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Thread: Thyroid Examination

  1. #1
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    Thumbs up Thyroid Examination

    Thyroid Examination


    Make the patient sitting, expose the head, neck and upper chest

    1- look at the whole patient- sitting still or agitated, looking nervous or slow in his/her movement
    - thin or fat
    - wasting or fating
    - generalized loss of weight or localized wasting to face, shoulder, hand
    - is he/she sweaty or feel cold
    - myxoedema face
    - any hair loss (especially the outer tow thirds of the eyebrows)

    2- look at the hand- feel the pulse : Tachycardia  thyrotoxcosis
    Bradycardia  myxoedema
    Collapsing pulse
    - the palms moist, sweaty?
    - palmar erythema
    - peripheral cyanosis
    - pallor
    - test for fine tremor (patient hold his/her arms out in front of them, elbow and wrist straight , fingers straight and separated)

    3- look at the eye
    - lid retraction (upper eyelid is higher than the normal)
    - lid lag
    - exophthalmos (eyeball is pushed forwards)
    - ophthalmoplegia (patient can not look upwards or outwards)
    - chemosis (edema of conjunctiva)

    4- inspect the neck from the front and either side- surface,
    - site,
    - Shape (diffuse, nodular. Symmetrical, asymmetrical)
    - size,
    - color (redness)
    - there is any scar for a previous surgery?
    - any other swellings
    - is there any distended veins?
    - look for the position of thyroid cartilage, at center or deviated?
    - It moves with the swallowing or not??
    - It moves with the protrusion of the tongue or not?
    - pemberton's sign

    5- palpate the neck from the front
    - tenderness,
    - temperature
    - measure the circumference
    - mobility ( relation to surrounding tissues : -muscles
    - Skin --tethering
    -- fixation
    - trachea (at center or deviated)
    - carotid artery pulse (is it displaced?)

    6- palpate the neck from behind
    - ask the patient to swallow while you are palpating
    - tenderness, shape, surface, size, consistency, thrill, Pulsatility, borders, mobility, temperature
    - determine the lower border of the gland
    - Palpate the cervical lymph nodes

    7- percussion
    To define the lower extent of a swelling that extends below the suprasternal notch

    8- auscultation:
    For a systolic bruit

    -Look for any proximal myopathy
    -Check the reflexes

    (Note: if you suspect cervical lymphadenopathy, or enlargement of a salivary glands there is another examination for them)


    Here is Video

    around 20 MB

    http://www.etu.sgul.ac.uk/cso/skills...id/thyroid.wmv
    Last edited by dhaval; 06-08-2008 at 05:22 AM.
    Thank you GOD

  2. #2
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    complete the link plz.


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    thanks

    vitrag. it's working with me

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    It's Nice.......thanx Doctor

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