Inspect the neck at rest and during a swallow, watching a thyroid or a mass move with swallowing, and note asymmetry or a surgical incision.
Assess range of motion actively, noting limitation, pain, or stiffness.
Palpate the thyroid where within scope — from behind or in front — for size, nodules, and tenderness, and have the patient swallow to feel the gland move.
Assess tracheal position by palpating in the suprasternal notch, and listen for stridor.
Palpate any mass for location, size, mobility, consistency, and tenderness, distinguishing a soft mobile from a hard fixed mass.
After thyroidectomy, inspect the incision and check for the signs of hypocalcemia (Chvostek and Trousseau where indicated) and for a hematoma or airway compromise.
Screen for systemic thyroid symptoms and refer their management to Endocrine/Metabolic.
For any airway compromise, stridor, or tracheal deviation, escalate rather than continuing the exam.
