Thyroid Exam Demonstration

Importance of Anatomy

• Key to Exam: Knowing the anatomy.
• Finger Placement:
  1. Tip of Chin: Place finger on the mentalis muscle.
  2. Slide Down Midline: First hard structure -> Thyroid cartilage (Adam's apple).
  3. Hyoid Bone: Generally not clearly felt in the midline.
  4. Edge of Thyroid Cartilage: Slide finger down, next structure -> Cricoid cartilage.
  5. Cricothyroid Membrane: Between thyroid and cricoid cartilage.
  6. First Two Rings of Trachea: Below the cricoid cartilage.

Thyroid Gland Location

• Not near the thyroid cartilage despite its name.

Examination Steps

1. Examiner Position: Best done from behind the patient.
2. Anatomy Detection: Locate thyroid cartilage, cricoid cartilage, first two rings of the trachea.
3. Finger Placement: Midline over the first two rings of the trachea (site of the isthmus of the thyroid).
4. Finger Flattening: Flatten fingers as though trying to choke the patient and slide them slightly to the side.
5. Swallow Test: Ask patient to swallow and observe disproportionate movement of fingers.
6. Thyroid Palpation:
   • Push thyroid with one hand.
   • Palpate lobes with the other hand.

Additional Checks

• Lymph Node Exam: Complete examination necessary.
• Hand Observation: Check for sweatiness and fine tremor.

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