- Look for signs of thyroid disease
Examine the neck
- Look for a goitre
- Ask the patient to take a sip of water and hold it in the mouth, then ask him or her to swallow while watching the neck - look for movement of goitre with swallowing
- Stand behind the patient and feel the thyroid with both hands, standing in the centre below the thyroid cartilage over the trachea, and moving laterally to the two lobes which extend behind the sternomastoid muscle. Ask the patient to swallow while palpating. Assess the goitre for size, nodularity or diffuse enlargement, discrete nodules and firmness
- Palpate for lymph nodes
- Auscultate - listen over the thyroid for a bruit
Assess thyroid status
- Pulse - count the rate and note the presence or absence of atrial fibrillation
- Palms - warm and sweaty
- Tremor of outstretched arms
Examine the eyes
- Exophthalmos
- Lid retraction
- Lid lag
Examine the reflexes
- Slow relaxation in hypothyroidism
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