Local Examination
1. Expose the neck adequately.
2. Ensure adequate lighting.
Inspection
Comment on position, size, shape, surface, pulsations.
overlying skin and movement on deglutition and protrusion of
the tongue.
Neck Measurements
Measure the circumference of the neck at the most prominent
part of the swelling.
Palpation
- Patient's neck is slightly flexed (to relax muscles).
- Examine from the front or from behind the patient.
- Otto's method: Place the thumb and fingers on the thyroid. Palpate the thyroid when the patient swallows.
- Lahey's method -Push the thyroid to one side Palpate the lobe on the side which becomes prominent.
Auscultation
For thyroid bruit
Others
1. Carotid pulse. Present or absent on each side.
2. Horner's syndrome.
3. Kocher's test: Press the lateral lobes of the thyroid (stridor
occurs In compressed trachea).
4. Lymph nodes for secondaries.
1. Relevant examination to elicit-symptoms and signs of hyper
or hypothyroidism.
Additional examination
a. Tongue: For any lingual thyroid.
b. Pemberton's sign: flic patient raises both his/her arms
until they touch the ears. Hold up for some
time. Congestion of the face, cyanosis and distress occur In
a retrosternal goitre.
