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Thyroid Test

1. This document outlines the steps for examining a patient who may have either hypothyroidism or hyperthyroidism. It details the inspection, palpation, percussion, and auscultation steps to assess appearance, pulse, skin, eyes, neck, thyroid gland, reflexes, and more. Specific signs and symptoms are listed for each condition. 2. Key examination techniques include inspecting the eyes, skin, and neck; palpating the thyroid gland and lymph nodes; assessing pulse and reflexes; and checking for signs of thyroid eye disease or proximal myopathy. Findings that differ between the two conditions are noted. 3. The examination is completed by thanking the patient and washing hands

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Wendy Dessy
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93 views1 page

Thyroid Test

1. This document outlines the steps for examining a patient who may have either hypothyroidism or hyperthyroidism. It details the inspection, palpation, percussion, and auscultation steps to assess appearance, pulse, skin, eyes, neck, thyroid gland, reflexes, and more. Specific signs and symptoms are listed for each condition. 2. Key examination techniques include inspecting the eyes, skin, and neck; palpating the thyroid gland and lymph nodes; assessing pulse and reflexes; and checking for signs of thyroid eye disease or proximal myopathy. Findings that differ between the two conditions are noted. 3. The examination is completed by thanking the patient and washing hands

Uploaded by

Wendy Dessy
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

1.

Greeting
Wash your hands.
Introduce yourself to patient.
Confirm patient details
Explain examination
Ask consent from patient.
Inspection Hypothyroidism Hyperthyroidism
Appearence • Agitated?
• Anxious?
• Fidgety?
Hands • Thyroid acropachy (Graves’)
• Peripheral tremor-put piece of paper on
the hand
Palm • Dry skin • Palmar erythema
• Sweat
Pulse rate • Decrease • Increase
• Irregular-atrial fibrillation
Face • Dry skin • Sweating
• Loss of outer third eyebrow
Eyes • Inspect for exophthalmos (Graves’)
• Lid retraction (sclera visible above the
iris)
• Inspect for anterior displacement of the
eye out by look at the side and behind
Eye movement (H • Observe for restriction of eye movement
test) • Access for lid lag
Close inspection • Skin changes-erythema
of neck • Scars-thyroidectomy
• Masses-goitre/ lymph node
Ask patient to • Observe the movement of any masses when swallowing
drink some water
Ask patient to • Observe the movement of any masses
protruded their • No movement
tongue o thyroid gland mass
o Lymph node
• Upward movement
o Thyroglossal cyst
Palpatation • Ask patient to flex their neck slightly forward and relax
• Began palpation at the thyroid cartilage (Adam’s apple)
• As we move downward, you will reach superior edge of cricoid cartilage
• Below cricoid cartilage is the isthmus of thyroid gland
• Palpate the isthmus and then assess each thyroid lobe individually
• Ask patient to protrude their tongue (thyroglossal cyst)
• Ask patient to swallow and assess symmetry of thyroid lobe elevation (asymmetry may
suggest unilateral thyroid mass)
• Palpate local LN for evidence of lymphadenopathy (thyroid malignancy)
Asses for tracheal • Put your hand the bottom of neck
deviation (large
goitre)
Percussion • Percuss to detect any retrosternal dullness (large goitre extending inferiorly)
Auscultation • Auscultate each lobe of the thyroid listening for the thyroid bruit (increase vascularity
secondary to Graves’ disease)
Special Test
Reflex in the arm • Hyporeflexia
• Use the reflex hammer the antecubital fossa
Look at the shin • Inspect the pre-tibial myxodema (Graves’
disease)
Assess for • Proximal myopathy by close arm and
proximal stand up.
myopathy
Last Thanks, the patient and wash hand

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