A site for medical students - Practical,Theory,Osce Notes

How to conduct thyroid examination an OSCE guide

Local Examination
1. Expose the neck adequately.
2. Ensure adequate lighting.
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.
  • 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.
Comment on position, size. shape, surface, consistency (uniform, variable, cystic, solid, firm. hard), mobility (Hortzontal and vertical), tenderness and on the рутаmidal lobe If present
For thyroid bruit
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.
 General Examination
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.