Thyroid examination

Question 1

general examination

Answer 1

Affect and clothing.
Hair and skin.
Pulse, tremor, sweatiness.
Eye disease – exophthalmos, proptosis, lid lag, lid retraction, ophthalmoplegia.
Inspection of nails – brittle nails, onycholysis. Slow relaxing reflexes.
Proximal myopathy – unable to stand from seated position without using hands.

Question 2

look

Answer 2

Inspect neck from the front and the sides: Symmetry or asymmetry
Movement of thyroid on swallowing water Deep breathing to check for stridor

Question 3

palpate

Answer 3

From behind patient, use fingertips of both hands to examine the thyroid and cervical nodes.
Thyroid – size, symmetry/asymmetry of lobes, tenderness, movement, texture (hard, soft), presence of nodules (multiple, solitary).
Cervical nodes – work systematically through the different regions, and compare sides: submental, submandibular, anterior triangle, posterior triangle, pre- auricular, post-auricular, occipital, supraclavicular.

Question 4

auscultate

Answer 4

bruits