2025/2026Graded A+
Abnormal finding on eye exam - ✔✔✔Squinting, leaning forward, hesitancy, or misreading letters on a snellen
chart.
Anterior approach - examining thyroid - ✔✔✔Stand in front of and facing the patient. Ask the patient to tilt his or
her head slightly forward and to the right, as noted above. Use your right thumb to shift the trachea over to the
patient's right side. Use your left thumb and fingers to grasp and the sternomastoid muscle. Ask the patient to
swallow as you feel for any thyroid changes.
Enlarged thyroid - ✔✔✔Place the bell of your stethoscope to auscultate the thyroid gland. A bruit is not normally
present. If found a thyroid bruit will produce a soft, whooshing, blowing, or pulsing sound. Further workup is
needed for the evaluation of hyperthyroidism. The increased blood flow to the thyroid is associated with the
hyperplasia of the gland.
Epistaxis - ✔✔✔
How to examine thyroid - ✔✔✔First: inspect the thyroid with a light that shines across the thyroid from the side.
Helping to illuminate any fullness or shadowing.
Have the patient take a sip of water and watch the thyroid move as they swallow. (should move up and down
symmetrically.)
May feel the thyroid from posterior or anterior approach.
Lymph nodes of the neck - ✔✔✔Preauricular: located in the front of the ear.
Posterior auricular/mastoid: above the mastoid process and behind the ear.
Occipital: at the base of the skull
Submental/midline: Behind the tip of the mandible.
Submandibular: midway under the mandible.
Jugulodigastic: under the angle of the mandible.
Superficial cervical: lying over the sternomastoid muscle.
Deep cervical: under the sternomastoid muscle.
Supraclavicular: just above and behind the clavicle.