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Related Concept Videos

The Thyroid Gland01:23

The Thyroid Gland

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The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
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Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
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Endotracheal intubation is a critical procedure that can be lifesaving for many patients with respiratory distress or failure. The role of nursing in managing endotracheal tubes is pivotal, as it involves pre-intubation preparation, assisting during the procedure, and post-extubation care.
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Synthesis and Regulation of Thyroid Hormones01:20

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Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
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Enteral Nutrition I: Orogastric and Nasogastric Feeding01:26

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Enteral nutrition delivers nutrients directly to the stomach or small intestine through a tube. This method is appropriate for patients who cannot eat but still have a functioning digestive system. It is also beneficial for individuals with swallowing difficulties, anorexia, malabsorption, or those who have undergone gastrointestinal (GI) surgery.
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Deglutition01:25

Deglutition

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Swallowing, otherwise known as deglutition, facilitates the transport of food from the mouth to the stomach. It is a multifaceted process that involves both the tongue and the muscles of the throat and esophagus. Saliva and mucus aid in this process, which takes approximately 4 to 8 seconds for semi-solid or solid food and around 1 second for liquids or very soft food.
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Minimal Invasive Resection of Large Retrosternal Thyroid Goiter
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Post Total Thyroidectomy Deglutition Syncope.

Mohamed Jailani1, Mahmoud Barbarawi2, Supriya Tigadi2

  • 1Internal Medicine, University of Connecticut, Farmington, USA.

Cureus
|December 29, 2022
PubMed
Summary

Deglutition syncope, a swallowing-induced faint, can be caused by heart rhythm issues. A patient experienced this after thyroid surgery, with a pacemaker resolving the symptoms.

Keywords:
deglutition syncopedual chamber pacemakersparoxysmal av blockpost-thyroidectomy complicationssinus pausesituational syncope

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Area of Science:

  • Cardiology
  • Neurology
  • Gastroenterology

Background:

  • Deglutition syncope is a rare situational syncope linked to swallowing.
  • It is often associated with pre-existing gastroesophageal conditions.

Observation:

  • A patient developed deglutition syncope post-thyroidectomy.
  • Symptoms included dizziness and lightheadedness during swallowing.
  • Cardiac evaluation revealed paroxysmal atrioventricular (AV) block with significant asystole during swallowing.

Findings:

  • Barium swallow showed normal esophageal motility.
  • The patient experienced prolonged asystole (up to 5.1 seconds) during swallowing.
  • Placement of a dual-chamber pacemaker effectively resolved the syncopal episodes.

Implications:

  • This case highlights a potential link between thyroidectomy and secondary cardiac dysfunction causing deglutition syncope.
  • It underscores the importance of cardiac evaluation in patients presenting with swallowing-induced syncope, especially post-thyroid surgery.
  • Pacemaker implantation can be an effective treatment for this specific type of situational syncope.