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BISMILLAHIRRAHMANIRRAHIM P HYSICAL EXAMINATION OF THYROID DISEASE. SITI ANNISA DEVI TRUSDA. INTRODUCTION. Once diabetes is excluded, thyroid disease constitute the main bulk of endocrine problems have to sort out during the clinical practice. Presents with : - PowerPoint PPT Presentation
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BISMILLAHIRRAHMANIRRAHIM
PHYSICAL EXAMINATION OF THYROID DISEASESITI ANNISA DEVI TRUSDA
INTRODUCTION
• Once diabetes is excluded, thyroid disease constitute the main bulk of endocrine problems have to sort out during the clinical practice.
Presents with : • Excessive hormonal activity hyperthyroidism• Under production of the hormone
hypothyroidism• CC: swelling of the neck
Anatomy of Thyroid Gland
Anatomy of Thyroid Gland
Physical Examination
• Assess the patient’s level of consciousness, blood pressure, pulse rate, respiration, temperature, height, body weight and BMI• Assess the Face and Eyes examination :
Lid retraction, Periorbital edema, Exophthalmos, Puffy face, Hoarse, husky voice
Exophthalmos
Assess the thyroid and pretracheal lymph nodes examination
Examination of thyroid gland :•Observe the neck, especially as the
patient swallows
Diffuse Goiter
Unilateral Swelling
Examine from front of patient :• to palpate the right lobe : palpate with
your left thumb while fixating the left lobe with your right thumb• rotate the gland slightly with one thumb
while palpating the other lobe with the other thumb• same principle for the other lobe
Palpation from the front
Examine from behind the patient :• ask the patient to flex the neck slightly
forward to relax the sternocleidomastoid muscles• place the three fingers of both hands on
the patient’s neck so that your index fingers are just below the cricoid cartilage• ask the patient to sip and swallow water as
before. Feel for thyroid isthmus rising up under your finger pads
Palpation from behind
• displace the trachea to the right with fingers of left hand, palpate lateral part of right lobe thyroid gland with the fingers of the right hand, • palpate in the space between the displaced
trachea and the relaxed sternocleidomastoid muscle, find the lateral margin. • In similar fashion, examine the left lobe. The
lobes are somewhat harder to feel than the isthmus• if the thyroid is enlarged, auscultation for
listen bruit by placing bell stethoscope above the lateral part of thyroid gland
• The size of thyroid nodules can be measured by first drawing and outline on the skin
Assess the cardiac condition :• Bradycardia and tachycardia
Assess the pulmonal condition :• Slow respiration, shortness of breath
• Assess the abdominal condition : slowed or rapid peristaltic• Assess the extremitas condition :• Tremor• Thyroid dermopathy• Moist hand, warm• Dry skin• Myxedema
Dermopathy
Assess the neuromuscular system• Slow reflexes• Hyper reflexes
Assess the musculoskeletal system•Muscular weakness
LID RETRACTION
LID RETRACTION
ALHAMDULILLAHSelamat Berlatih