......

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Thyroid Dr. El-Matary

:




: : :
:

thyroid





anatomy thyroid
anatomy of the breast
thyroid breast
anatomy thyroid
anatomy thyroid
breast
milk line
axilla groin
breast 12

,,

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Thyroid Dr. El-Matary

embryology thyroid

,,,

,,

) ,,, (
,,
,,,


,,,

,, ,,,

,,

embryology
,,,

,,
,,










branchial arch
branchial arch
branchial arch

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Thyroid Dr. El-Matary

,,,
embryo

:

,,
,,, rudimentary
rudimentary
ductus arteriosus

rudimentary
rudimentary
,,,
,,



,,, ,,
,,


Over growth

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Thyroid Dr. El-Matary

,,




anterior 2/3 Post 1/3
,,,
Anterior 2/3 posterior 1/3
sulcus terminal

Anterior 2/3 posterior 1/3
foramen foramen caecum
caecum

caecum
caecum
Blind pouch

caecum
foramen foramen caecum

branchial arch
branchial arch
branchial arch
branchial arch

neck
branchial arch

neck branchial arch
branchial arches

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Thyroid Dr. El-Matary

branchial arch
branchial arch anterior 2/3
brachial arch posterior 1/3 of the tongue
branchial arch



branchial arch

thyroglossal duct
thyroid
thyroglassal duct
thyroid
foramen caecum

thyroglossal
tongue thyroid
thyroglossal duct
thyroid
foramen caecum
branchial arch
branchial arch
duct thyroglossal duct

thyroid
branchial arch



branchial arch
branchial arch

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Thyroid Dr. El-Matary

neck
,,
thyroid
branchial arch

thyroid






ultimobranchial body

ultimobranchial body
4th branchial arch
thyroid
ultimobranchial body
ultimobranchial body

!!!!!
Ultimo
!!!!

rudimentary

ultimo
Branchial
body branchial

Ultimobranchial body

,,
Ultimobranchial body

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Thyroid Dr. El-Matary

Body branchial ultimo

Body branchial ultimo

embryology thyroid
thyroid
Thyroglossal duct ultimobranchial body

thyroid embryology
the thyroglossal duct
thyroglossal duct foramen
Foramen caecum of the tongue
branchial arch
isthmus lobe

duct
thyroglossal duct
4th branchial arch
ultimobranchial body

body branchial ultimo
thyroid








4th branchial arch
C cells

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Thyroid Dr. El-Matary

follicle thyroid follicular cells

C cells
Calcitonin
superior parathyroid

) (
MEN type 2
MEN Multiple endocrine neoplasia type two
,,,
medullary carcinoma C cells
hyper parathyroidism
,,,
medullary carcinoma Hyper parathyroidism
: embryology
ultimobranchial body
4th branchial arch

MEN type two
MEN
: MENS

MEN type two

Medullary carcinoma pheochromocytoma Hyper parathyroidism

,,

,,
goitre
medullary carcinoma
: ,, medullary carcinoma
: ,, medullary carcinoma
general examination
) ,,, Chachexia : (
Metastasis

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Thyroid Dr. El-Matary

:
Cachexia metastasis
Medullary carcinoma

Pheochromocytoma
Ca
hyper parathyroidism
MEN type two

:
: embryology
Ultimobranchial body
: embryology thyroid


flash back
goitre

Medullary carcinoma
medullary carcinoma
medullary carcinoma
general examination

:

: pheochromocytoma
Investigations
:

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Thyroid Dr. El-Matary

hyper parathyroidism

: MEN type 2
MEN type two
: embryology
embryology
Ultimobranchial body :

)
(
,,
,,

,,,
thyroglossal cyst
thyroglossal duct

thyroglossal duct

,,,
obliterate
,,,
thyroid
thyroglossal duct

thyroglossal cyst
thyroglossal cyst
Move with deglutition and protrusion of the tongue

general
thyroid

10

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Thyroid Dr. El-Matary

examiner
: thyroid


thyroid move with
thyroglossal cyst move with deglutition and protrusion of the tongue


thyroglossal cyst moves with the tongue
: thyroglossal duct
: thyroid tongue
: thyroid tongue
tongue thyroid!!!

,,,

thyroglossal duct
thyroglossal duct
thyroglossal cyst
deglutition protrusion of the tongue

thyroid embryology
Composite of two embryological origin
Thyroglossal duct ultimobranchial body
thyroglossal duct
thyroid
ultimobranchial body
C cells
superior parathyroid gland

,,,
anatomy
thyroid

11

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Thyroid Dr. El-Matary

) embryology
,,
(
embryology
embryology
composite
embryology
composite

embryology thyroid
it is a composite :
composite :
: composite
composite

It is composite
Composite
Thyroglossal duct ultimobranchial body
,,,
parts
thyroid lobes
thyroid
thyroid
thyroid
,,, thyroid

,,,

,,
thyroid
thyroid
Two lobes and isthmus
thyroid two lobes and isthmus

,,,

12

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Thyroid Dr. El-Matary

two lobes isthmus

,,,
pyramidal lobes

Pyramidal lobe
thyroglossal duct
thyroglossal duct

pyramidal lobe
levator glandulae thyroidae
remnant thyroglossal duct

,,,
two lobes isthmus
Minimum
,, weight
thyroid

2.5
2

,,

2.5 2
,,,
,,,
oral
:
: simple nodular goitre
:
: partial thyroidectomy
partial thyroidectomy

13

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Thyroid Dr. El-Matary

,,
: Normal lobe

normal lobe
: 2.5 2

Normal lobe
,, !!! Normal lobe
,,
Normal lobe


,,

thyroid


isthmus
,,


isthmus
,,, examiner
8
text
partial thyroidectomy

14

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Thyroid Dr. El-Matary

,,
partial thyroidectomy


,,
:
: Normal lobe
: Normal lobe
:
,,
:
: ,,
:
2.5 2
:



,,

weight
,,,
position

thyroid ,,,
,,
,,

thyroid cartilage
,,
thyroid cartilage ,,
thyroid cartilage
hyoid bone

) (

15

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Thyroid Dr. El-Matary

thyroid cartilage
cartilage trachea
cricoid cartilage
trachea

:
hyoid bone
thyroid cartilage
cricoid cartilage
trachea
,,


,, thyroid cartilage
,, cricoid cartilage Hyoid bone
,,

hyoid bone ,, Hyoid bone ,,
) greater horn ( lesser horn
,, Hyoid bone
trachea
thyroid ,,
Muscular triangle
Muscular triangle front of the neck ,,

,,
oblique line thyroid cartilage tracheal ring 6
oblique line thyroid cartilage tracheal ring 6
oblique line thyroid cartilage tracheal ring 6

,,,
thyroid
thyroid

16

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Thyroid Dr. El-Matary

,,
thyroid ,, thyroid

,,,
thyroid ,,
thyroid ,, related trachea
related trachea esophagus
,,
oblique line thyroid cartilage 6
tracheal ring

,,
vertebrae
,, ,, cervical vertebrae
thyroid Upper part of the neck lower
part of the neck
Lower part
oblique line thyroid cartilage

,, thyroid
,,
,,



thyroid
thyroid oblique Line thyroid cartilage
thyroid cartilage
thyroid
4 x 2.5 x 2

20 ) 8 8 + 4 + ( isthmus
,,
thyroid Position Neck
In the front of the neck

17

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Thyroid Dr. El-Matary

,, muscular triangle
In front of the neck
oblique line thyroid cartilage tracheal ring 6

,,
vertebrae
5,6,7
cervical vertebrae

thyroid Lower part of the neck upper part

Lower part of the neck
isthmus
tracheal ring 2,3,4
Isthmus tracheal ring 2,3,4
,,
relations
embryology ,, thyroid
thyroid
,, composite ,,
composite ,,

Thyroglossal duct
Ultimobranchial body

thyroid
thyroglossal duct
ultimobranchial body
,, C cells superior para thyroid
,,
thyroid two lobes isthmus
cm x 2.5cm x 2 cm 4
isthmus
oblique line thyroid cartilage tracheal ring 6

18

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Thyroid Dr. El-Matary

Isthmus tracheal ring

thyroid neck relations
thyroid
Medial relations thyroid
trachea
esophagus
nerve recurrent laryngeal nerve
medial relation ,, trachea esophagus recurrent laryngeal
nerve

,, :
,, goiter :

Dyspnea
Dysphagia
Change of voice

,, Medial relations trachea esophagus recurrent laryngeal
nerve

,, goiter dyspnea dysphagia change of voice
lateral relations
Strap muscle
Sterno mastoid
general ,,
,, goiter ,,
swelling

deep to sternomastoid and strap muscles

general
sternomastoid Origin insertion Nerve supply
,, Origin ,, clavicle sternum
,, Insertion Mastoid

19

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Thyroid Dr. El-Matary

,, Nerve supply spinal part of accessory

spinal part of accessory
accessory
Cranial nerve ,, 11

action sternomastoid
,, ,, ) ,, ,,, : ,,
(
,, sternomastoid
sternomastoid
,,
sternomastoid ,,

,, sterno mastoid
,,
sterno mastoid ,,
strap muscles
strap muscles

,, strap
strap ,, strap muscles

Sterno hyoid
Sterno thyroid
Omo hyoid

!!!!
,, ,, sterno
hyoid
: sternum Hyoid
Hyoid
,, sterno thyroid
sternum thyroid
thyroid gland cartilage
thyroid cartilage

20

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Thyroid Dr. El-Matary

Oblique line sterno thyroid

sterno thyroid ,,
thyroid ,,
gland ,,
,, goiter gland ,,

thyroid

sterno thyroid muscle
clinical
examiner : goiter gland

,,

,,
,,

IQ

,, thyroid
,, retro sternal goiter
:

,, : sterno thyroid
muscle

examiner
,, origin Insertion
sternum thyroid cartilage
sterno hyoid sterno thyroid Origin Insertion
Omo hyoid
Omo
,,,

21

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Thyroid Dr. El-Matary

Omo

Omo

Omo scapula
,,
scapula Omo
Omo hyoid
scapula hyoid bone
anatomy
: omo hyoid ,, two bellies
Superior belly hyoid
Inferior belly scapula
inter mediate tendon
Omo hyoid ,, superior belly Hyoid
Inferior belly scapula
Intermediate tendon

,,
Omo ,,
Hyoid scapula
:
Superior belly
Inferior belly
Intermediate tendon ,,

,,
: ,,

,, hyoid scapula

strap muscles
steron hyoid
sterno thyroid
Omo hyoid

22

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Thyroid Dr. El-Matary

break ,,
Lateral relation ,, thyroid strap muscles sterno mastoid
skin subcutaneous tissue Platysma

Operative
: ,, skin subcutaneous tissue Platysma
saliva
!!!!! Platysma platysma

Platysma
rudimentary muscle
,,,
: platysma
,,

,,,
examiner :
: ,,
skin subcutaneous tissue Platysma
Platysma Rudimentary muscle

,, ,,
!!!! rudimentary muscle
pectoralis major

thyroid skin subcutaneous tissue
platysma

,,
: ,, platysma
,, ,, platysma ,,
adherent scar
Platysma
thyroid disease More common in males females
,, females
females ,,, cosmetics

23

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Thyroid Dr. El-Matary

,, goiter

:
,, ,,
: ,, ,,
Ugly scar
thyroid
platysma separate layer adherent scar



platysma
,, Platysma examiner
Platysma
rudimentary muscle

: Platysma
: Platysma dartos muscle corrugators cutis ani
) anus (
: platysma Nerve supply
cervical branch of facial nerve :
: ,,
,, More details
Oral questions
platysma
anatomy of
thyroid
Platysma thyroid
thyroid Platysma
Operative

,,
,,
Platysma rudimentary muscle

% 20

24

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Thyroid Dr. El-Matary

examiner platysma



pan ,,
carnivorous ,, ,,
,,
,,
platysma ,,
,, muscle rudimentary
platysma dartos
scrotum ,, dartos muscle
scrotum

corrugators cutis ani

,, anus
,, anus

:
platysma
dartos
corrugators cutis ani

Nerve supply ,, platysma

cervical branch of facial nerve
,, Platysma
) ,, (
,, subcutaneous tissue

,, subcutaneous tissue
,, skin
,, subcutaneous tissue
,, Platysma : ,, Platysma

,,

25

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Thyroid Dr. El-Matary

Platysma dartos corrugators cutis ani
nerve supply cervical branch of facial nerve
,, platysma
Platysma
,,
skin subcutaneous tissue ,, Platysma
thyroid
thyroid
,,

muscles

sterno mastoid
strap muscles
retractor sterno mastoid strap muscles

retractor
: sterno mastoid strap muscles
: strap muscles
:
Sterno hyoid
Sterno thyroid
Omo hyoid
Origin Insertion Nerve supply

Nerve supply ,,
Ansa cervicalis
Ansa

Ansa ,,

,,
Ansa
Cervicalis
Nerve ,,
,,

26

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Thyroid Dr. El-Matary

,, ,,

Ansa
Ansa
,,

Ansa cervicalis


,,
strap muscles Nerve
Ansa cervicalis

thyroid ,,
sternum thyroid Hyoid bone strap
muscles

retractors
) ( thyroid ,,
,,
strap muscles
strap muscle thyroid ,,
thyroid ,,
,,
strap muscles ,, thyroid ,,
thyroid
strap muscles
strap muscles thyroid
: ,, ,, Nerve
,, supply Ansa cervicalis ,,

,,
,, ,,
,,
,, ,,
as high as possible
ansa cervicalis ,,
,,

27

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Thyroid Dr. El-Matary

as high as possible

,,
anatomy surgical anatomy
anatomy classic

anatomy platysma
,,
,, rudimentary muscle
strap muscles
,,
,, ) (
Medial relation : thyroid
trachea
esophagus
recurrent laryngeal

Lateral relations : thyroid
skin
subcutaneous tissue
platysma
sterno mastoid
strap muscles

posterior relation thyroid
carotid sheath
: thyroid carotid
artery
syncopal attack transient ischemic attack

,,
,,

28

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Thyroid Dr. El-Matary

: vein black out red

out
,, congestion of the retina

,,
,,
,,
: vagus

Nerve of Arnold
vagus ,, nerve of arnold ,,
thyroid vagus Nerve of
Arnold

,,
thyroid carotid
,, Syncopal attack ,, TIA
transient ischemic attack
,,
,, jugular vein congestion of retina

,, Jugular vein
,, sinus
Lateral sinus
sigmoid skull jugular vein
,, lateral sinus ,, sigmoid skull

Internal jugular vein

external jugular vein
internal jugular
external
: anatomy
external jugular

,, ,, ,,
Internal jugular vein lateral sinus
Lateral sinus sigmoid

29

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Thyroid Dr. El-Matary

,, Jugular vein

IQ
sigmoid sinus skull foramen
Jugular foramen

,, Jugular vein ,, Jugular vein
congestion Head and neck
,, congested retina
retina ,, congested

Visual hallicuination

) (

,, thyroid ,, goiter


,, medial
trachea
esophagus
recurrent laryngeal nerve
Dyspnea ,, dysphagia ,, change of voice

Carotid artery
Vagus
Internal jugular vein

sterno thyroid
thyroid ,,, sterno thyroid
relations operative
clinical
,, Orinted goiter
anatomy
medial relations thyroid

30

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Thyroid Dr. El-Matary

trachea
esophagus
recurrent laryngeal nerve
lateral relations thyroid
skin
subcutaneous tissue
platysma
sternomastoid
strap muscles
Posterior relations thyroid
carotid sheath

thyroid
related larynx Pharynx
related trachea esophagus
trachea esophagus
larynx Pharynx
,,
larynx pharynx
thyroid related larynx Pharynx
thyroid related trachea esophagus
,,
Internal jugular vein
,, Lateral sinus Lateral sinus sigmoid sinus
jugular foramen
jugular vein

Carotid artery

left
arch of Aorta
right
innominate artery

31

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Thyroid Dr. El-Matary

innominate artery ,, :

Right subclavian
Right common carotid

breast
arch of the aorta
arch of the aorta

Aorta ,,
left common carotid left subclavian arch of aorta

extension ) Innominate brachiocephalic

( artery

Right common cartoid

Right subclavian artery

blood vessel
,,
arteries
arch of aorta
arch of aorta


arch of aorta :
left subclavian artery
left common carotid artery
right
Innominate

innominate :
Right common cartoid
Right subclavian

,, ,, ,,,

,,
,, Carotid sheath
cartoid artery

32

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Thyroid Dr. El-Matary

Internal jugular vein

vagus

cartoid sheath ,, applied

vascular
avscular
vertebrae disk
disk
avascular
bone
,,

Vascular

,,
,, Malignant goiter carotid sheath
cartoid sheath
Fibrous tissue
vascular
,, blood vessels
cartoid sheath
cartoid artery Internal jugular vein
carotid sheath
carotid sheath

,, ,, ,,,
: carotid sheath
Then

Infilitrate it ,,
behaviour
carotid sheath avascular fibrous tissue vascularity

sympathetic chain
Horner syndrome

special

33

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Thyroid Dr. El-Matary

Hornor syndrome

Ptosis
Miosis
Anhydrosis
Enophthalmos

,,

ganglion
special ganglion
ganglion
sympathetic chain
,, Nerve
,, skull sacrum
,, ganglion

cervical ) thoracic thoracic ( cervical

,, )
( ganglion
,, hornor syndrome

thyroid ,, Moves with
deglutition

: thyroid moves with deglutition
pretracheal fascia
: thyroid moves with deglutition

pretracheal fascia
,, pretracheal fascia
deglutition
,,

34

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Thyroid Dr. El-Matary

attachment of pretracheal fascia deglutition
,,
,, attachment
examiner
thyroid ,, Moves with deglutition attachment of
pretracheal fascia deglutition
,,
attachment
: attachment
fibrous pericardium
carotid sheath
fibrous pericardium cartoid sheath
attachment
thyroid cartilage
Hyoid bone
,, larynx ,,

Larynx
epiglottis larynx


thyroid cartilage ,,
Pretracheal fascia contents

contents
,,
,, :
,,,
: ,, thyroid ,, Moves with deglutition
: Moves with deglutition
: pre tracheal fascia

35

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Thyroid Dr. El-Matary

:
:
Pretracheal fascia

,, attachment of
pretracheal fascia

,,
anatomy ,, ,,
move with deglutitions


: pretracheal fascia
fibrous pericardium

Carotid sheath

,,
Oblique line thyroid cartilage Hyoid bone
,,
Pretracheal fascia content
content Pretracheal fascia
thyroid

,,
,, ,, thyroid Para
,, Para thyroid gland

: Pretracheal fascia
thyroid
Para thyroid
pre tracheal lymph nodes
Prelaryngeal lymph nodes

36

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Thyroid Dr. El-Matary

thyroglossal cyst
,,
trachea pretracheal fascia
,,

Pre tracheal ,, Pre fascia trachea
trachea ,, peritracheal
Pre tracheal



,,
: trachea pretracheal fascia
,,

,,

: trachea pretracheal fascia

:
,, pre
,, Pre fascia trachea
trachea !!!!!

thyroid pretracheal fascia

thyroid
Para thyroid
pretracheal lymph nodes
pre laryngeal lymph nodes
thyroglossal cyst

,,
contents of pretracheal fascia

37

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swellings deglutitions swellings :

deglutitions neck
thyroid
para thyroid
pre laryngeal lymp nodes pre tracheal
thyroglossal cyst
composite embryology thyroid

:
Thyroglossal duct
Ultimobranchial body

thyroid
thyroglossal duct
ultimobranchial body
superior para thyroid ,, C cells
,, thyroid
isthmus Two lobes
8 Lobe
4 isthums
20 total
x 2.5 x 2 cm 4 Lobe

infront of the neck thyroid

tracheal ring 6 thyroid cartilage Oblique line
C5,6,7 ,,
relations thyroid ,,,
thyroid lateral relations
skin
subcutaneous tissue
platysma
sterno mastoid
strap muscles
Medial relations
Page |

38

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Thyroid Dr. El-Matary

trachea
esophagus
recurrent laryngeal nerve

Posterior relations
Carotid sheath

Carotid artery
Internal jugular vein
Vagus

ansa cervicalis
sympathetic chain

ansa cervicalis nerve supply

Strap muscles

Ansa
,,

,,
thyroid fascia
,,, Pretracheal fascia false capsule thyroid
pretracheal fascia
fibrous pericardium

carotid sheath

thyroid cartilage Hyoid bone
,, pretracheal fascia contents
contents
thyroid
para thyroid
Pretracheal prelaryngeal lymph nodes
thyroglossl cyst

,,

39

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Thyroid Dr. El-Matary

,, ,, ,,


,,

Larynx ,,
Larynx
) gravity
(
,,
,, larynx gravity ....
larynx
strap musclse
sterno hyoid sterno thyroid
Larynx ,, larynx ,, active
,,

,,



,,
:
:
:
,, ,,


larynx

digastric muscle
digastric muscle Hyoid bone
larynx
strap muscles


digastric ,, strap

40

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Thyroid Dr. El-Matary

,,
thyroid
artery superior thyroid artery

superior thyroid artery
external carotid artery
superior thyroid artery

,,
head and neck
external carotid
,, neck carotid artery

External carotid artery
Internal carotid artery
Internal

Internal carotid artery ,, Head and neck
,,
Head and neck common carotid
:

Internal carotid
External carotid

Internal carotid
,,
head and neck external carotid
,,
,, lingual artery
external carotid artery

41

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Thyroid Dr. El-Matary

external carotid artery

,, facial artery
,, external carotid

external carotid artery
common carotid
Internal ,, external
internal Head Neck ,,

,,
,, head and neck external carotid
,,
Occipital artery Pharyngeal artery
,, external carotid
Head and neck ,, external carotid artery
external carotid
artery external carotid

,, ,,
: superior thyroid artery
: superior thyroid artery
,,

,,

Internal carotid
common carotid
external carotid ,,
,, ,, ,,

superior thyroid artery ,, ,,
gland ,, Nerve
external laryngeal nerve

42

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Thyroid Dr. El-Matary

superior thyroid artery nerve

external laryngeal nerver

superior thyroid artery ,, gland
gland
Nerve
external laryngeal nerve ,,
cricothyroid muscle

,,
cricothyroid muscle ,, origin Insertion
cricoid thyroid

Cricothyroid muscle

cricothyroid
,, ,, ,,
depend mainly cricothyroid muscle

,, cricothyroid
external laryngeal nerve ,, slow dance

,, recurrent laryngeal external
larygneal
,, superior thyroid artery
) ( ,, external laryngeal nerve

: ,,

,,

: ,, ,,
,,
,,
Loss of high pitched voice
superior thyroid artery

43

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Thyroid Dr. El-Matary

external carotid artery
,, superior thyroid
artery external carotid

,,
superior thyroid artery ,, related ,, Nerve
external laryngeal nerve
external laryngeal nerve Loss of high pitched voice
,,
,, anatomy
superior thyroid artery external carotid
,,,
artery inferior thyroid artery
anatomy
,, Inferior thyroid artery thyrocervical trunk of the first
part of subclavian artery

,,, ,,
,, Inferior thyroid artery thyrocervical
trunk subcalavian artery
,,
,,
,, subclavian artery
subclavian artery
Right Left
,, right Innominate
,, left arch of aorta
,, ,, ,, ,,
subclavian artery
subclavian artery thyrocervical

,, ,,

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Thyroid Dr. El-Matary

,, :
thyrocervical trunk
: thyroid cervical
,, inferior thyroid artery
cervical artery ,, transverse cervical
,,
,, : ,,
Operative ,,
: ,, ,,
:
:
: thyroidectomy
: ,, full mark thyrocervical
trunk
: ,, Inferior thyroid transverse cervical
full mark

,, examiner
examiner :
:
: full mark

,, ,,
examiner ,, thyrocervical trunk
: ,, anatomy
artery thyrocervical
,, thyrocervical ,, inferior thyroid artery
transverse cervical

,,
: Inferior thyroid artery
thyrocervical trunk

first part of subclavian artery

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Thyroid Dr. El-Matary

,,,
,, subclavian artery thyrocervical truck ,, Inferior thyroid artery

,,
,, superior thyroid artery inferior thyroid artery
artery anatomy artery :
thyroid Ima artery
congenitally
congentially absent
,, Inferior thyroid artery away
from the gland

Inferior thyroid artery thyroid gland
,, gland
recurrent laryngeal nerve

,, subcalvain artery ,, thyrocervical trunk artery
inferior thyroid
thyroid gland
related recurrent laryngeal nerve
recurrent laryngeal nerve
artery ,, away from the gland
,,
,,
superior thyroid artery gland
Inferior thyroid artery away from the gland

inferior thyroid artery away from the gland to avoid injury of recurrent
laryngeal nerve

,,
,,



,,

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Thyroid Dr. El-Matary

,,
,, Proximal stump ,,
Proximal stump
,, ,, Hemothorax
thoracotomy

,,
thyroid
,, partial thyroidectomy ,,
Inferior thyroid artery
Posteromedial part
,,

blood supply ,,
gland ,, blood
supply

,, ,, Infarction
,, Infarction
branch accessory esophageal and tracheal
branches

,,,
,, anatomy thyroid gland

arterial supply of the thyroid gland ,,
superior thyroid artery external carotid artery
inferior thyroid artery thyrocervical trunk of the first part of the
subclavian artery
,, thyroid ima artery ,, May be absent
accessory esophageal and tracheal branches

,, ,, vessels ,, examiner

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.......

,, vessels :

,, ,, ,, :
,, ,,, anatomy
accessory esophageal and tracheal branches
Ligament of Berry gland
Ligament of Berry ,, ,, pretracheal fascia
accessory esophageal and tracheal branches
Ligament of ,, Pretracheal fascia thickened
Berry
Accessory esophageal and tracheal branches
thyroid
Berry
,, general
sign of Berry
displacement carotid thyroid
carotid
Sign of Berry
thyroid ,, Berry
sign of Berry Ligament of Berry
Pretracheal fascia thickened Ligament of Berry
accessory esophageal and tracheal branches

thyroid arterial supply
external carotid artery ,, Superior thyroid artery
within the ,, superior thyroid artery
gland
to avoid injury of external laryngeal nerve
thyrocervical trunk of the first part of ,, Inferior thyroid artery
subclavian artery
away from the ,, Inferior thyroid artery ,,
gland
Ligation in continuity ,,

,,
away from the gland to avoid injury of recurrent laryngeal nerve
absent ,, artery
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Thyroid Dr. El-Matary

Thyroid ima artery

,, accessory esophageal and tracheal branches Ligament
of Berry
Ligament of Berry

,,
,,,
Internal jugular
,,
internal jugular vein :

internal jugular ,, ,,
,, Limb
,, : Internal jugular
:
: external jugular
:
: jugular Jugular external internal

Internal jugular vein subclavian

,, ,,
,,

: ,, Internal jugular vein

: Internal jugular subclavian
:
:
,,
Internal jugular subclavian
) Brachiocephalic vein ( innominate
Innominate vein
,,
Superior vena cava

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Thyroid Dr. El-Matary

,,
superior vena cava innominate vein
superior vena cava - superior vena cava ,,

:
anatomy

,,

superior vena cava innominate vein
,,
Innominate
artery
Innominate vein
Innominate vein superior vena cava

innominate artery :

Right common carotid

Right subclavian

,,

thyroid vascular blood vessels
blood vessels

,,

superior vena cava two innominate vein

venous drainage thyroid
,,

,,
,,

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,, ,, ,,

,,
anatomy

,,
anatomy of the breast

,, depth
,,,
,, anatomy
anatomy
vein Internal jugular vein
internal jugular vein ,,
,, Internal
jugular lateral sinus
sigmoid sinus jugular foramen
carotid sheath
subclavian vein innominate

,,
,,
,, subclavian vein Internal jugular
,, Innominate

,,
Innominate vein
superior vena cava
superior vena cava : ,,
:
,, superior vena cava
Inferior vena cava ,,
,, ,,
superior vena cava
left innominate Right right
left

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Left innominate vein ,,

left right left innominate vein
right
superior vena cava
Left innominate vein
Journey ,,
Inferior thyroid vein
left innominate
left

right lobe left innominate
Journey ,,

,, ,,
,,
,,

Operative
: Inferior thyroid vein
Inferior thyroid vein : veins

vein veins S

Inferior thyroid vein :

: Inferior thyroid vein
: Inferior thyroid vein
: innominate vein

: Innominate vein
: innominate vein

: Innominate vein !!!!

:
: ,, ,,

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: ,, ,,


,,
,, inferior thyroid vein
Vein veins ,, Innominate
,,
,,
: superior vena cava
superior vena cava
:
,, ,,
: ,,
:
:

,, ,,
,,
superior vena cava
,,
superior thyroid vein middle thyroid vein
Internal jugular
superior thyroid middle thyroid vein
Internal jugular vein
,, ,, middle thyroid
vein

,,

,, thyroid

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blood vessels

,, ,, ,,
,,
organ blood vessel
,, ,, exposure
blood vessel

: Mobilization
excision

blood vessel ,, ,, thyroidectomy

Middle thyroid vein

,, lobes ,,
blood vessel ,, Middle thyroid
vein
operative
Middle thyroid vein ,,

Middle thyroid vein
) (
special
special ,,

: ,,


,, ,,
middle thyroid vein
Middle thyroid vein air
embolism

,,

Middle thyroid vein

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accessory esophageal and tracheal vein

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