Professional Documents
Culture Documents
Inspection
Sitting Position with Neck
Extending
Exposure Top of Head Mid
Chest
1. Site
In front of Neck
Extending from 1 Steromastoid to
other
Vertically
(Suprasternal Notch Thyroid
Cartilage)
2. Size
3. Shape
4. Movement with Swallowing
5. Surface
Palpation
Semiflexed Position
(Relax Sternomastoid)
Smooth
Adenoma
Puberty
Goitre
Graves
1.
2.
3.
4.
5.
6.
7.
Irregular
Carcinoma
Nodular
MNG
6. Lower Border
(Ask patient to Swallow)
7. Skin
Dilated Veins
Infiltration of Skin
Scar
8. Swelling moves with
Deglutition
Due to Ligament of Berry
If Restriction
Malignancy
Retrosternal Goitre
Large Goitre
Previous Surgery
9. Movement on Protrusion of
Tongue
Thyroglossal Cyst
10. Surrounding Structure
Get Smaller on
Sternomastoid Contraction
Percussion
Upper Part of Manubrium
(Retrosternal Goitre)
Temperature
Tenderness
Site
Size
Shape
Surface
Consistency
Soft
Firm
Hard
Graves
Adenoma
Colloid
Goitre
MNG
Carcinom
a
Calcificati
on of
MNG
8. Thrill
9. Lower Edge
Confirm movement with
swallowing
Feel Lower Edge
10. Surrounding Structure
Skin Sliding, Push & Pinch,
Swelling under skin
Sternomastoid Pinch
Sternomastoid from swelling
during swallowing
Trachea Fixed or not,
Displaced
Carotid Pulse Displaced,
Berrys Sign
Other Swelling Lymph Nodes
11. Movement with
Swallowing
Pizillos Method
(Obese, Short Neck)
Auscultation
Each Lobe (at Upper Pole)
Bruit
Sign of Blood Supply
(Hyperthyroidism)
(Occasionally use of Antithyroid
Drugs)
Differentiate from Carotid Bruit
Pembertons Sign
Lift both arms as high as possible (few moments)
Sign of
Cyanosis
Respiratory Distress
Naffzigers
Method
Detect
Exophthalmos
Marked Exophthalmos
Lid Retraction
Stellwags Sign
Unilateral Lid
Retraction
Mocbius Sign
Difficult
Convergence
Joffroys Sign
No Wrinkles
Chemosis
Abdomen
Liver
Metastases
CHF
Splenomegaly
Thyroid Lymphoma
Severe Chemosis
Upper Limb
Hand
Warm
Sweaty
Fine Tremors
Water Hammer (Collapsing)
Pulse
Lower Limb
Hyperthyroi
Hypothyroidi
dism
sm
Hyperreflexia
Hyporeflexia
Pretibial
Myxedema
CVS
Tachycardia
Murmurs
Graves Disease
Hashimoto Disease
Back
Vertebral Metastases
Malignant Ascites
Hypothyroidism
Dark Skin
Pale Skin