F00574 020 g003
o EXAMINATION OF THE THYROID GLAND
• Inspect from front to side
• Palpate from behind
Thyroid moves on swallowing Cervical lymph nodes Tracheal deviation
• Auscultate for bruit
Ask patient to hołd breath If present, check for radiating murmur
• Percuss for retrosternal thyroid
• Consider systemie signs of thyroid dysfunction (Box 20.6)
Abnormal findings
Diffuse soft goitre with bruit Graves' disease (p. 754)
Diffuse firm goitre
Hashimoto‘s thyroiditis (p. 757) Diffuse tender goitre
Subacute thyroiditis (p. 757)
Multinodular goitre (p.759)
± Retrosternal extension, tracheal compression
Solitary nodule (p. 753)
Adenoma, cyst or carcinoma Cen/ical lymphadenopathy Suggests carcinoma
© Elsevier. Boon et al.: Davidson's Principles and Practice of Mediclne 20e - www.studentconsult.com
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