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BISMILLAHIRRAHMANIRRAHIM

PHYSICAL

EXAMINATION OFTHYROID DISEASESITI ANNISA DEVI TRUSDA

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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

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Anatomy of Thyroid Gland

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Anatomy of Thyroid Gland

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Physical Examination

Assess the patients 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

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Exophthalmos

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Assess the thyroid and pretracheal

lymph nodes examination

Examination of thyroid gland :

Observe the neck, especially as the

patient swallows

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Diffuse Goiter

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Unilateral Swelling

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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

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Palpation from the front

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Examine from behind the patient :

ask the patient to flex the neck slightlyforward to relax the sternocleidomastoid

muscles

place the three fingers of both hands onthe patients neck so that your index

fingers are just below the cricoid cartilage

ask the patient to sip and swallow water asbefore. Feel for thyroid isthmus rising up

under your finger pads

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Palpation from behind

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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

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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

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Assess the abdominal condition : slowed

or rapid peristaltic

Assess the extremitas condition :

Tremor

Thyroid dermopathy

Moist hand, warm Dry skin

Myxedema

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Dermopathy

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Assess the neuromuscular system

Slow reflexes

Hyper reflexes

Assess the musculoskeletal system

Muscular weakness

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LID RETRACTION

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LID RETRACTION

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