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Thyroid Examination

Thyroid Examination. Wail A lamoudi. General examination Local examination. Local examination. Inspection ( at rest , tongue , swallowing , raising both hands ) Palpation Percussion Auscultation. Inspection at rest. Tip the patients head back a bit Inspect thyroid gland & scar

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Thyroid Examination

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  1. Thyroid Examination Wail Alamoudi

  2. General examination Local examination

  3. Local examination • Inspection • ( at rest , tongue , swallowing , raising both hands ) • Palpation • Percussion • Auscultation

  4. Inspection at rest Tip the patients head back a bit Inspect thyroid gland & scar A visibly enlarged thyroid gland is called a goiter. Note whether it is visible and symmetrical

  5. Is This a Thyroid? • Ask patient to stick tongueout while palpating: • Ask patient to swallow water: Thyroglossal cyst Should NOT move Should move

  6. Inspection while raising hands • pemberton's sign ( retrosternal goiter ) development of facial flushing, distended neck and head superficial veins, inspiratory strider and elevation of the jugular venous pressure (JVP) upon raising of the patient's both arms above head 2. Proximal myopathy

  7. palpation ANATOMIC BONDARIES OF THYROID • Cricoid cartilage • Suprasternal notch • Carotid arteries

  8. ANATOMIC RELATIONSHIPS OF THE THYROID

  9. Palpation

  10. Palpation • Palpate the thyroid gland from behind • Localize anatomic boundaries • Thyroid isthmus is often palpable • Thyroid lobes are barely or not palpable • The consistence is rubbery, similar to that of sternomastoid muscle

  11. Classical Clinical Examination • The following information could be obtained • volume • consistency • mobility of the thyroid gland • surface • temperature • sensibility

  12. Percussion On the upper part of the manubrium looking for retrosternal goiter

  13. Auscultation Looking for bruit over each thyroid lobe

  14. General examination Local examination

  15. General inspection • body built • Eyes & Face • Hands • Arms & Legs

  16. body built • Thin • Obese

  17. Face • malar flush • Hair loss Eyes • Exophthalmos • Lid retraction • Lid lag • Xanthelasma

  18. Hands • Sweaty hand • Temperature • Acropachy (clubbing) • Onycholysis( plummer’s nails ) • Palmer erythema • vitiligo • Tremor • Pulse

  19. Legs and Arms • Proximal myopathy • Reflexes • Pretibial myxedema

  20. Wail Alamoudi 0504649662

  21. Identify the cricoid cartilage with the fingers of both hands. • Move downward two or three tracheal rings while palpating for the isthmus. • Move laterally from the midline while palpating for the lobes of the thyroid. • Note the size, symmetry, and position of the lobes, as well as the presence of any nodules. The normal gland is often not palpable.

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