Physical examination maneuver
Physical Exam
Thyroid Palpation
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Standing behind or in front of the seated patient with the patient's neck slightly flexed, gently place the pads of your fingers at the base of the anterior neck in the spaces between the trachea and the sternocleidomastoid muscles bilaterally. Ask the patient to swallow (offer a sip of water if needed) and feel the gland rise with the swallow. Note the size, symmetry, consistency, nodularity, and tenderness.
How to Interpret
Showing 8 of 15 findings
Chronic Obstructive Pulmonary Disease
Maximum laryngeal height ≤4 cm
Rule in
Somewhat helpful
Rule out
Minimally helpful
Evidence:Moderate
Laryngeal descent >3 cm
Rule in
Not helpful
Rule out
—
Evidence:Moderate
Goiter
Palpably enlarged thyroid (goiter)
Rule in
Somewhat helpfulNo CI
Rule out
Somewhat helpfulNo CI
Evidence:Moderate
Thyroid Carcinoma
Thyroid nodule, very firm nodule
Rule in
Very helpfulDerived CI
Rule out
Not helpfulDerived CI
Evidence:Moderate
Firm or hard nodule on palpation
Rule in
Somewhat helpfulDerived CI
Rule out
HelpfulDerived CI
Evidence:Moderate
Thyroid nodule or goiter fixed to surrounding tissues (does not move on swallowing)
Rule in
Somewhat helpfulDerived CI
Rule out
Not helpfulDerived CI
Evidence:Moderate
Thyroid nodule/goiter fixed (fixation) to surrounding tissues
Rule in
Somewhat helpfulDerived CI
Rule out
Not helpfulDerived CI
Evidence:Moderate
Thyroid Nodule
Palpable solitary thyroid nodule
Rule in
Not helpfulDerived CI
Rule out
Not helpfulDerived CI
Evidence:Moderate
Related Bedside Tests
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Thyroid Inspection
Rule in:HGoiter, HThyroid Nodule, IEThyroglossal Duct Cyst
Rule out:SHGoiter, MHThyroid Nodule, IEThyroglossal Duct Cyst
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Blood Pressure
Rule in:VHHypovolemia, VHMortality, VHStructural Brain Lesion +22 more
Rule out:VHCardiac Tamponade, VHHypovolemia, HLow Cardiac Output +22 more
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Heart Rate
Rule in:SHAtrial Fibrillation, SHDecompensation, SHHypothyroidism +15 more
Rule out:HDecompensation, SHAtrial Fibrillation, SHPostoperative Complication +15 more
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Point of Maximal Impulse
aka Apical impulse; apex beat
Rule in:VHAortic Stenosis, VHHypertrophic Cardiomyopathy, VHLeft Ventricular Dilation +14 more
Rule out:VHAortic Stenosis, VHLeft Ventricular Dilation, SHLeft Ventricular Hypertrophy +14 more
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Extraocular Movements
Rule in:VHStroke, SHHyperthyroidism, SHMyasthenia Gravis +9 more
Rule out:HMyasthenia Gravis, SHHyperthyroidism, NHOrbital Fracture +9 more
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Lung Auscultation
Rule in:VHChronic Obstructive Pulmonary Disease, VHPneumothorax, HMainstem Bronchus Intubation +29 more
Rule out:VHChronic Obstructive Pulmonary Disease, HPleural Effusion, SHInterstitial Lung Disease +28 more