The thyroid gland is found inferior to the larynx and just superior to the clavicles on either side of the trachea. It consists of two lobes connected by an isthmus. Palpate the gland using a bimanual technique where one hand supports the tissue and the other hand palpates the gland on one side and then the reverse is done to examine the opposite side of the gland (Figure 21).
Figure 21. Bimanual palpation of the thyroid gland.
The normal thyroid gland should not be visible and is most often not palpable. In addition, the area surrounding the gland should elevate smoothly and symmetrically during swallowing (Figure 22).
Figure 22. Hold the fingers lightly over the gland while the patient swallows.
Any variation from these normal findings should be discussed with the patient and the patient should be referred to their physician for further evaluation (see provided forms for referral – Appendix A, B & C). An increase in thyroid carcinoma with an undetermined etiology has been reported in recent years. The National Cancer Institute estimates 53,990 new diagnoses of thyroid cancer and 2,060 deaths from thyroid cancer will occur in the United States in 2018.39