Neck and thyroid Flashcards
Thyroid exam general inspection
Hair
Skin (dry hypo)
Behaviour (agitation/anxiety in hyper)
Build (weight gain hypo, weight loss hyper)
Clothing (summer clothes in winter hyper, winter clothes in summer hypo)
What do you need to do a thyroid examination?
Stethoscope
Glass of water
Tendon hammer
Piece of paper
What are you inspecting for in the hands for thyroid?
Thyroid acropachy (hyper) Sweating (hyper) Dry skin (hypo) Palmer erythema (hyper) Fine tremor (hyper) Pulse (tachy/AF hyper)
How and what do you inspect in the eyes for thyroid?
Inspect for chemosis of conjuntiva, periorbital oedema and erythema
Eyebrows (outer 1/3 hair loss in hypo)
Exopthalmus (inspect from front side and top)
Eye movements and lid lag
What happens after looking at the eyes in a thyroid examination?
Look at neck, goitre, skin changes, scars
Ask pt to stick out tongue and swallow water
Palpate from behind and get pt to swallow and stick out tongue
Assess for size, symmetry, consistency, masses, thrill
Lymph node palpation
Tracheal deviation
Percuss retrosternal goitre and auscultate for a bruit
Examine legs
What do you check the legs for in thyroid exam?
Examine legs for pretibial myoxoedema
Proximal myopathy
Reflexes in knees (slow relaxing in hypo)
Treatment of thyrotoxicosis?
Carbimazole and beta blockers
Radio iodine
Surgery
Treatment of hypothyroidism
Levothyroxine replacement
What do you discuss in a thyroid history?
Weight loss/gain Appetite Sweating/dry skin Preference for hot/cold weather Muscle weakness Changes to menstrual cycle Temper/agitation
Name the cervical lymph node areas
Post auricular Preauricular Submental Submandibular Occipital Anterior chain Posterior chain Supraclavicular
Name the areas of axillary lymph nodes
Central Lateral Apical Posterior Subscapular
Name the borders of the posterior triangle of the neck
Anterior: sternocleidomastoid
Posterior: trapezius
Inferior: middle clavicle
What is in the posterior triangle of the neck?
Omhyoid muscle External jugular vein Subclavian vein Accessory nerve Cervical plexus (C3-5)
What can the posterior triangle be split into?
Occipital triangle and subclavian triangle
Split by omhyoid muscle
Name the borders of the anterior triangle of the neck
Superiorly: mandible
Laterally: sternocleidomastoid
Medially: midline
