ABSTRACT
Establishes how long the swelling has been present and whether it has changed over time Enquires about any local effects of the swelling, in particular pain, difficulty swallowing and difficulty breathing Asks if patient is currently in any pain
Examination
Ensures patient is sitting upright in a chair with the neck exposed Inspects neck from the front and side – commenting on the presence/absence of surgical scars, asymmetry, and any obvious swellings Inspects for movement of swelling whilst patient takes a sip of water, and protrudes tongue Palpates swelling Palpates for movement of swelling whilst patient takes a sip of water, and protrudes tongue Palpates for cervical lymphadenopathy Assesses for tracheal deviation Auscultates over swelling for thyroid bruit
Cleans hands by washing or using alcohol gel
Fluency of examination Competence in presenting findings, summarizing and forming differential diagnoses
KEY Read the instructions to this station carefully. If you have been asked to examine the neck, the mark-sheet opposite is adequate; however, if you have been asked to examine the thyroid gland, there are some additional things you will need to do and these are described in the following station.