Behind The Knife: The Surgery Podcast Behind the Knife ABSITE 2025 - Parathyroid
Nov 29, 2024
Dive into the fascinating world of parathyroid anatomy and physiology. Learn about the intricate blood supply and the roles of PTH and calcitonin in calcium regulation. Discover the causes of hypercalcemia, from primary hyperparathyroidism to malignancy. The hosts discuss surgical techniques for managing multigland disease and highlight the importance of intraoperative PTH monitoring. Explore unique cases like benign familial hypocalciuric hypercalcemia and the surgical approaches for MEN syndromes. Get ready to ace your surgical exams!
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Parathyroid Embryology And RLN Relationship
- Superior parathyroids are posterior and lateral to the recurrent laryngeal nerve while inferior glands are anterior and medial.
- Inferior glands originate from the third pouch and have more variable locations due to longer migration.
PTH Physiology Summarized
- Chief cells release PTH in response to low serum calcium to raise blood calcium via bone and kidney effects.
- PTH also increases active vitamin D production to boost gut calcium absorption.
Calcitonin's Role
- Calcitonin is released from thyroid C-cells in response to high calcium and inhibits osteoclast-mediated bone resorption.
- It also reduces renal calcium and phosphate reabsorption to lower serum calcium.