What does the Thyroid Hormone-Receptor Complex bind to?

A protein complex that binds to specific DNA sequences called thyroid response elements, initiating the process of transcription.

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How does the Thyroid Hormone-Receptor Complex affect transcription?

The Thyroid Hormone-Receptor Complex interacts with co-activators and co-repressors to start or stop gene transcription, which leads to changes in protein synthesis.

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How does Thyroid Hormone affect fat metabolism?

Thyroid hormone plays a role in stimulating the breakdown of fats, increasing the use of free fatty acids, and decreasing cholesterol levels.

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How does Thyroid Hormone affect carbohydrate metabolism?

Thyroid hormone influences various metabolic processes, including increased glucose uptake, enhanced glycolysis, enhanced gluconeogenesis, and increased insulin secretion.

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What are the other metabolic effects of Thyroid Hormone?

Thyroid hormone helps regulate energy production and utilization. It increases mitochondria number, oxygen consumption, protein synthesis, and the overall basal metabolic rate.

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What is iodide trapping?

Iodide trapping is the first step in thyroid hormone synthesis, where iodide ions from the bloodstream are actively transported into thyroid follicular cells against their concentration gradient.

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What is the sodium-iodide symporter (NIS)?

The sodium-iodide symporter (NIS) is a protein embedded in the basal membrane of thyroid follicular cells. It uses the energy of the sodium gradient to transport iodide ions from the bloodstream into the cell.

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What is the role of Pendrin in thyroid hormone synthesis?

Pendrin is a protein located in the apical membrane of thyroid follicular cells. Its role is to transport iodide ions from the cell into the colloid, the fluid-filled space within the follicle.

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What is the role of thyroid peroxidase (TPO) in thyroid hormone synthesis?

Thyroid peroxidase (TPO) is an enzyme crucial for the oxidation and organification of iodide. It catalyzes the conversion of iodide to iodine and its subsequent attachment to tyrosine residues of thyroglobulin.

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What is Pendred syndrome?

Pendred syndrome is a genetic disorder that results in defective Pendrin function, leading to iodide deficiency in the thyroid gland and congenital hypothyroidism.

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What is the thyroglossal duct?

The thyroglossal duct is a transient structure that connects the developing thyroid gland to the tongue during embryonic development.

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Where does the thyroid gland develop in the embryo?

The thyroid gland begins its journey high in the neck, near the tongue, and eventually migrates down to its final position in the lower neck, anterior to the trachea.

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What is a thyroglossal duct cyst?

It occurs when the thyroglossal duct doesn't completely disappear, and instead persists as a cyst (fluid-filled sac) in the neck.

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What is the fate of the thyroglossal duct?

The thyroglossal duct normally vanishes by 7-10 weeks of gestation, leaving no trace behind.

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What is ectopic thyroid tissue?

Ectopic thyroid tissue refers to thyroid tissue that develops in an abnormal location, often along the path of the thyroglossal duct.

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What is a lingual thyroid?

Lingual thyroid is a rare condition where thyroid tissue develops in the tongue, a common location for ectopic thyroid tissue.

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What are the main thyroid hormones?

T3 (triiodothyronine) and T4 (thyroxine) are the primary thyroid hormones synthesized by the thyroid gland and are essential for regulating metabolism.

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What is reverse T3 (rT3)?

Reverse T3 (rT3) is a biologically inactive form of thyroid hormone. It's important to note it's not directly involved in regulating metabolism.

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How is T4 converted to T3?

T4 is converted to T3 by deiodinase enzyme in peripheral tissues, particularly the liver and kidneys. T3 is much more potent than T4, roughly 4 times stronger.

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Is T4 or T3 the primary active thyroid hormone?

T3 is considered the main active form of thyroid hormone. T4 is considered a prohormone, meaning it needs conversion to T3 to become active.

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What enzymes are involved in converting T4?

The outer-ring monodeiodinase enzyme converts T4 to active T3. While the inner-ring monodeiodinase converts T4 to the inactive form, rT3.

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How does T3 circulate?

The thyroid gland is responsible for releasing T4, while the peripheral tissues convert it to T3. Most T3 in circulation comes from peripheral conversion, only about 20% comes directly from the thyroid gland.

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How is T3 production regulated in cells?

When cellular T3 levels are sufficient, the cell switches to the inner-ring enzyme, producing inactive rT3. This helps regulate the amount of active T3 in the cell.

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How is thyroid hormone production regulated?

The hypothalamus, pituitary gland and thyroid gland are involved in regulating the production of thyroid hormones. This involves a negative feedback loop.

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What is the role of TRH and TSH in thyroid hormone production?

The hypothalamus releases thyrotropin-releasing hormone (TRH) which stimulates the pituitary gland to produce thyroid-stimulating hormone (TSH). TSH then stimulates the thyroid gland to release thyroid hormones.

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How does the negative feedback loop regulate thyroid hormone levels?

High levels of thyroid hormones in the blood inhibit the release of TRH and TSH, thus reducing thyroid hormone production. Low levels of thyroid hormones stimulate TRH and TSH release, resulting in increased thyroid hormone production.

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What is the effect of thyroid hormone levels on TSH release?

Increased thyroid hormone levels have a negative feedback effect on TSH release. Conversely, decreased thyroid hormone levels stimulate TSH release.

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Define TSH and its role.

Thyroid stimulating hormone (TSH) is a glycoprotein produced by the anterior pituitary. It plays a crucial role in regulating the growth, development and function of the thyroid gland.

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Increased gluconeogenesis due to high hormone levels

This is a condition where the body raises the level of glucose in the blood by breaking down proteins, often due to excess levels of certain hormones. This can be detrimental as it uses protein reserves for energy instead of carbs.

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Increased respiration

The respiratory system increases its activity, meaning you breathe faster and deeper. This is often a response to increased metabolism and the need for more oxygen.

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Thyroid hormone's role in CNS development

Thyroid hormone plays a key role in developing the central nervous system in the fetus and young children. Without it, the nervous system might not develop completely.

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Thyroid hormone's effect on cognition

Thyroid hormone is essential for proper mental function. It enhances focus, memory, and learning abilities, making it easier to concentrate and store information.

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Thyroid hormone's impact on emotional well-being

Thyroid hormone helps regulate your mood. It's linked to emotional stability and a balanced emotional state. A lack of it might contribute to mood swings.

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What is Pendrin?

Pendrin is a protein found on the apical membrane of thyroid follicular cells. Its role is to move iodide ions (I-) from the cell into the colloid, the fluid-filled space within the follicles where thyroid hormone is synthesized.

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What is thyroid peroxidase (TPO)?

Thyroid peroxidase (TPO) is an enzyme essential for the oxidation and organification of iodide. It converts iodide ions (I-) to iodine (I2) and then couples it to tyrosine residues on the thyroglobulin protein.

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Which thyroid hormone is more active?

T4 (thyroxine) is the primary thyroid hormone secreted by the gland, but T3 (triiodothyronine) is 2-10 times more biologically active.

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Which thyroid hormone has a longer Half-life?

T4 has a longer half-life than T3, meaning it stays in the bloodstream longer.

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How do thyroid hormones travel in the bloodstream?

Most of the circulating T4 and T3 in the bloodstream are bound to carrier proteins, specifically TBG (thyroxine-binding globulin), TBPA (thyroxine-binding prealbumin), and albumin.

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What is the relationship between T4 and T3?

T4 is the precursor to T3, undergoing conversion in peripheral tissues by deiodinase enzymes. This conversion process is essential for producing the biologically most active form of the hormone.

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What is the active form of thyroid hormones?

Free thyroid hormones (not bound to carrier proteins) are the active forms responsible for affecting target tissues. Their concentration is tightly regulated.

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What is a thyroid follicle?

The functional unit of the thyroid gland, composed of follicular cells surrounding a lumen filled with colloid.

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What are follicular cells?

These cells are responsible for synthesizing and releasing thyroid hormones. They line the lumen of the thyroid follicle.

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What is colloid?

This is a viscous fluid found in the lumen of the thyroid follicle. It contains thyroglobulin, a protein that binds to thyroid hormones.

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What are the capillaries that surround the thyroid follicle?

These are blood vessels that supply nutrients to the thyroid gland and transport thyroid hormones to other parts of the body.

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What role does sympathetic innervation play in the thyroid follicle?

This is the nervous system that influences the synthesis and secretion of thyroid hormones.

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What are C-cells (Parafollicular Cells)?

These are small structures near the thyroid follicle that produce calcitonin, a hormone involved in calcium regulation.

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How does the thyroid gland develop?

The thyroid gland develops from the thyroglossal duct, a diverticulum appearing on the floor of the pharynx during embryonic development.

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Thyroid Gland Development

The thyroid gland descends during development and forms two lobes, connected by an isthmus. This occurs around the 7th-8th week of gestation.

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Thyroglossal Duct

During embryonic development, a passage called the thyroglossal duct connects the developing thyroid gland to the tongue. However, this duct typically disappears completely by 7-10 weeks of gestation.

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Thyroglossal Duct Cyst

If the thyroglossal duct doesn't entirely disappear, a fluid-filled sac called a thyroglossal duct cyst can form in the neck. It's usually located near the midline, just below the hyoid bone.

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Ectopic Thyroid Tissue

Thyroid tissue can sometimes develop in locations other than its normal position. This can occur along the path of the thyroglossal duct, including the tongue and even the chest.

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Lingual Thyroid

A rare condition where thyroid tissue develops in the tongue. It's a common location for ectopic thyroid tissue.

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Thyroid Hormones

The primary thyroid hormones, T3 (triiodothyronine) and T4 (thyroxine), are produced by the thyroid gland and play a crucial role in regulating metabolism.

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Reverse T3 (rT3)

Reverse T3 (rT3) is a biologically inactive form of thyroid hormone. Unlike T3 and T4, it doesn't have a major role in regulating metabolism.

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Iodide Trapping

Iodide is trapped in thyroid follicular cells by active transport. This is the first step in thyroid hormone synthesis.

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Thyroid hormone and CNS development

Thyroid hormone is crucial for the development of the central nervous system (CNS) in fetuses and young children. It helps create and mature the brain and nervous system.

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Thyroid hormone and cognitive function

Thyroid hormone increases the brain's ability to learn and retain information. It enhances alertness, focus, and overall mental function.

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Thyroid hormone and emotional well-being

Thyroid hormone is involved in regulating emotional balance and stability. It helps maintain a healthy emotional state, making you feel more grounded and less prone to mood swings.

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Thyroid hormone and nerve function

Thyroid hormone is essential for increasing the speed and strength of nerve impulses. It makes your nerve signals travel faster and more efficiently.

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Thyroid hormone and body temperature

Thyroid hormone plays a role in regulating your core body temperature. It helps maintain a balanced temperature by increasing your metabolic rate and how much energy your body burns.

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What is deiodination?

The conversion of inactive T4 to active T3, primarily in the liver and kidneys.

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What is extrathyroidal deiodination?

A process of converting T4 into either active T3 or inactive rT3 that occurs within target tissues.

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How does T4 act like a prohormone?

T4 acts as a precursor that is transformed into the more potent T3.

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Describe the regulation of thyroid hormone production.

The hypothalamus, pituitary gland, and thyroid gland are involved in regulating the production and level of thyroid hormones. This involves a feedback loop where high levels of thyroid hormones inhibit further production.

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How does the negative feedback loop function in thyroid hormone production?

The thyroid gland, pituitary gland, and hypothalamus are involved in a negative feedback loop, where high levels of thyroid hormones suppress the production and release of TSH.

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What is TSH and what is its role?

Thyroid-stimulating hormone (TSH) is a glycoprotein synthesized in the anterior pituitary gland. It stimulates the thyroid gland to produce and release thyroid hormones.

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How does thyroid hormone exert its effects?

The mechanism by which thyroid hormone affects gene expression and metabolism. It involves binding to thyroid receptors which then regulate gene transcription.

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What is increased respiration in the context of thyroid hormone?

Increased oxygen consumption in the body, often due to thyroid hormone stimulation of metabolism, leading to increased energy expenditure.

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What is increased gluconeogenesis?

A condition where the body increases the level of glucose in the blood by breaking down proteins. This can be detrimental to health.

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Study Notes

Thyroid Hormone Synthesis, Transport and Cellular Mechanism

  • The thyroid gland is located below the thyroid cartilage, behind the strap muscles.
  • It is a bilobed structure connected by an isthmus, situated below the cricoid cartilage.
  • Approximately 50% of adults have a pyramidal lobe; this is non-palpable and enlarges with disease.
  • Iodide trapping is a critical step in the process stimulated by TSH.

Learning Outcomes

  • Describe the structure and location of the thyroid.
  • Describe the origin of the thyroid gland and its functional relationships.
  • Explain the mechanisms and control of thyroid hormone synthesis.
  • Outline the biochemical and clinical functions of thyroid hormones.

Thyroid Follicles

  • The functional unit of the thyroid gland is the thyroid follicle (or acinus).
  • Follicles are composed of follicular (epithelial) cells and a lumen filled with colloid.
  • Capillaries deliver nutrients and transport hormones.
  • Sympathetic innervation influences hormone synthesis and secretion.
  • Lymphatics drain excess fluid.
  • C-cells (para-follicular cells) produce calcitonin.

Blood Supply and Innervation

  • Arterial supply: superior thyroid artery (from external carotid), inferior thyroid artery (from thyrocervical trunk).
  • Venous drainage: superior and middle thyroid veins, inferior thyroid vein (draining to internal jugular vein), brachiocephalic vein.
  • Innervation: recurrent laryngeal nerve (branch of vagus).
  • Damage to recurrent laryngeal nerve may cause vocal cord paralysis.
  • Emergency airway: cricothyrotomy through the cricothyroid membrane.

Thyroid Gland Origin (Embryology)

  • The thyroid is the first endocrine gland to develop, approximately on day 24 of gestation/3rd week of gestation.
  • The thyroid gland arises from the first pharyngeal arch.
  • Thyroid precursor develops from a thyroglossal duct diverticulum in the floor of the pharynx.
  • The duct descends in the neck as an initially hollow structure solidifying to become bilobed and connected by an isthmus.
  • Initial descent is anterior to the pharynx.
  • Initially, still connected to the tongue by the thyroglossal duct, then bifurcates into two lobes.
  • Thyroglossal duct atrophies in the 7-10 week of gestation, with remnants sometimes persisting.
  • Ectopic thyroid tissue can arise along this path.
  • The thyroid gland origin diagram illustrates the embryological development of the thyroid.

Thyroid Hormone Synthesis – Building Blocks

  • Iodine: A critical micronutrient in food (seafood, dairy, grains and vegetables). Recommended daily intake varies by age and pregnancy status (Kids 90-130 mcg, Adults 150 mcg, Pregnant 220 mcg, Lactating 290 mcg). Iodized salt is a significant source.
  • Thyroglobulin: Large glycoprotein produced by the rough ER of thyroid follicular epithelial cells. Stored in vesicles and exocytosed into the colloid. Composed of two subunits. Contains tyrosine residues sterically oriented for hormone production.
  • Tyrosine: An amino acid component.

Thyroid Hormone Synthesis – Steps

  • Iodide trapping (stimulated by TSH): iodide is actively transported from the bloodstream to thyroid follicular cells against its concentration gradient using iodide symporter (Na+/K+ ATPase).
  • Oxidation/Organification: iodide (I-) is converted to iodine (I2) by thyroid peroxidase (TPO) in the presence of hydrogen peroxide (H₂O₂).
  • Coupling: formed products are monoiodotyrosine (MIT) and diiodotyrosine (DIT). Iodine (I₂), combines with tyrosine residues of thyroglobulin (catalyzed by TPO).
  • Endocytosis: stored colloid is pinocytosed into follicular cells.
  • Proteolysis: lysosomal proteases digest thyroglobulin and release T3 and T4. MIT and DIT are degraded.
  • Transport: T4 and T3 diffuse across the basolateral membrane into capillaries and enter the circulation.

Thyroid Hormone Synthesis - Overview

  • Thyroid hormones (T3 and T4) are synthesized from iodide and tyrosine residues of thyroglobulin.
  • Reverse T3 (rT3): a biologically inactive form, found in significant amounts.

Transport

  • Thyroid hormones are hydrophobic and need carrier proteins to travel in the bloodstream.
  • T4 is bound more tightly than T3 to serum binding proteins.
  • Affinity of these serum proteins is highest for thyroxine-binding globulin (TBG) followed by thyroxine-binding prealbumin (TBPA), and then albumin. Only a small fraction of T3 and T4 (~0.015% and 0.33% respectively) are unbound in the blood.

Conversion of Iodothyronines

  • The peripheral tissues (liver and kidneys) convert T4 to T3 by deiodinase enzyme.
  • T3 is 2-10 times more active than T4.
  • Total serum T3 is about 2% of T4.
  • T4 acts as a prohormone for the active T3 after deiodination.

Thyroid Hormone Regulation

  • Thyroid is under hypothalamic-pituitary control.
  • Negative feedback loop: TRH, TSH, T3, and T4 through the hypothalamic-pituitary-thyroid axis. Hypothalamus releases TRH. Anterior pituitary releases TSH. Thyroid gland releases T3 & T4. Factors controlling thyroid hormone synthesis include the availability of iodine, integrity of the gland, and the conversion of T4 to T3.

Thyroid Stimulating Hormone (TSH)

  • A glycoprotein synthesized in the anterior pituitary.
  • Secretion occurs in pulses with slightly higher levels at night.
  • TSH stimulates thyroid hormone synthesis and increases the size and vascularity of the thyroid gland.
  • Increased thyroid hormone levels have a negative feedback effect on TSH release from the pituitary.
  • Decreased thyroid hormone levels lead to an increase in TSH release.

Thyroid Response to TSH

  • Increase in cAMP, Ca²⁺, calmodulin activity, and increase in protein kinase activity.
  • Increase in colloid uptake, Increased liberation of T3 and T4, Increased production of Thyroglobulin, Increased iodine uptake, Increased iodination of thyroglobulin
  • Increased size and activity of thyroid cells, Increased number of thyroid cells (growth).

Inhibitors of Thyroid Hormone Synthesis

  • Drugs and goitrogens inhibit thyroid hormone synthesis.
  • Iodine and various drugs block iodide trapping and other steps.

Thyroid Function Tests

  • Key tests are used to measure thyroid function: TSH, free T4, free T3, total T4, and total T3. Normal ranges for these tests are included in a separate section.

Thyroid Disorders

  • Primary hypothyroidism: Low TSH, low free T4, and free T3.
  • Graves' Disease: High TSH, low free T4 and free T3.
  • TSH deficiency: high TRH, high TSH but low free T4 and free T3.

Summary of Actions

  • Thyroid hormones have various effects on growth and development, body systems, and intermediary metabolism. Summary of actions also included.

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Test your knowledge on the thyroid gland's anatomy and physiology with this quiz. It covers the thyroid's location, structure, hormonal function, and related syndromes. Perfect for students studying human anatomy or endocrinology.

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