Examination of the neck

This video contains everything I would want to do in a neck exam. I am most comfortable with the following order:

Inspection

• Visible lump
• Scars
• Swallow + look at lump
• Stick out tongue + look at lump
  
• Eyes (exopthalmos = appearance of protruding eyes; lid retraction)
• Face: Non-pitting oedema in hypothyroidism (also in hands and feet)
  
• Weight
• Hair thinning = hyper; dry hair = hypo
  
• Eyebrows - loss of outer third in hypothyroidism)
  
• Clothes - temperature appropriate?

Touchy feely - ask about pain

• Palpate. Tender?
  
• Palpate with swallow
• Palpate against muscles
• Lymph nodes
• Proptosis - Eyes protrude beyond the orbit
• Percuss
• Listen for thyroid bruits

Eyes

• Eye movements
• Lid lag

Hands

• Acropachy
• Sweaty
• Tremor
• Pulse
• Reflexes

Pretibial myxoedema

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Remember: Lid lag and lid retraction are not exclusive to Graves', but all the other eye signs are exclusive to Graves'.