Thyroid Exam

Question 1

General Exam

Answer 1

**similar to peripheral responses exam

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.
-reflexes with the stick of the calf

Pulse- on wrist- tachycardic or bradycardia

Proximal myopathy – unable to stand from seated position without using hands.

Eyes- get patient follow finger for lid lag

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

Feel

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.

Asculate the thyroid itself

Question 4

Move

Answer 4

Swallow water
movement of eyes

-can the patient stand up? (with arms crossed)