Thyroid examination •Introduce •consent •Expose till the nipples or whole chest •Ask patient 4 questions. -weight loss or change in appetite -heat or cold intolerance -nervousness fatigue or exhaustion •If patient answers yes to all this means he has toxic goitre •examine pulse palmar erythema and tremor •look for lid lag and exopthalmos along with nystagmus in eyes •now come to actual swelling •ask patient to swallow •protrude tongue to rule out thyroglossal cyst •Inspect from front for size symmetry any colour change or visible veins •palpate from front •see tracheal position •do penburton sign to check for restrosternal goitre by asking patient to hold hands above behind ears •now palpate from back •percussion over sternum to rule out retrosternal goitre •auscultate over upper poles of thyroid to auscultate for bruit •tell your findings in terms of single nodule or diffuse goitre and whether it's simple goitre or toxic goitre
