Where-is-the-thyroid

Where is the thyroid?

The thyroid is a butterfly-shaped gland that sits low on the front of the neck. Your thyroid lies below your Adam’s apple, along the front of the windpipe. The thyroid has two side lobes, connected by a bridge (isthmus) in the middle. When the thyroid is its normal size, you can’t feel it.

The thyroid gland produces hormones that regulate the body’s metabolic rate as well as heart and digestive function, muscle control, brain development and bone maintenance. Its correct functioning depends on having a good supply of iodine from the diet.

Do this on yourself or someone:

  1. Put your finger on tip of your chin (mentalis).
  2. Slide finger down the midline and the first hard structure you hit is the top of the thyroid cartilage. (Surprisingly, one does not feel the hyoid bone in the midline, although sometimes its lateral end is misidentified as a hard lymph node).
  3. Run your finger down the prow or the free edge of the thyroid cartilage (Adam’s apple).
  4. The next thing you hit is the cricoid cartilage (and see if you can get your fingernail in between the thyroid and cricoid cartilage–that is the cricothyroid membrane which is where trans-tracheal aspirations for pneumonia can be performed).
  5. Below the cricoid ring are the first two rings of the trachea, and the ISTHMUS of the thyroid overlies those two rings.
  6. Ask patient to flex neck slightly forward and relax.
  7. Go through the landmarks as above.
  8. Place first two digits of both hands just below cricoid cartilage so that left and right fingers meet on the patient’s midline. Place thumbs posterior to patient’s neck and flatten all fingers against the neck.
    • Use finger pads, not tips, to palpate.
    • Identify the isthmus.
  9. Gently draw fingers laterally 1-2cm.
    • Gently palpate lateral lobes.
  10. NOW ask patient to swallow (give them a glass of water if possible).
    • Assess for asymmetrical elevation of lobes (suggests nodularity).
  11. When you are done with above, move to next phase, which is displacing the soft tissues on one side to the midline while assessing for size with the other hand. Repeat in opposite direction.

 

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