The Thyroid Examination

Age, gender, general comfort

Heart rate, blood pressure, resp rate, temp

Alert, oriented, confused, obtunded

Weight gain ( ↓ ) / loss ( ↑ ), BMI, shape

Anxiety ( ↑ ),mental slowness ( ↓ )

Onycholysis ( ↑ / ↓ ), peripheral cyanosis ( ↓ )

Increased soft tissue in distal phalanges (Graves)

Tachycardia ( ↑ ) / bradycardia ( ↓ ), rhythm

For thoracic outlet obstruction - retrosternal goitre

Patient lifts arms as high as possible for 1 min, look for facial congestion and cyanosis

Reduced ( ↓ ) / normal / hyper-reflexive ( ↑ )

Alopecia ( ↑ )

Pigmentation ( ↑ ), thickening ( ↑ )

Exophthalmos (Graves)

Lid retraction ( ↑ ), lid lag ( ↑ )

Periorbital oedema ( ↓ ), loss of outer 1/3 of eyebrow ( ↓ )

Swelling of tongue ( ↓ )

Scars, veins, erythema, swelling, swallow

Size, shape, nodules, thrill, fixation, consistency

Upper part of manubrium

Over each lobe for bruits

Systolic flow murmur ( ↑ ), crackles, pericardial / pleural rub

Stridor, crackles, pleural rub

Bilateral, firm, elevated dermal nodules

Reduced ( ↓ ) / normal / hyper-reflexive ( ↑ )