Hand and upper extre­mities Heart rate, ABP, tremor, colla­psing pulse, warmth, hyperhydrosis,
and palmar erythema
Upper and lower extre­mity Signs of proximal myopathy (ask the patient to raise the arm above head), and arm reflexes
Eyes Lid lag, lid retraction, exoptha­lmus, opthalmoplegia, chemosis
Chest Gynecomastia, heart murmurs
Legs Pretibial myxedema, proximal myopathy, and reflexes
Thyroid exam Inspection:

Inspect the front and sides
of the neck
and check for localized or generalized swelling of
the thyroid gland

Carefully inspect the
neck while the
patient is swallowing

Inspect the neck while
the patient is protruding the tongue;
presence of a lump that moves as
the tongue protrudes is
indica­tive of likely
thyroglossal cyst

Check for neck scars

Check for dilated veins
(thoracic inlet obstruction)

Palpation:Palpate from the
front and from behind the patient
(gland and/or lump):

Size

Consistency:soft, firm,
rubbery, stone hard

Tenderness

Shape

Surface

Mobility

Check for thrill

Palpate the cervical lymph
nodes

Check the trachea's
position (displaced in retrosternal
goiter)

Percussion: over the
manubrium
Auscultation: listen for bruit
on each lobe of the thyroid gland
Pemberton's sign: plethora
when the patient lifts both arms
as high as possible, which indicates
thoracic inlet obstruction