Thyroid
Examination
Wail Alamoudi
•General examination
•Local examination
Local examination
• Inspection
• ( at rest , tongue , swallowing , raising both hands )
• Palpation
• Percussion
• Auscultation
Inspection at rest
•Tip the patients head back a bit
•Inspect thyroid gland & scar
•A visibly enlarged thyroid gland is
called a goiter.
•Note whether it is visible and
symmetrical
Is This a Thyroid?
• Ask patient to stick tongue out while
palpating:
Should NOT move
• Ask patient to swallow water:
Should move
Thyroglossal cyst
Inspection while raising hands
1. pemberton's sign ( retrosternal goiter )
development of facial flushing, distended neck and head superficial
veins, inspiratory strider and elevation of the jugular venous pressure
(JVP) upon raising of the patient's both arms above head
2.
Proximal myopathy
palpation
ANATOMIC BONDARIES OF THYROID
• Cricoid cartilage
• Suprasternal notch
• Carotid arteries
ANATOMIC RELATIONSHIPS OF THE THYROID
Palpation
Palpation
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Palpate the thyroid gland from behind
Localize anatomic boundaries
Thyroid isthmus is often palpable
Thyroid lobes are barely or not palpable
The consistence is rubbery, similar to that of
sternomastoid muscle
Classical Clinical Examination
The following information could be obtained
volume
consistency
mobility
of the thyroid gland
surface
temperature
sensibility
Percussion
On the upper part of the manubrium
looking for retrosternal goiter
Auscultation
Looking for bruit over each thyroid lobe
•General examination
•Local examination
General inspection
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body built
Eyes & Face
Hands
Arms & Legs
body built
• Thin
• Obese
Face
1. malar flush
2. Hair loss
Eyes
1.
2.
3.
4.
Exophthalmos
Lid retraction
Lid lag
Xanthelasma
Hands
1.
2.
3.
4.
5.
6.
7.
8.
Sweaty hand
Temperature
Acropachy (clubbing)
Onycholysis( plummer’s nails )
Palmer erythema
vitiligo
Tremor
Pulse
Legs and Arms
• Proximal myopathy
• Reflexes
• Pretibial myxedema
Wail Alamoudi
0504649662
• Identify the cricoid cartilage with the fingers
of both hands.
• Move downward two or three tracheal rings
while palpating for the isthmus.
• Move laterally from the midline while
palpating for the lobes of the thyroid.
• Note the size, symmetry, and position of the
lobes, as well as the presence of any nodules.
The normal gland is often not palpable.