Thyroid exam Flashcards
General inspection
Patient’s clothes
What are you looking for in the hands?
Palmar erythema
Graves acqupassy (clubbng)
Irregularly irregular pulse (AF) / tachycardia
Hyperthyroidism face
Thin britte eyebrows
Flushed face
What do you see on the eyes in hyperthyroidism?
Lid lag
Lid retraction
In graves - opthalmoplegia
Why does lid retraction occur? What is it?
The white sclera is seen above the eye
t3/t4 sensitises the body to catecholamines ?, so sympathetic nervous system is more active
LPS is sympathetically controlled
What is graves opthalmoplegia
When they lose their upward gaze as the muscles at the back of the eye are attacked by the antibodies
Neck
Find adam’s apple
Find cricothyroid membrane and ismthus of membrane
Go either side to find
When swallowing, which bit is seen as the thyroid?
Last thing to move up
What are you checking for about the
Symmetrical
nodular
enlarged
If the thyroid moves when the tongue is stuck out, what is it? Why?
Thyroglossal cyst
Remaining embryological attachment between
What do you do after palpating neck?
Palpate nodes
Why do you listen to the thyroid?
Hypervascularisiation of gland in hyperthyroidism, so you might hear a bruit
What do you percuss?
Percuss sternum as a large goitre might descend, causing
What would you look for in the legs?
Pretibial myxdema - Graves
Non pitting generalised oedema - hypothyroidism
What specific signs do you get in Graves?
Pretibial myxedema
opthalmoplegia
Lid retraction ?
