This evaluation is crucial for assessing the health and function of various endocrine glands. Here are the key aspects to consider: 1. **Approaching the Physical Examination**: - **First Impressions**: As a medical professional, your demeanor during the examination matters. Establish rapport with the patient and maintain professionalism. - **Set-Up**: Ensure patient comfort and avoid unnecessary position changes. - **General Examination**: - **Color**: Observe skin color for any abnormalities. - **Temperature**: Assess body temperature. - **Hydration**: Check for signs of dehydration. - **Oedema**: Look for swelling. - **Nutritional Status**: Evaluate overall nutrition. - **Lymph Nodes**: Palpate regional lymph nodes. - **Hands and Upper Limbs**: Examine for recognizable syndromes and vitamin deficiencies. - **The Elderly Patient**: Consider age-related changes. - **Symptoms in Endocrinology**: Gather relevant history. 2. **General Endocrine Examination**: - **Thyroid Examination**: - **Inspection**: Look for visible anterior neck masses (mobile on swallowing). - **Palpation**: Sequentially palpate each thyroid lobe and isthmus. Assess consistency and check for discrete nodules. - **Percussion**: May be needed for suspected retrosternal goiters. - **Auscultation**: Listen for bruits over superior thyroid poles (hyperdynamic circulation). - **Hashimoto's Disease Queen-Anne's Sign**: Observe for lateral eyebrow hair loss. - **Bradycardia**: Hypothyroidism can cause bradycardia and AV block. 3. The Eye in Endocrine Disease Projecting confidence and maintaining respectful communication are essential during the physical examination. Always have a chaperone present for intimate examinations.

1. General,Physical
Examination of
Endocrine System
By Sangeet Kumar Dhuriya

2. Glands of the Endocrine System
● Hypothalamus
● Posterior Pituitary
● Anterior Pituitary
● Thyroid
● Parathyroids
● Adrenals
● Pancreatic islets
● Ovaries and testes

3. Thyroid gland examination
Inspect the neck from the front.
Look for a swelling while the patient swallows a sip of water. The thyroid (or a
thyroglossal cyst) moves upwards on swallowing since it is enveloped in the pre-
tracheal fascia which is attached to the cricoid cartilage.
Ask the patient to sit with the neck muscles relaxed and stand behind him.
Place your hands gently on the front of the patient’s neck, with your index
fingers just touching ( Fig. 5.2B ). Ask the patient to swallow a sip of water while
you feel over the gland as it moves upwards.

4. Parathyroid gland examination
 Shake hands and note excessive warmth and sweating.
 Look for fine tremor of outstretched hands and acropachy of
the fingers
(hyperthyroidism).
 Examine the radial pulse. An irregularly irregular pulse is likely
to
indicate atrial fibrillation.
 Examine the thyroid and describe its size, surface and
consistency.
 Listen for a thyroid bruit
 Look for evidence of thyroid eye disease.
 Inspect the shins for pretibial myxoedema.

5. Pancreatic gland examination
 Fever, hypotension, tachycardia, tachypnea, or diaphoresis.
 Abdominal examination typically reveals notable tenderness to
palpation, guarding.
 Possible signs of peritoneal irritation, distension, or rigidity.
 Bowel sounds are typically decreased.

6. Adrenal gland examination
 Blood and urine tests help measure the amount of
adrenal hormones, which can detect a functional
tumor.
 A computed tomography (CT or CAT) scan or a
magnetic resonance imaging (MRI) scan may be
useful in diagnosing an adrenal gland tumor and
determining whether it is cancerous.

7. Thank you