Thyroid

Physical examination
Anatomy
Anatomy
 Signs and symptoms
• Swellng
• Dyspnea
• Dysphagia
• Hoarseness of voice
• Toxic features (tremors of the hand, sweating,
intolerance to heat, preference to cold,
excitability, irritability, proptosis, weight loss)
• Palpitations
 Techniques of examination
1. Inspection
• The size
• The shape
• Surface (smooth, irregular, nodular)
• Swelling movement
– Moves up with deglutition
• Movement with protrusion of the tongue
(thyroglossal cyst)
 Techniques of examination
2. Palpation
• Should be done from behind
• The size,
• The shape
• Surface and border
• Consistency
– Soft- graves disease, colloid goiter
– Firm-adenoma, Multinodular goiter
– Hard- carcinoma, calcification in MNG
 Techniques of examination
2. Palpation
• Confirm movement with deglutition by
holding thyroid gland
Multinodular goiter
 Palpation tests
• Intrinsic mobility: reduced in case of carcinoma
because of infiltration into the trachea
• Sternomastoid contraction test: when only one
lobe is enlarged
• Chin test: the patient is asked to bend the chin
downwards against resistance
• Crile’s method and Lahey’s method
• Kocher’s method: gentle compression of lateral
lobes produces stridor
Palpation tests
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