goiter exam
Sit at edge of chair -
- skin
- scar - kocher scar - transverse cervical incision
- erythema
- no other masses
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- ask to swallow / tongue protrusion to check goiter (if positive continue examination of goiter behind the patient, then ask patient to swallow then palpate… palpate the both lobes) tender in thyroiditis check patient eyes - identify lower edge of thyroid for retrosternal goiter ++ then check lymphnodes - retrosternal percussion - tracheal deviation (three fingers - do gently as it is painful) - auscultate for bruit in graves
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- tremor palmar eryhema irregular pulse temprature, myxedema, edema, lid retration, exophalamos
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- Lidlag - H test
diffused (nodular? huge?) large neck mass more on left mass associated with (Lid retraction, exophlamos)
protrusion of tongue Midline swelling (could be infection or congenital)
1- cystic hydroma 2-
1- cystic hydroma 2- branchial/cleidomastoid tumors
5,7- cystic hydrome
1- branchial cyst - anterior 1/3 mass 3- branchial or carotid
4, 5- branchial fistula - secretion 67 - bilaternal branchial fistula
?
1,2,3- valsava maneuvear - laryngocele
4,5,6 - carotid body tumour
3,4 - lymphnedenopathy (secondary sacroma?) hard enlarge lymph nodes in neck - primary lesion was insiginifanct mole above his right eyebrow
6,7,8 torticollus?
1,2 - Cervical Rib - from T1 - present as fullness at base of neck
3,4 - subclavian aneurysm
1 - epidermal 1,2 - sebeacous cyst
4 - fat pad?
5- lipoma
7 - thyroglossal cyst, sabbecous cyst, goiter - depending on protrusion, or swallow
3- brachial cyst 4- granula 6- sabbecous cyst 8- cold abcess