Thyroid Gland

- is one of the largest endocrine glands. The thyroid gland is found in the neck, below the thyroid cartilage (which forms the laryngeal prominence, or "Adam's apple"). The thyroid gland controls how quickly the body uses energy, makes proteins, and controls how sensitive the body is to other hormones.

FUNCTION:
-production of the hormones T3, T4 and calcitonin. - the thyroid hormones, triiodothyronine (T3) and thyroxine (T4), are tyrosine-based hormones produced by the thyroid gland that are primarily responsible for regulation of metabolism.

DISORDERS:
- hyperthyroidism (abnormally increased activity), - hypothyroidism (abnormally decreased activity) - thyroiditis, inflammation of the thyroid - thyroid nodules, which are generally benign thyroid - - neoplasms (tumours), but may be thyroid cancers.

Client Preparation
- patient should hold a glass of water and be seated - There should be room for the examiner on all sides of the seated patient - place the patient's head in slight hyperextension with good crosslight falling on the anterior neck and then ask the patient to swallow

Procedure:
-place the patient's head in slight hyperextension with good crosslight falling on the anterior neck and then ask the patient to swallow - Identify the thyroid cartilage, the thyrocricoid membrane, and the cricoid cartilage, a horizontal structure 5 mm wide that marks the superior border of the isthmus. - Palpate the isthmus (frequently impalpable unless enlarged), and if standing to the side of the patient, slide the tips of your fingers so that their palmar surfaces rest on the trachea with the dorsal surface medial to the sternocleidomastoid muscle. - Identify the landmarks and isthmus with one hand, and when in position to feel the thyroid lobe on that side, place the fingers of your other hand symmetrically on the other side of the trachea. - Feel the gland's surface, note any asymmetry, texture, and estimate the size of each lobe (normally 7 to 10 g). - When goiter is present, measure any discrete masses as well as the neck's greatest circumference. - palpate the neck for lymphadenopathy and search for masses (especially in the midline for abnormalities of the thyroglossal duct) and surgical scars. - Transillumination is helpful only in confirming the nature of a superficial thin-walled cyst.

Normal Findings:
1. The neck is straight. 2. No visible lumps or mass. 3. Symmetrica 4. No jugular venoous distention (suggestive of cardiac congestion). 5. The trachea is palpable. 6. It is positioned in the line and straight. - lymph nodes are palpated using palmar tips of the fingers via systemic circular movements.

Normal Findings:
1. May not be palpable. Maybe normally palpable in thin clients. 2. Non-tender if palpable. 3. Firm with smooth rounded surface. 4. Slightly movable. 5. About less than 1 cm in size. 6. The thyroid is initially observed by standing in front of the client and asking the client to swallow. Palpation of the thyroid can be done either by posterior or anterior approach. 7. Normally the thyroid is non palpable. 8. Isthmus maybe visible in a thin neck 9. No nodules are palpable.

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