1. Thyroid Examination

2. Thyroid Gland Anatomy

5. Parathyroid Glands

6. RLN

7. Histology of Thyroid Gland

8. Histology of Thyroid Gland

9. Physiology of Thyroid Gland

10. Physiology of Thyroid Gland

11. Pathology of Thyroid Gland
Hormone
Hyperthyroidism
Hypothyroidism
Gland
Nodule or Cyst
Goiter

12. History of Thyroid Diseases
Local
Dysphagia
Dyspnea
Voice
Pain
Mass
Neck fullness
Systemic
hyperthyroidism
hypothyroidism
Other
Acropachy
Ophthalmopathy
Dermatopathy

13. Presentation of Thyroid Diseases

14. Steps of Clinical Examination1-
Privacy and Light
Wash your hands 2-
Introduce your self
Clarify the patient’s identity 3-
Explain the procedure and gain the patient’s acceptance
Start the Examination

15. Wash your hands

16. Initial observation of the patient.
Does he seems abnormally hyper- or hypoactive?
Does he appears sweaty?
What condition is their skin and hair?
Does their voice sound normal?

17. Examine the hands Look for any tremor palmar erythema
feel the hands for any sweating
Look for any tremor
palmar erythema
Check the nails for any thyroid Acropachy :
digital clubbing
swelling of digits and toes
& periosteal reaction of extremity bones
feel the pulse

18. thyroid Acropachy :

19. thyroid Acropachy :

20. TED : Thyroid Eye Disease
Eyes Examination
TED : Thyroid Eye Disease
Upper eyelid retraction (Darlimple's sign)
Lid lag 
Redness  conjunctivitis
Exophthalmos
Diplopia

21. Eyes Examination hypothyroidism Apathetic face Bilateral ptosis
Loss of eyebrows laterally (Hertoge's sign)
Periorbital edema

22. Neck Examination Inspection look from the front and the side looking
pay particular attention to the area of the thyroid
look for any obvious abnormalities

23. Neck Examination Palpation feel the gland The approach is from behind
Palpate both lobes & the isthmus
Note any swellings or lumps
note the shape and consistency of any lumps as well as whether they are tender or mobile
examine while the patient drinks to assess whether the lump moves with swallowing.
examine the cervical lymph nodes
examine the eyes from behind and above to look for any Exophthalmos
Neck Examination

24. Neck Examination Auscultation
auscultate the thyroid and carotid arteries for Bruit
PALPATE THE Trachea looking for retrosternal goiter
Percusse the manibruim for retrosternal goiter

25. Look for Pretibial Myexedema
Lower Limbs
Look for Pretibial Myexedema

26. Thank your patient and report your findings to the examiner

27. Then Order thyroid function
TSH
Free T3
Free T4
Thyroid Ultrasound
FNAC

28. Thyroid function results interpretation
Primary Hypothyroidism
TSH: ↑ Free T3 and free T4: ↓
Secondary Hypothyroidism
TSH: ↓ or ↔ Free T3 and free T4: ↓
Hyperthyroidism
TSH: ↓  Free T3 and free T4: ↑