Between the fourth and sixth weeks of embryonic life, the pharyngeal region of the foregut flattens from front to back and develops five lateral outpouchings. The floor of the pharynx gives rise to the tongue, thyroid gland, (pink) larynx and trachea. The parathyroid glands develop from the third and fourth pouches.
The third branchial pouch gives rise to the inferior parathyroid glands (dark blue) in close association with the primordia of the the thymus gland (orange). As the thymus descends to the anterior mediastinum, parathyroids III follow along, ultimately coming into contact with the developing thyroid caudal to parathyroids IV (yellow). The parathyroid glands derived from pouch IV take a more direct route to come in contact with the thyroid, and become the more cephalad or superior glands. A portion of pouch IV (light blue) contributes a lateral C-cell component to the thyroid. The parathyroids usually (~80%) lie near the posterolateral capsule of the thyroid lobes.
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The superior parathyroid glands are most commonly found about the middle third of the thyroid lobe, at the level of the cricothyroid junction, and near the point where the recurrent laryngeal nerve passes beneath the inferior pharyngeal constrictor to enter the larynx (see
thyroid anatomy).
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