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. inspection
<ol>
	<li>Basculer la tête du patient légèrement en arrière et inspecter soigneusement le cou antérieur. Si elle est visible, la thyroïde apparaît entre l’encoche de creux et de cartilage cricoïde. Vérifier la symétrie, diffuse des masses gonflements et évidentes.</li>
	<li>Demander au patient d’avaler et observer comme le cartilage cricoïde, cartilage thyroïde et la glande thyroïde monter et descendre.</li>
</ol>
2. palper
Bien que la thyroïde peut être palpée à partir de positions soit antérieures ou postérieures, cette dernière approche est traditionnelle.
<ol>
	<li>Demander au patient de fléchir légèrement le cou pour détendre les muscles sternomastoïdien.</li>
	<li>Derrière le patient, se propagent dans les deux mains et vos doigts permet d’identifier les points de repère de haut en bas : mobile os hyoïde juste en dessous de la mandibule, le cartilage thyroïde avec son encoche supérieure, cartilage cricoïde, anneaux trachéaux et creux encoche.</li>
	<li>Placez vos doigts index juste en dessous du cartilage cricoïde.</li>
	<li>Demandez au patient d’avaler comme avant et se sentir pour l’isthme thyroïde levant sous vos plaquettes de doigt. Il n’est pas toujours palpable. Vous vous sentirez de taille, forme et consistance, notant les nodules ou tendresse.</li>
	<li>En utilisant les doigts de votre main droite, doucement déplacer la trachée vers la gauche et se sentir pour le lobe droit dans l’espace entre le muscle de la trachée et sternomastoïdien.</li>
	<li>De même examiner le lobe gauche.</li>
	<li>Si un goitre est détecté, écouter un bruit en plaçant le stéthoscope sur les lobes latéraux.</li>
</ol>

Une hypertrophie de la glande thyroïde, ou goitre, est le plus souvent associé à la fonction normale de la glande thyroïde (euthyroïdiens), mais peuvent être associé à l’hyper- ou conditions d’hypothyroïdie. Par conséquent, anomalie thyroïdienne trouvé à l’examen physique devrait inciter à une évaluation minutieuse des signes systémiques et symptômes associés avec les deux hautes et basses d’hormones thyroïdiennes. Une thyroïde normale peut être difficile à palper, surtout chez les patients avec le grand cou. Toutefois, ...

examen de la thyroïde

Source : Richard Glickman-Simon, MD, professeur adjoint, département de santé publique et médecine sociale, Tufts University School of Medicine, MA
La glande thyroïde est située dans la trachée de cou antérieur entre le cartilage cricoïde (ci-dessus) et le cran en creux (dessous) (Figure 1). Il se compose d’un lobe droit et gauche, relié par un isthme. L’isthme couvre la deuxième, troisième, et anneaux trachéaux quatrième et les lobes courbe vers l’arrière sur les côtés de la trachée et l’oesophage. La glande normale, pesant 10-25 g, est habituellement invisible sur l’inspection et souvent difficile à palper. Un goitre est une hypertrophie de la thyroïde soit la cause. En plus d’évaluer sa taille, il est important de palper la glande thyroïde pour sa forme, la mobilité, la cohérence et la tendresse. Une thyroïde normale est douce, lisse, symétrique et non d’offres, et elle glisse vers le haut légèrement en avalant. Élargissement symétrique d’un soft, thyroïdiennes lisse suggère hypothyroïdie endémique en raison de la carence en iode ou l’une des deux maladies auto-immunes répandues : la maladie de Basedow ou la Hashimoto thyroïdite de. Les nodules thyroïdiens sont fréquentes et généralement accidentels ; Cependant, 10 % des nodules thyroïdiens s’avèrent malignes. Ils peuvent être uniques ou multiples et sont le plus souvent ferme et non d’offres. Un goitre tendre, symétrique indique en général la thyroïdite.
<img alt="Figure 1" src="/files/ftp_upload/10098/10098fig1.jpg"> 
Figure 1. Anatomie de la glande thyroïde. Illustration de l’emplacement et l’anatomie de la glande thyroïde en ce qui concerne les structures du cou.
Maladie de la thyroïde se manifeste rarement par un goitre palpable dans l’isolement. Les hormones thyroïdiennes servent à maintenir l’homéostasie principalement en stimulant le métabolisme cellulaire dans tout le corps. Ainsi, hypo et hyperthyroïdie sont associés à une gamme de symptômes et de signes physiques (tableau 1). Il est important de noter que goitre euthyroïdien (niveaux normaux d’hormone thyroïdienne), hyperthyroïdie ou hypothyroïdie. Maux de tête ou des troubles visuels peuvent suggérer un trouble de la thyroïde secondaire due à un Adénome hypophysaire
<img alt="Table 1" src="/files/ftp_upload/10098/10098table1.jpg">
Le tableau 1. Les symptômes et les signes physiques d’hypo - et hyper-hypo-thyroïdie.

Examen de la thyroïde

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

Education

Enseignement

JoVE Science Education

Clinical Skills

Compétences cliniques

Physical Examinations II

Examens physiques 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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Cette collection est une édition spécialisée dans les méthodologies et les procédures associées à des examens physiques plus sensibles et plus complets tels que les examens nez, bouche, gorge, oreilles, yeux, les examens abdominaux et les examens pelviens.

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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