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. 검사
<ol><li>환자의 머리를 약간 뒤로 기울이고 앞쪽 목을 조심스럽게 검사합니다. 볼 수 있는 경우, 갑상선은 크리피드 연골과 상류요노치 사이에 나타납니다. 대칭, 확산 붓기 및 명백한 질량을 확인합니다.</li>
	<li>환자를 삼키고, 크리시드 연골, 갑상선, 갑상선이 위아래로 움직일 때 관찰하십시오.</li>
</ol>2화 팔파테
갑상선은 전방 또는 후방 위치에서 만져질 수 있지만 후자의 접근 방식은 전통적입니다.
<ol><li>환자에게 흉골 근육을 이완시키기 위해 목을 약간 구부려 달라고 부탁하십시오.</li>
	<li>환자 뒤에서, 양손으로 주위를 도달하고 상단에서 아래로 랜드 마크를 식별하기 위해 손가락을 사용 : 맨디블 바로 아래 이동 효이뼈, 우수한 노치와 갑상선 연골, cricoid 연골, 기관 반지, 그리고 초라 스테른 노치.</li>
	<li>치수 손가락을 크리시드 연골 바로 아래에 놓습니다.</li>
	<li>환자에게 이전과 같이 삼키도록 요청하고 손가락 패드 아래에서 일어나는 갑상선 이스머스에 대해 느껴보십시오. 항상 만져볼 수 있는 것은 아닙니다. 모든 목절이나 부드러움을 지적, 크기, 모양, 일관성에 대한 느낌.</li>
	<li>오른손의 손가락을 사용하여 기관지의 왼쪽을 부드럽게 움직이고 기관지와 흉골 근육 사이의 공간에서 오른쪽 엽을 느낍니다.</li>
	<li>마찬가지로 왼쪽 로브를 검사합니다.</li>
	<li>고이터가 감지되면 측면 엽 위에 청진기를 배치하여 브루트를 들어보십시오.</li>
</ol>

확대 갑상선, 또는 갑상선, 또는 갑상선, 가장 자주 정상적인 갑상선 기능 (갑상선)와 연관되어 있지만 갑상선 또는 갑상선 상태와 관련될 수 있습니다. 따라서, 신체 검사에서 발견 된 갑상선 이상은 높고 낮은 갑상선 호르몬 수준과 관련된 전신 징후 및 증상에 대한 신중한 평가를 촉구해야합니다. 일반적인 갑상선은 특히 큰 목을 가진 환자에서, 만지질 어려울 수 있습니다. 그러나, 그 위치는 정확하게 근처의 뼈와 카르틸라기 랜드 마크를 식별하여 결정 될 수있다 : 위의 크리키드 연골과 아래의 상골 노치. 크기가 증가하는 것 외에도 선은 비대칭, 고인 또는 부드러움을 보일 수 있습니다. 대칭 고이터와 갑상선 딱절공은 드물지 않으며, 그들의 탐지는 항상 추가 조사를 촉구해야합니다.

갑상선 검사

출처: 리처드 글릭먼-사이먼, MD, 조교수, 공중 보건 및 지역 사회 의학학과, 터프츠 의과 대학, 석사
갑상선은 크리시드 연골(위)과 상류층 노치(아래)(그림 1)사이의 목 전방 기관체에 위치하고 있다. 그것은 isthmus에 의해 연결된 오른쪽과 왼쪽 로브로 구성되어 있습니다. 이스머스는 두 번째, 세 번째, 네 번째 기관 고리를 커버하고, 로브는 기관및 식도의 측면을 뒤후방으로 곡선합니다. 10-25g의 일반 선은 일반적으로 검사에서 보이지 않으며 종종 눈에 띄지 않습니다. 가이터는 어떤 원인에서 확대 갑 상선입니다. 그 크기를 평가하는 것 외에도 모양, 이동성, 일관성 및 부드러움에 대해 갑상선을 만지는 것이 중요합니다. 정상적인 갑상선은 부드럽고 매끄럽고 대칭적이며 비부드럽으며 삼키면 약간 위로 미끄러집니다. 부드럽고 매끄러운 갑상선의 대칭 확대는 요오드 결핍 또는 두 가지 널리 퍼진 자가 면역 질환 중 하나인 그레이브스 병 또는 하시모토갑염으로 인한 발병 저갑상선증을 시사합니다. 갑상선 딱두얼은 일반적이고 일반적으로 부수적입니다; 그러나 갑상선 목절의 10%는 악성으로 판명되었습니다. 그들은 단일 또는 여러 수 있습니다., 그리고 가장 자주 확고 하 고 비 부드러운. 부드럽고 대칭적인 가이터는 일반적으로 갑상선염을 나타냅니다.
<img alt="Figure 1" src="/files/ftp_upload/10098/10098fig1.jpg"> 그림 1. 갑상선의 해부학. 목 구조에 대하여 갑상선의 위치 및 해부학의 삽화.
갑상선 질환은 거의 고립에서 만져 볼 수있는 고이터로 명시되지 않습니다. 갑 상선 호르몬 은 몸 전체에 걸쳐 세포 대사를 자극 하 여 주로 항상성을 유지 하는 역할을. 따라서, 갑상선 기능항진증은 증상및 신체적 발견의 범위와 연관된다(표 1). 갑상선 (정상적인 갑상선 호르몬 수준), 갑상선 또는 갑상선 일 수 있다는 점에 유의하는 것이 중요합니다. 두통 또는 시각 장애는 뇌 하 수 체 선 종으로 인해 이차 갑 상선 장애를 제안할 수 있습니다.
<img alt="Table 1" src="/files/ftp_upload/10098/10098table1.jpg">
표 1. Hypo-and hyper-갑상선에 대 한 증상 및 물리적 결과.

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

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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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이 컬렉션은 HEENT 시험, 복부 검사 및 골반 시험과 같은 보다 민감하고 포괄적인 신체 검사와 관련된 방법론과 절차를 특징으로 하는 전문 판입니다.

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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development-and-reproduction-of-the-laboratory-mouse

Development and Reproduction of the Laboratory Mouse

Successful breeding of the laboratory mouse (Mus musculus) is critical to the establishment and maintenance of a productive animal colony. Additionally, ...

Genetic Crosses

To dissect genetic processes or create organisms with novel suites of traits, scientists can perform genetic crosses, or the purposeful mating of two ...

Construct an explanation based on evidence for how the structure of DNA determines the structure of proteins which carry out the essential functions of life through systems of specialized cells.

HS-LS1-1.

Palpating the Thyroid for Goiter

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