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