Name: palpating the thyroid for goiter
Uploaded: 2015-03-10T16:57:07.000Z
Duration: 6 min 35 s
Channel: JoVE

K12 Standards

new-york-state-science-learning-standards

New York State Science Learning Standards

High School

Life Science

Structure and Function

HS-LS1-3.

Thyroid Exam

1. Inspektion
<ol>
	<li>Kippen Sie der Kopf des Patienten leicht nach hinten, und überprüfen Sie sorgfältig den vorderen Hals. Wenn sichtbar, erscheint die Schilddrüse zwischen Ringknorpel Knorpel und Suprasternal Kerbe. Suchen Sie nach Symmetrie, diffuse Schwellung, und offensichtliche Massen.</li>
	<li>Lassen Sie den Patienten schlucken, und beobachten Sie wie der Ringknorpel Knorpel Schilddrüse Knorpel und Schilddrüse hoch und runter bewegen.</li>
</ol>
(2) palpieren
Obwohl die Schilddrüse vom vorderen oder hinteren Positionen getastet werden kann, ist die zweite Methode traditionelle.
<ol>
	<li>Bitten Sie den Patienten, leicht beugen den Hals um die Sternomastoid Muskeln zu entspannen.</li>
	<li>Hinter dem Patienten, um zu erreichen, mit beiden Händen und mit den Fingern um die Sehenswürdigkeiten von oben nach unten zu identifizieren: mobile Zungenbeins direkt unter dem Unterkiefer, Schilddrüse Knorpel mit seiner überlegenen Kerbe, Ringknorpel Knorpel trachealen Ringe und Suprasternal Kerbe.</li>
	<li>Legen Sie Ihren Zeigefinger direkt unterhalb des Schildknorpels Knorpel.</li>
	<li>Lassen Sie den Patienten schlucken wie zuvor, und das Gefühl für die Schilddrüse Isthmus erhebt sich unter Ihrem Finger-Pads. Es ist nicht immer spürbar. Das Gefühl für die Größe, Form und Konsistenz, feststellend, dass Knötchen oder Zärtlichkeit.</li>
	<li>Mit den Fingern der rechten Hand, sanft die Luftröhre nach links verschieben und das Gefühl für den richtigen Lappen in den Raum zwischen der Luftröhre und Sternomastoid Muskel.</li>
	<li>In ähnlicher Weise untersuchen des linken Lappens.</li>
	<li>Wenn ein Kropf erkannt wird, achten Sie auf eine Bruit indem man das Stethoskop über die seitlichen Lappen.</li>
</ol>

Eine vergrößerte Schilddrüse oder Kropf, in den meisten Fällen normale Schilddrüse Funktion (euthyreoten) zugeordnet ist, aber möglicherweise mit hyper- oder hypothyroid Bedingungen. Daher Schilddrüse Anomalie gefunden bei der körperlichen Untersuchung sollte eine sorgfältige Abklärung für die systemische Zeichen veranlassen und Symptome verbunden mit den beiden Ebbe und Schilddrüsenhormone. Eine normale Schilddrüse kann schwierig zu ertasten, insbesondere bei Patienten mit großen Hals sein. Aber seine Lage genau ermitte...

untersuchung der schilddrüse

Quelle: Richard Glickman-Simon, MD, Assistant Professor, Department of Public Health and Community Medicine Tufts University School of Medicine, MA
Die Schilddrüse liegt im vorderen Hals Luftröhre zwischen den Ringknorpel Knorpel (oben) und die Suprasternal Kerbe (unten) (Abbildung 1). Es besteht aus einem rechten und linken Lappen, durch eine Landenge verbunden. Isthmus umfasst die zweite, dritte und vierte trachealen Ringe und die Lappen Kurve nach hinten um die Seiten der Luftröhre und der Speiseröhre. Die normale Drüse, mit einem Gewicht von 10-25 g, ist in der Regel unsichtbar auf Inspektion und oft schwer zu ertasten. Ein Kropf ist eine vergrößerte Schilddrüse jeglicher Ursache. Neben der Bewertung seiner Größe, ist es wichtig, die Schilddrüse für seine Form, Mobilität, Konsistenz und Zärtlichkeit zu ertasten. Eine normale Schilddrüse ist weich, glatt, symmetrisch und nicht-Ausschreibung, und es rutscht leicht nach oben, beim Schlucken. Symmetrische Erweiterung von einem weichen, glatten Schilddrüse schlägt endemische Hypothyreose durch Jodmangel oder eine der beiden vorherrschenden Autoimmun-Erkrankungen: Morbus Graves oder Hashimoto Thyreoiditis. Schilddrüsenknoten sind häufig und in der Regel zufällig; 10 % der Schilddrüsenknoten erweisen jedoch bösartig. Sie möglicherweise einzelne oder mehrere, und sind in den meisten Fällen fest und nicht-Ausschreibung. Ein zartes, symmetrische Kropf gibt in der Regel Thyreoiditis.
<img alt="Figure 1" src="/files/ftp_upload/10098/10098fig1.jpg"> 
Abbildung 1: Anatomie der Schilddrüse. Darstellung der Lage und Anatomie der Schilddrüse im Hinblick auf die Hals-Strukturen.
Erkrankungen der Schilddrüse selten manifestiert sich als eine tastbare Struma isoliert. Schilddrüsen-Hormone dienen in erster Linie durch anregende zellulären Stoffwechsel im ganzen Körper Homöostase. So sind Hypo- und Hyperthyreose assoziiert mit einer Reihe von Symptomen und körperliche Befunde (Tabelle 1). Es ist wichtig zu beachten, dass Goiters euthyreoten (normale Schilddrüsenhormone), Hyperthyreose oder Hypothyreose sein können. Kopfschmerzen oder Sehstörungen können eine sekundäre Schilddrüsen-Erkrankung aufgrund eines Hypophysen Adenom vorschlagen.
<img alt="Table 1" src="/files/ftp_upload/10098/10098table1.jpg">
Tabelle 1. Symptome und körperlichen Befunde für Hypo - und hyper-Thyroidism.

Untersuchung der Schilddrüse

Source: Richard Glickman-Simon, MD, Assistant Professor, Department of Public Health and Community Medicine, Tufts University School of Medicine, MA
The ...

Education

Lehre

JoVE Science Education

Clinical Skills

Klinische Fertigkeiten

Physical Examinations II

Körperliche Untersuchungen II

palpating the thyroid for goiter

The thyroid gland sits in the front of the neck, in front of the trachea. It lies between the cricoid cartilage above and the suprasternal notch below. The gland has a right lobe and a left lobe joined by an isthmus, which covers the second, third, and fourth tracheal rings.

A normal thyroid weighs about 10 to 25 g. It is usually not visible on inspection and can be hard to feel. When the gland is enlarged, this is called a goiter, and the enlargement can have many causes.

During a thyroid exam, size is only one part of the assessment. The gland should also be checked for shape, mobility, consistency, and tenderness. A normal thyroid is soft, smooth, symmetrical, and non-tender. It also moves upward slightly when the patient swallows.

A smooth, symmetrical enlargement can suggest endemic hypothyroidism from iodine deficiency. It can also point to Graves' disease or Hashimoto's thyroiditis, which are common autoimmune disorders. Thyroid nodules are also common and are often found by chance. They may be single or multiple, and they are most often firm and non-tender, although about 10% are malignant.

A tender, symmetrical goiter usually suggests thyroiditis. Thyroid disease rarely appears as only a palpable goiter. Thyroid hormones help maintain homeostasis by stimulating cellular metabolism throughout the body, so hypo- and hyperthyroidism can cause many symptoms and physical findings. Goiters may be euthyroid, hyperthyroid, or hypothyroid. Headaches or visual changes may suggest a secondary thyroid disorder caused by a pituitary adenoma.

Palpating the Thyroid for Goiter

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Diese Sammlung ist eine spezialisierte Edition mit Methoden und Verfahren, die mit empfindlichen und umfassenden physischen Prüfungen wie HEENT Untersuchungen, Bauch-Untersuchungen und Becken-Untersuchungen verbunden sind.

Learn how the thyroid is examined in the neck, what a normal gland feels like, and how goiter, nodules, and thyroiditis can suggest disease.

Palpating the Thyroid for Goiter | JoVE K12

Richard Glickman-Simon

Overview

Thyroid Anatomy and Physiology

Inspection and Palpation

Summary

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HS-LS1-1.

Palpating the Thyroid for Goiter

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