Thyroid Physical Exam

  • WIPE, blah blah 🙂
  • “Take vital signs”
  • Position: sitting
  • Proper exposure: of the neck

 

  • General inspection of the pt:
    • Appearance: lethargic \ restless
    • Body built: Over \ under wt
    • Clothing: over \ under dressed
    • Voice: hoarseness
  • Hands\arms:
    • Hands: temperature, dry\sweaty, muscle wasting, palmar erythema
    • Nails: oncholysis, acropachy
    • Fine tremor
    • Pulse: rate\rhythm, collapsing pulsethyroid 3
    • “Measure BP”
    • Proximal myopathy
    • Pemberton sign
  • Head\face:
    • Hair: loss\thin hair, loss of outer 1\3 of eyebrow
    • Facial puffiness
  • Eyes:
    • Periorbital edema, thyroid stare\exophthalmos
    • Conjunctiva: redness\inflamed (chemosis)
    • Lid retraction (sclera visible above iris)
    • Lid lag (+ do “H” formation + ask about diplopia)
  • Neck:
    • Inspection: obvious masses, scars, skin changes
    • Swallow test + ask pt to stick their tongue out
    • Palpate: thyroid, LN, trachea
    • Auscultate: over each lobe for bruit
  • Legs:
    • Proximal myopathy
    • Pretibial myxedema
    • Reflexes

 


Download the PDF version: here

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