Palpation of the thyroid gland Flashcards
Starting from the chin downwards name key structures in the neck?
Hyoid bone
Thyroid notch
Laryngeal prominenece- location of the thyroid cartilage
Oblique line on the thyroid cartilage
Critcothyroid ligament
Arch of cricoid
Isthmus of the throid gland- a strip of tissue below the arch of cricoid
Left and right thyroid gland on either side of the Isthmus of the thyroid gland
not often oviosnot
Before inspecting the thyroid what should be done in preparation?
1- take clothes off above the waist- so that he neck is fully exposed
2- inspect from the front to see if there are any scars or masses
Why are thyroid scars not obvious?
often low and transverse and hidden by Langers lines
What is important to know before palpating the thyroid?
if the patient has undergone a thyroidectomy
What can help aid in diagnosing any scars or masses found during thyroid inspection?
1- ask patient to stick out tongue - a THYROGLOSSAL CYST will move upwards with the tongue whilst a THYROID NODULE/LYMPH NODE will not
2- Ask patient to drink plenty of water - a mass in the thyroid will move upwards with swallowing whilst a lymph node will not
Describe how to feel for the thyroid and cervical lymph nodes?
Feel from behind and in the mirror so you can make eye contact with the patient .
whether you use a mirror or not it is still important to tell the patient what you are planning to do
What landmarks are important?
Thyroid cartilage Hyoid bone cricoid cartilage spinous process of the C7 Lateral mass of the atlas
How can you locate each of the important landmarks?
thyroid cartilage -find the laryngeal prominence, this is made from an anterior protrusion of the thyroid cartilage.
hyoid bone- start from the laryngeal prominence and the hyoid bone is above it. You can feel it if the patient swallows, as it moves up and then down. Get them to swallow water and have your index finger and thumb in a pincher position to exactly locate the hyoid bone.
cricoid cartilage- start from the laryngeal prominence, and move your figner down. First you feel a depression, which is the cricothyroid membrane, and below this is a ridge, which is the cricoid cartilage.
spinous process of C7 , ask the patient to bend their head forward, you can see a prominent bump at the bottom of the back of the neck. This is the spinous process of C7, and an important surface landmark to be able to countdown to find vertebral levels.
Lateral mass of the atlas- place your fingers at the base of the skull and allow their head to sink into your hands. Palpating upwards should allow you to feel the lateral mass of the atlas.
How do you examine the thyroid gland?
1- starting from the laryngeal prominence, move your fingers lateral to the midline of the laryngeal prominence by around 2-3cm.
2- repeat and ask the patient to stick their tongue out and to take a sip of water (ask the patient to hold the water in their mouth whilst you position your hands, so that they can swallow at the right time).
What should you feel when examining a healthy thyroid?
the thyroid gland shouldnt be palpable as this would suggest an enlarged thyroid gland
What may cause enlarged thyroid glands?
thryroid nodules
Graves disease
