Behind The Knife: The Surgery Podcast Behind the Knife ABSITE 2026 - Parathyroid
Dec 5, 2025
Dive into the intriguing world of parathyroid physiology! Explore the anatomy and blood supply of parathyroid glands as well as the crucial roles of PTH and calcitonin in calcium regulation. Learn about the causes and symptoms of hypercalcemia, including malignancy-driven cases. Discover imaging techniques for adenoma localization and criteria for surgical intervention. Uncover the complexities of multigland disease, parathyroid carcinoma, and management strategies. Wrap up with quick clinical pearls to sharpen your surgical acumen!
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Embryology Explains Gland Locations
- Superior parathyroids derive from the fourth pouch and lie posterior-lateral to the recurrent laryngeal nerve while inferior glands come from the third pouch and are more variable.
- Remember inferior glands migrate farther (with the thymus) so expect ectopic locations.
Know The Inferior Thyroid Artery Supply
- Check parathyroid blood supply: the inferior thyroid artery supplies most glands and comes from the thyrocervical trunk.
- Use this knowledge during dissection to avoid devascularizing glands.
PTH’s Coordinated Calcium Strategy
- PTH from chief cells responds to low calcium by increasing bone resorption, renal calcium reabsorption, and activating vitamin D.
- PTH also 'trashes' phosphate by reducing renal phosphate reabsorption.
