Site Map	Examine the Neck

• Introduce yourself and check the patient's identity
• Establish rapport with patient
• Ask about relevant symptoms
  • Pain and tenderness
  • Changes in the size of the lump
  • Onset of the lump
  • Difficulty swallowing
  • Hyperthyroid and Hypothyroid symptoms
• Ask permission to examine & explain examination
• Ensure appropriate position to examine the patient
  • Expose the neck adequately and observe the lump
• Palpate the lump
  • Test if lump moves on swallowing
    • Offer water to aid swallowing
  • Test if lump moves on protruding tongue
• Assess if lump transilluminates
• Auscultate the lump
• Examine
  • Lymph nodes
  • Tracheal position
  • Retro-sternal extension
• Assess stigmata of thyroid disease
  • Hand tremour
  • Pulse rate and rhythm
  • Skin and hair changes
  • Eye changes
    • Exopthalmos
    • Lid lag / Lid retraction
  • Pre-tibial myxoedema
• Ensure patient dignity is maintained
  • Replace clothes at the end of the procedure
• Care taken to
  • Use appropreate language
  • Use appropreate questions; open, closed & clarifying
  • Encourage and answer patients questions
  • Acknowledge patient concerns
• Summary and analysis of findings
• Wash hands

	Any comments or feedback please contact me by email: Tom Williams