Thyroid exam Flashcards
Where should the patient be?
On a chair
Equipment
Glass of water
Steps of the exam
Inspection
Palpation
Auscultate
Inspection
Behaviour Hands Pulse Face Eyes Thyroid
Behaviour
Hyperactive, fidgety, agitated = hyperthyroid
Hands
Dry skin- hypothyroid Increased sweating - hyperthyroid thyroid acropachy- phalangeal bone overgrowth- Graves palmar erythema- hyperthyroidism peripheral tremor- hyperthyroidism
Pulse
Tachycardia- hyperthyroid
Bradycardia- hypothyroid
Irregular > AF - thyrotoxicosis
Face
Dry skin- hypothyroid
Sweating- hyperthyroid
Loss of outer 1/3rd of eyebrows- hypothyroid
Eyes
Exophthalmus
Lid retraction
Eye movements
Lid lag
Thyroid inspection
any erythema
any scars
any noticeable masses or enlargement of the gland
Palpation
3 fingers of each hand on each side of the neck, just below the chin, find Adam’s apple (thyroid cartilage)
Move inferiorly to cricoid cartilage
Feel isthmus, then move outwards to feel each lobe
After palpation
ask the patient to swallow water and feel the thyroid gland rise
When palpating the thyroid gland assess
size symmetry consistency masses palpable thrill
You palpate the thyroid gland and palpate …
lymph nodes
What do you auscultate for?
Bruit
