Thyroid Examination

General Inspection - (Patient sitting up)

Anorexia Irritability & Emotional lability Sweating Scant clothing (Heat intolerance) Goitre - Give glass of water - only goitre & thyroglossal cyst rise with swallowing Stridor (Tracheal compression) Hoarseness (Recurrant laryngeal nerve compression)

Arms

Tremor Proximal myopathy Warm periphery Pulse   Sinus tachycardia Atrial Fibrillation (AF) Biceps jerk - Brisk reflexes

Face

Flushed Eyes   Exopthalmos Proptosis Lid lag Protrude tongue - thyroglossal cyst rises

Neck - (From behind)

Goitre   Site Size Shape Nodules Consistency Movement on swallowing Retrosternal involvement Tracheal deveation Pemberton's Sign (Facial plethora, stridor and Jugular Venous Pressure (JVP) elevation when raising arms, due to superior vena caval (SVC) obstruction)

Legs

Pretibial myxoedema