{"id":1287,"date":"2017-01-08T13:57:47","date_gmt":"2017-01-08T13:57:47","guid":{"rendered":"http:\/\/www.ahmadfanaei.com\/en\/?post_type=post&#038;p=1287"},"modified":"2018-05-05T07:48:29","modified_gmt":"2018-05-05T07:48:29","slug":"physical-examination-in-thyroid-patients","status":"publish","type":"post","link":"https:\/\/ahmadfanaei.com\/en\/physical-examination-in-thyroid-patients\/","title":{"rendered":"Physical Examination in Thyroid Patients"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_85 counter-flat ez-toc-counter ez-toc-white ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Table of Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/ahmadfanaei.com\/en\/physical-examination-in-thyroid-patients\/#Inspection\" >Inspection<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/ahmadfanaei.com\/en\/physical-examination-in-thyroid-patients\/#Palpation\" >Palpation<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/ahmadfanaei.com\/en\/physical-examination-in-thyroid-patients\/#Hands\" >Hands<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/ahmadfanaei.com\/en\/physical-examination-in-thyroid-patients\/#Pulse\" >Pulse<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/ahmadfanaei.com\/en\/physical-examination-in-thyroid-patients\/#Eyes\" >Eyes<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/ahmadfanaei.com\/en\/physical-examination-in-thyroid-patients\/#References\" >References<\/a><\/li><\/ul><\/nav><\/div>\n<h2><span class=\"ez-toc-section\" id=\"Inspection\"><\/span>Inspection<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Tip the patient&#8217;s head slightly back, and carefully inspect the anterior neck. If visible, the thyroid appears between the cricoid cartilage and suprasternal notch. Check for symmetry, diffuse swelling, and obvious masses.<\/p>\n<p>Have the patient swallow, and observe as the cricoid cartilage, thyroid cartilage, and thyroid gland move up and down.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Palpation\"><\/span>Palpation<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Although the thyroid can be palpated from either anterior or posterior positions, the latter approach is traditional.<\/p>\n<p>Ask the patient to slightly flex the neck to relax the sternomastoid muscles.<\/p>\n<p>From behind the patient, reach around with both hands and use your fingers to identify the landmarks from top to bottom: mobile hyoid bone just beneath the mandible, thyroid cartilage with its superior notch, cricoid cartilage, tracheal rings, and suprasternal notch.<\/p>\n<p>Ask the patient to swallow as before, and feel for the thyroid isthmus rising up under your finger pads. It is not always palpable. Feel for size, shape, and consistency, noting any nodules or tenderness.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Hands\"><\/span>Hands<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Dry skin, increased sweating and palmar erythema can be surveyed as symptoms of thyroid diseases.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Pulse\"><\/span>Pulse<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Assess the radial pulse for Tachycardia (hyperthyroidism), Bradycardia (hypothyroidism), and Irregular \u2013 thyrotoxicosis.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Eyes\"><\/span>Eyes<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Inspect for any redness \/ inflammation of the conjunctiva.<\/p>\n<p><em>Bilateral exophthalmos is associated with Graves\u2019 disease, caused by abnormal connective tissue deposition in the orbit and extra-ocular muscles.<\/em><\/p>\n<p><em>Lid retraction (the visibility of sclera above the iris) is also a sign for Graves\u2019 disease.<\/em><\/p>\n<p>Observe for restriction of eye movements &amp; ask the patient to report any double vision or pain. <em>Eye movement can be restricted in Graves\u2019 disease due to abnormal connective tissue deposition in the orbit and extra-ocular muscles.<\/em><\/p>\n<h3><span class=\"ez-toc-section\" id=\"References\"><\/span>References<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><a href=\"https:\/\/www.jove.com\/science-education\/10098\/thyroid-exam\">https:\/\/www.jove.com\/science-education\/10098\/thyroid-exam<\/a><\/p>\n<p><a href=\"http:\/\/geekymedics.com\/thyroid-status-examination\/\">http:\/\/geekymedics.com\/thyroid-status-examination\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Inspection Tip the patient&#8217;s head slightly back, and carefully inspect the anterior neck. If visible, &#8230; <a class=\"cz_readmore\" href=\"https:\/\/ahmadfanaei.com\/en\/physical-examination-in-thyroid-patients\/\"><i class=\"far fa-square-plus\" aria-hidden=\"true\"><\/i><span>\u0627\u062f\u0627\u0645\u0647 \u0645\u0637\u0644\u0628<\/span><\/a><\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-1287","post","type-post","status-publish","format-standard","hentry","category-news"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.4 (Yoast SEO v28.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Physical Examination in Thyroid Patients - Dr.Ahmad Fanaei<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/ahmadfanaei.com\/en\/physical-examination-in-thyroid-patients\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Physical Examination in Thyroid Patients\" \/>\n<meta property=\"og:description\" content=\"Inspection Tip the patient&#8217;s head slightly back, and carefully inspect the anterior neck. If visible, ... \u0627\u062f\u0627\u0645\u0647 \u0645\u0637\u0644\u0628\" \/>\n<meta property=\"og:url\" content=\"https:\/\/ahmadfanaei.com\/en\/physical-examination-in-thyroid-patients\/\" \/>\n<meta property=\"og:site_name\" content=\"Dr.Ahmad Fanaei\" \/>\n<meta property=\"article:published_time\" content=\"2017-01-08T13:57:47+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2018-05-05T07:48:29+00:00\" \/>\n<meta name=\"author\" content=\"mohammad\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"mohammad\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/ahmadfanaei.com\\\/en\\\/physical-examination-in-thyroid-patients\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/ahmadfanaei.com\\\/en\\\/physical-examination-in-thyroid-patients\\\/\"},\"author\":{\"name\":\"mohammad\",\"@id\":\"https:\\\/\\\/ahmadfanaei.com\\\/en\\\/#\\\/schema\\\/person\\\/01c9b8a50e9a062128f09bd42cb0401b\"},\"headline\":\"Physical Examination in Thyroid Patients\",\"datePublished\":\"2017-01-08T13:57:47+00:00\",\"dateModified\":\"2018-05-05T07:48:29+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/ahmadfanaei.com\\\/en\\\/physical-examination-in-thyroid-patients\\\/\"},\"wordCount\":286,\"commentCount\":0,\"articleSection\":[\"News\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/ahmadfanaei.com\\\/en\\\/physical-examination-in-thyroid-patients\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/ahmadfanaei.com\\\/en\\\/physical-examination-in-thyroid-patients\\\/\",\"url\":\"https:\\\/\\\/ahmadfanaei.com\\\/en\\\/physical-examination-in-thyroid-patients\\\/\",\"name\":\"Physical Examination in Thyroid Patients - Dr.Ahmad Fanaei\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/ahmadfanaei.com\\\/en\\\/#website\"},\"datePublished\":\"2017-01-08T13:57:47+00:00\",\"dateModified\":\"2018-05-05T07:48:29+00:00\",\"author\":{\"@id\":\"https:\\\/\\\/ahmadfanaei.com\\\/en\\\/#\\\/schema\\\/person\\\/01c9b8a50e9a062128f09bd42cb0401b\"},\"breadcrumb\":{\"@id\":\"https:\\\/\\\/ahmadfanaei.com\\\/en\\\/physical-examination-in-thyroid-patients\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/ahmadfanaei.com\\\/en\\\/physical-examination-in-thyroid-patients\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/ahmadfanaei.com\\\/en\\\/physical-examination-in-thyroid-patients\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/ahmadfanaei.com\\\/en\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Physical Examination in Thyroid Patients\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/ahmadfanaei.com\\\/en\\\/#website\",\"url\":\"https:\\\/\\\/ahmadfanaei.com\\\/en\\\/\",\"name\":\"\u062f\u06a9\u062a\u0631 \u0633\u06cc\u062f \u0627\u062d\u0645\u062f \u0641\u0646\u0627\u06cc\u06cc\",\"description\":\"\u062f\u06a9\u062a\u0631 \u0627\u062d\u0645\u062f \u0641\u0646\u0627\u06cc\u06cc\u060c \u062c\u0631\u0627\u062d \u062a\u06cc\u0631\u0648\u0626\u06cc\u062f \u0648 \u067e\u0627\u0631\u0627\u062a\u06cc\u0631\u0648\u0626\u06cc\u062f \u0648 \u062f\u0627\u0646\u0634\u06cc\u0627\u0631 \u062c\u0631\u0627\u062d\u06cc \u0639\u0645\u0648\u0645\u06cc\u060c \u0639\u0636\u0648 \u0641\u0639\u0627\u0644 \u0627\u0646\u062c\u0645\u0646 \u062a\u06cc\u0631\u0648\u0626\u06cc\u062f \u0622\u0645\u0631\u06cc\u06a9\u0627 (ATA) \u0628\u0648\u062f\u0647 \u0648 \u062a\u0627 \u0627\u0645\u0631\u0648\u0632 \u0628\u06cc\u0634 \u0627\u0632 \u06f5\u06f0\u06f0\u06f0 \u0639\u0645\u0644 \u062c\u0631\u0627\u062d\u06cc \u062a\u06cc\u0631\u0648\u0626\u06cc\u062f \u0645\u0648\u0641\u0642 \u062f\u0627\u0634\u062a\u0647\u200c\u0627\u0646\u062f.\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/ahmadfanaei.com\\\/en\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/ahmadfanaei.com\\\/en\\\/#\\\/schema\\\/person\\\/01c9b8a50e9a062128f09bd42cb0401b\",\"name\":\"mohammad\"}]}<\/script>\n<!-- \/ Yoast SEO Premium plugin. -->","yoast_head_json":{"title":"Physical Examination in Thyroid Patients - Dr.Ahmad Fanaei","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/ahmadfanaei.com\/en\/physical-examination-in-thyroid-patients\/","og_locale":"en_US","og_type":"article","og_title":"Physical Examination in Thyroid Patients","og_description":"Inspection Tip the patient&#8217;s head slightly back, and carefully inspect the anterior neck. If visible, ... \u0627\u062f\u0627\u0645\u0647 \u0645\u0637\u0644\u0628","og_url":"https:\/\/ahmadfanaei.com\/en\/physical-examination-in-thyroid-patients\/","og_site_name":"Dr.Ahmad Fanaei","article_published_time":"2017-01-08T13:57:47+00:00","article_modified_time":"2018-05-05T07:48:29+00:00","author":"mohammad","twitter_card":"summary_large_image","twitter_misc":{"Written by":"mohammad","Est. reading time":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/ahmadfanaei.com\/en\/physical-examination-in-thyroid-patients\/#article","isPartOf":{"@id":"https:\/\/ahmadfanaei.com\/en\/physical-examination-in-thyroid-patients\/"},"author":{"name":"mohammad","@id":"https:\/\/ahmadfanaei.com\/en\/#\/schema\/person\/01c9b8a50e9a062128f09bd42cb0401b"},"headline":"Physical Examination in Thyroid Patients","datePublished":"2017-01-08T13:57:47+00:00","dateModified":"2018-05-05T07:48:29+00:00","mainEntityOfPage":{"@id":"https:\/\/ahmadfanaei.com\/en\/physical-examination-in-thyroid-patients\/"},"wordCount":286,"commentCount":0,"articleSection":["News"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/ahmadfanaei.com\/en\/physical-examination-in-thyroid-patients\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/ahmadfanaei.com\/en\/physical-examination-in-thyroid-patients\/","url":"https:\/\/ahmadfanaei.com\/en\/physical-examination-in-thyroid-patients\/","name":"Physical Examination in Thyroid Patients - Dr.Ahmad Fanaei","isPartOf":{"@id":"https:\/\/ahmadfanaei.com\/en\/#website"},"datePublished":"2017-01-08T13:57:47+00:00","dateModified":"2018-05-05T07:48:29+00:00","author":{"@id":"https:\/\/ahmadfanaei.com\/en\/#\/schema\/person\/01c9b8a50e9a062128f09bd42cb0401b"},"breadcrumb":{"@id":"https:\/\/ahmadfanaei.com\/en\/physical-examination-in-thyroid-patients\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/ahmadfanaei.com\/en\/physical-examination-in-thyroid-patients\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/ahmadfanaei.com\/en\/physical-examination-in-thyroid-patients\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/ahmadfanaei.com\/en\/"},{"@type":"ListItem","position":2,"name":"Physical Examination in Thyroid Patients"}]},{"@type":"WebSite","@id":"https:\/\/ahmadfanaei.com\/en\/#website","url":"https:\/\/ahmadfanaei.com\/en\/","name":"\u062f\u06a9\u062a\u0631 \u0633\u06cc\u062f \u0627\u062d\u0645\u062f \u0641\u0646\u0627\u06cc\u06cc","description":"\u062f\u06a9\u062a\u0631 \u0627\u062d\u0645\u062f \u0641\u0646\u0627\u06cc\u06cc\u060c \u062c\u0631\u0627\u062d \u062a\u06cc\u0631\u0648\u0626\u06cc\u062f \u0648 \u067e\u0627\u0631\u0627\u062a\u06cc\u0631\u0648\u0626\u06cc\u062f \u0648 \u062f\u0627\u0646\u0634\u06cc\u0627\u0631 \u062c\u0631\u0627\u062d\u06cc \u0639\u0645\u0648\u0645\u06cc\u060c \u0639\u0636\u0648 \u0641\u0639\u0627\u0644 \u0627\u0646\u062c\u0645\u0646 \u062a\u06cc\u0631\u0648\u0626\u06cc\u062f \u0622\u0645\u0631\u06cc\u06a9\u0627 (ATA) \u0628\u0648\u062f\u0647 \u0648 \u062a\u0627 \u0627\u0645\u0631\u0648\u0632 \u0628\u06cc\u0634 \u0627\u0632 \u06f5\u06f0\u06f0\u06f0 \u0639\u0645\u0644 \u062c\u0631\u0627\u062d\u06cc \u062a\u06cc\u0631\u0648\u0626\u06cc\u062f \u0645\u0648\u0641\u0642 \u062f\u0627\u0634\u062a\u0647\u200c\u0627\u0646\u062f.","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/ahmadfanaei.com\/en\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Person","@id":"https:\/\/ahmadfanaei.com\/en\/#\/schema\/person\/01c9b8a50e9a062128f09bd42cb0401b","name":"mohammad"}]}},"_links":{"self":[{"href":"https:\/\/ahmadfanaei.com\/en\/wp-json\/wp\/v2\/posts\/1287","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ahmadfanaei.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ahmadfanaei.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ahmadfanaei.com\/en\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/ahmadfanaei.com\/en\/wp-json\/wp\/v2\/comments?post=1287"}],"version-history":[{"count":0,"href":"https:\/\/ahmadfanaei.com\/en\/wp-json\/wp\/v2\/posts\/1287\/revisions"}],"wp:attachment":[{"href":"https:\/\/ahmadfanaei.com\/en\/wp-json\/wp\/v2\/media?parent=1287"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ahmadfanaei.com\/en\/wp-json\/wp\/v2\/categories?post=1287"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ahmadfanaei.com\/en\/wp-json\/wp\/v2\/tags?post=1287"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}