Thyroid examination Flashcards
What is the blood supply of the thyroid?
superior thyroid artery, inferior thyroid artery from internal carotid and subclavian
What mass issues canthyroid issues have?
Swallowing, cough pain in neck
where can the thyroid go if it grow?
It can extend retrosernally
How do thyroid disease present?
Lump in the neck of mass effect unilateral mass bilateral mas symetrical or asymetrical.
Hypothyroidsism Hyperthyroidism or graves-specific features
What to ask about lump in neck?
When did it start, how quickly is it changing if at all, family histroy is there any pain, just in enlargement over whole gland slow or sudden onset
What is usually present when there is a goitre?
hyperthyroidism
What is thyroglossal cyst?
Get a swelling in upper part of the neck embryological reminant
What are presentation of hypothyroidism?
Tiredness, weight gain lethargy lack of concentraton depression/low mood cold intollerance headaches menorrhagia constipation dry skin hoarse voice (Myxoedema swollen)
HYpothyroid questions if suspected?
How long speed of onset treatment for thyroid in past drugs lithium low amiodarone either asssociated with vitiligo type 1 diabetes addisons disease
What can cause hypothyroidism?
Primary, Dyshormonegenesis, iodine deficiency autoimmunity post radioactive iodine post thyroidectomy, secondary tertiary, pituitary tumours pituitary granulomas empty sella isolated TRH deficiency hypothalamic disorder
What to examine thyroid mass?
Inspect it get to swallow and see if it moves should move wiht swallowing and if when stick tongue out if moves then its thyroglossal cyst feel for it feel for lymph nodes, virus could cause this or metastatic cancer,
What does dullness at upper sernum show?
Thyroid mass extens retrosternal
Auscultation of thyroid what is it?
Bruit in neck from good blood supply
What to look at eyes in thyroid?
Lid lag stare activation of sympathetic nervous system this is non speciffic for graves. exathalmos swelling of eyes is specific for graves. assess for opthalmoplegia
What too look for in ankle?
reflexes also brachial
