Internal Diseases · MU Sofia

Practical · 8. Examination of the neck. Physical methods of examination of the thyroid gland and lymphatic nodes.

Covers how to examine the thyroid gland and the cervical lymph nodes, starting with inspection during swallowing and then palpation from behind the seated patient, including the features to assess such as size, consistency, tenderness and mobility. It also lists the examiner positions used for the thyroid, and the palpation order for the lymph node groups from preauricular to supraclavicular, with the Virchow's node and Troisier's sign noted. The note ends with what to assess in the nodes.

Inside: 3 sections · 3 labelled pictures · 15 flashcards · 2 min

Topic 65 of 88 in the MU Sofia syllabus for Internal Diseases (Dental Medicine, Year 4). The free AceMed note covers it in 3 sections, about 330 words (2 min of reading), with 15 flashcards.

In this note

  1. Examination of the neck. Physical methods of examination of the thyroid gland and lymphatic nodes.
  2. A. Thyroid Gland Examination
  3. B. Lymph Node Examination

A. Thyroid Gland Examination

1. Inspection

  • Position: Examiner stands in front of the patient.
  • Ask the patient to sip water and swallow.
  • Observe: Upward movement of any visible thyroid swelling (goiter) during swallowing. Thyroid moves with swallowing as it is enclosed by pretracheal fascia.

2. Palpation

  • Position: Examiner moves behind the seated patient.
  • Hands: Thumbs at nape of neck, fingers curved around the front on both sides of trachea.
  • Technique:
  • Displace trachea to one side gently with one hand.
  • Palpate opposite lobe with the other hand.
  • Repeat for the other side.
  • Ask the patient to swallow during palpation. Swallowing helps feel the gland as it moves beneath the fingers.
  • Assess:
  • Size (normal, enlarged)
  • Shape
  • Consistency (soft, firm, nodular – nodules may suggest pathology)
  • Tenderness (pain may indicate thyroiditis)
  • Mobility (normally mobile; fixation may indicate malignancy)

3. Types of Thyroid Examination by Examiner Position

  • Behind the Patient (most common) – Preferred for bilateral palpation, assessing size and nodules.
  • In Front of the Patient – Used mainly for inspection, palpation possible.
  • Sitting in Front of the Patient – For detailed palpation, esp. if goiter/nodules suspected.
  • Lateral Position – Useful for examining deep nodules/lateral lobes.

Continue reading free

The whole note, all 3 sections, is free with an AceMed account, with its 15 flashcards. Premium adds flashcard recall, highlights and Ask AI.

Start freeAlready a member? Open the note