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The thyroid gland lies in the midline of the anterior neck, just caudal to the thyroid cartilage. To inspect the thyroid gland, the examiner stands in front of the patient. The examiner asks the seated patient to dorsiflex (extend) the neck and swallow a sip of water. Minor enlargement of the gland may only become apparent on inspection in this position. Palpation of the thyroid gland is typically performed with the examiner standing behind the patient. Both lobes and the isthmus of the thyroid gland should be palpated for any nodules or diffuse enlargement. Mobility of the thyroid gland with swallowing should be assessed with palpation. Nodules arising from the thyroid gland typically move with swallowing. A hard, fixed thyroid gland could indicate malignancy. If a central nodule is identified, the patient is asked to protrude the tongue. Upward movement of the central nodule on protrusion of the tongue indicates a thyroglossal cyst. Auscultation is performed at the superior poles of bilateral lobes as this is where the superior thyroid artery is most superficial and bifurcates into its terminal branches. A bilateral bruit over the superior poles suggests Graves disease. Examination of the thyroid gland is completed by palpating the regional cervical lymph nodes for any enlargement.
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How to perform a Thyroid Gland Examination - Clinical Skills Revision
The thyroid examination is one of the first sessions of the clinical skills block for medical students at Warwick Medical School - largely as it touches lightly on to other clinical areas, such as the cardiac examination, and the peripheral neurological examination making it an excellent starting point for building further knowledge
This is a clinical examination of the thyroid gland is performed by Dr James Gill following the approach in Macleod’s Clinical examination.
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Please note that there is no ABSOLUTE way to perform a clinical examination. Different institutions and even clinicians will have differing degrees of variations - the aim is the effectively identify medically relevant signs.
However, during OSCE assessments. Different medical schools, nursing colleges and other health professional courses will have their own preferred approach to a clinical evaluation - you should concentrate on THEIR marks schemes for your assessments.
The examination demonstrated here is derived from Macleods Clinical Examination - a recognised standard textbook for clinical skills.
Some people may experience an ASMR effect from watching this medical clinical examination
#ThyroidExamination #ClinicalSkills #DrGill #ASMR
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