Parathyroid Glands Facts & Worksheets

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In most cases, the parathyroid glands are found near the thyroid gland. There are two superior parathyroid glands and a pair of inferior parathyroid glands. 

See the fact file below for more information about the Parathyroid Glands, or you can download our 28-page Parathyroid Glands worksheet pack to utilize within the classroom or home environment.

Key Facts & Information

HISTORICAL BACKGROUND

• Richard Owen identified parathyroid glands in the Indian rhinoceros in 1852. Owen described the glands as “a small compact yellow glandular body attached to the thyroid at the point where the veins emerged” in his neck anatomy.
• Ivar Viktor Sandström (1852-1889), a Swedish medical student, discovered the glands in humans in 1880 at Uppsala University. Unaware of Owen’s description, he referred to the glands in his treatise “On a New Gland in Man and Fellow Animals” as the “glandula parathyroidea,” mentioning their presence in dogs, cats, rabbits, oxen, horses, and people. 
• The parathyroid glands contain two distinct types of cells: chief cells and oxyphil cells.

STRUCTURE AND FUNCTION

• Chief cells are responsible for the release of parathyroid hormone. When examined, the cells show a prominent Golgi apparatus and an established endoplasmic reticulum, which aid in hormone synthesis and secretion. The principal cells are smaller than the oxyphil cells but more frequent.
• The function of Oxyphil cells is not fully understood. They are larger than the primary cells and appear to grow in number with age.  
• The parathyroid glands assist in regulating blood calcium levels. When blood calcium levels drop, the parathyroid gland secretes a parathormone or parathyroid hormone (PTH). PTH is first synthesized as a polypeptide hormone, which is subsequently expelled as pre-pro parathyroid hormone (115 amino acids), followed by pre-parenthood hormone (90 amino acids), and finally parathormone (84 amino acids). 
• When PTH is secreted, it affects specific organs such as the kidneys, gut, and skeletal system.  
  • Kidney. PTH stimulates calcium reabsorption and phosphate excretion. 
• The ascending loop of Henle, the distal tubule, and the collecting tubule facilitate reabsorption. PTH also increases the conversion of 25-hydroxyvitamin D to its active form (1,25-dihydroxy vitamin D-3) by activating 1-hydroxylase in the proximal tubules.
• Intestine: Activated vitamin D enhances calcium absorption by increasing the production of calcium-binding proteins in intestinal epithelial cells.
• Bone: Rapid Phase- PTH acts on both osteoblastic and osteoclastic cells. PTH binds to cellular receptors, pumping calcium from the osteocytic membrane. This has an immediate effect, allowing calcium levels to climb within minutes. The slow phase requires several days to cause an increase in blood serum calcium. Because mature osteoclasts lack PTH receptors, this process is carried out by osteoblasts. The osteoblast activates the mature osteocytes via cytokines. 

EMBRYOLOGY

• The parathyroid glands develop by the endoderm third and fourth pharyngeal pouches, with help from the neural crest and ectoderm. The pouch appears hollow, but as it grows, cell proliferation happens, which allows for solidification and migration.

BLOOD SUPPLY AND LYMPHATICS

• The thyroid and parathyroid glands have a comparable blood supply. The inferior thyroid arteries serve the parathyroid glands through their branches. In most cases, the inferior and superior parathyroid glands are supplied. 
• Collaterals can also be delivered through the superior thyroid, thyroid ima, laryngeal, tracheal, and esophageal arteries. Parathyroid veins flow towards the thyroid vein plexus.
• Parathyroid lymphatic veins empty into deep cervical and paratracheal lymph nodes. 

SURGICAL CONSIDERATIONS

• The placement of parathyroid glands varies significantly between individuals. Because of these variations, injury to the glands could happen during neck surgery, particularly thyroidectomy. Identifying and preserving more parathyroid glands as feasible is critical to a safe thyroidectomy. 
• While a part of a single parathyroid gland should be enough to keep serum calcium levels stable, it is best to detect and preserve all glands. Patients should be advised beforehand that lifetime calcium and vitamin D supplements may be required.
• A hyperfunctional parathyroid gland frequently needs surgical intervention. When the parathyroid gland secretes too much PTH, there are hazards linked with high serum calcium. However, many patients arrive with unintentionally found hypercalcemia.
• For instance, these people may require monitoring, and even minor symptoms can be managed appropriately. These “biochemically” hyperparathyroid individuals (who are otherwise asymptomatic) pose an ongoing quandary: some nephrologists suggest parathyroidectomy, while others advise medication therapy. However, when hypercalcemia-related symptoms are present, surgical intervention is necessary.
• Bilateral Neck Exploration. The most traditional surgical method is bilateral neck exploration. During this treatment, the surgeon will detect all four glands and decide whether to remove a portion or all of them based on their appearance. This is particularly relevant in patients with renal failure who have secondary hyperparathyroidism.
• Focused Parathyroidectomy. Another less invasive method may allow for a restricted operation of the affected gland. This enables the surgeon to target the gland identified during preoperative localization testing.  

CLINICAL SIGNIFICANCE

• Hyperparathyroidism is an increase in PTH caused by overactive parathyroid glands, often resulting in hypercalcemia. Hyperparathyroidism can be divided into several subtypes.
  • Primary: Hyperparathyroidism is the result of direct gland changes. Excess PTH secretion results in hyperparathyroidism, but it can also cause hypercalcemia, hypoglycemia, osteoporosis, and hypertension. 
  • Secondary: Chronic kidney disease is the most prevalent cause; however, vitamin D insufficiency and malnutrition can also play a role.
  • Tertiary: This happens after long-term secondary hyperparathyroidism. Due to the prolonged increase in PTH production, structural changes occur in the parathyroid glands.
  • Malignant: Certain malignancies can create a parathyroid-like protein that mimics PTH activity. This can be determined by monitoring serum levels of both intact PTH and parathyroid-related hormone (which the tumor produces).
• On the other hand, Hypercalcemia can develop from an overactive parathyroid gland. Symptoms might vary from non-existent to severe.
  • General: headache and fatigue
  • Kidneys: kidney stones cause back and flank pain, excessive urination, and extreme thirst.
  • Abdomen: vomiting, constipation, nausea, decreased appetite, and abdominal pain
  • Heart: abnormal electrical rhythms
  • Neurological symptoms: memory loss, irritability, depression, confusion, and coma
• Meanwhile, Hypoparathyroidism results from the gland’s diminished activity. This condition has both primary and secondary classifications.
  • Primary: A gland fails, causing a reduction in PTH output. Patients suffering from this disease will frequently require calcium supplementation.
  • Secondary: This occurs when the parathyroid glands are surgically removed or injured. This is frequently an unintentional result of neck surgery or is to be expected following more severe neck surgery, such as a total laryngectomy with thyroidectomy.

Parathyroid Glands Worksheets

This fantastic bundle includes everything you need to know about Parathyroid Glands across 28 in-depth pages. These ready-to-use worksheets are perfect for teaching kids about the Parathyroid Glands. In most cases, the parathyroid glands are found near the thyroid gland. There are two superior parathyroid glands and a pair of inferior parathyroid glands.

Complete List of Included Worksheets

Below is a list of all the worksheets included in this document.

1. Parathyroid Glands Facts
2. How It Works?
3. Parathyroid Things
4. File It!
5. The Importance
6. Parathyroid Vs. Thyroid
7. #Parathyroid_Cure
8. Knowledge recap
9. P.G and PTH
10. Infographic
11. Parathyroid in 3D

Frequently Asked Questions

What are the parathyroid glands and where are they located?

The parathyroid glands are small, pea-sized glands located in the neck behind the thyroid gland. There are usually four parathyroid glands, but some people may have more. They are responsible for regulating the body’s calcium levels.

What is the primary function of the parathyroid glands?

The primary function of the parathyroid glands is to produce and secrete parathyroid hormone (PTH). PTH helps regulate the levels of calcium, phosphorus, and magnesium in the blood and bones. It increases blood calcium levels by stimulating the release of calcium from bones, increasing the absorption of calcium from the intestines, and reducing the loss of calcium through the kidneys.

What are common disorders associated with the parathyroid glands?

Common disorders of the parathyroid glands include:

• Hyperparathyroidism: This condition is characterized by the overproduction of PTH, leading to high levels of calcium in the blood (hypercalcemia). Symptoms may include bone pain, kidney stones, fatigue, and depression.
• Hypoparathyroidism: This condition occurs when the parathyroid glands produce insufficient amounts of PTH, leading to low levels of calcium in the blood (hypocalcemia). Symptoms may include muscle cramps, tingling in the fingers, and cognitive disturbances.

How is hyperparathyroidism diagnosed and treated?

Hyperparathyroidism is typically diagnosed through blood tests that measure levels of calcium, PTH, and sometimes vitamin D. Imaging tests, such as ultrasound or Sestamibi scan, may be used to locate any overactive parathyroid glands. Treatment often involves surgical removal of the overactive gland(s). In some cases, medication and monitoring may be used, especially if surgery is not an option or if the condition is mild.

What lifestyle changes can help maintain healthy parathyroid function?

Maintaining healthy parathyroid function can be supported by:

• Adequate Calcium and Vitamin D Intake: Ensuring sufficient dietary calcium and vitamin D through foods or supplements can help maintain healthy calcium levels.
• Regular Exercise: Weight-bearing exercises can help strengthen bones and support overall calcium metabolism.
• Avoiding Smoking and Excessive Alcohol: Both smoking and excessive alcohol consumption can negatively impact bone health and calcium levels.
• Regular Check-Ups: Regular medical check-ups can help monitor calcium and PTH levels, especially for individuals with a history of parathyroid or calcium-related disorders.

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Link will appear as Parathyroid Glands Facts & Worksheets: https://kidskonnect.com - KidsKonnect, July 3, 2024