List the steps for palpating the thyroid gland using the posterior approach.

A.       briefly discuss some of the percussion notes in the thorax, include its description and cause/s.

crackles

coarse crackles"

Five Process of Palpation of Thyroid Gland by Posterior Technique

 Position the Patient:

 Ask the patient to sit comfortably with their neck slightly aligned at a several factors basic position. Thus, the position of the patient should be as calm and comfortable as possible: the shoulders should be down and, ideally, aligned with the rest of the body, turned forward.

 Stand Behind the Patient:

 Stand beside the patient, and in this way, ensure that you are comfortable to use both of your hands.

 Locate the Thyroid Gland:

 Put your four fingers across the patient’s neck and your thumb on the other side of the trachea. It is situated in front of the cervical vertebrae from the C5 to C7 and lies just below the larynx (voice box) and above the .

 Palpate the Lobes:

 With the tips of the fingers of both the right and the left hand feel with the thyroid lobes using a circular motion. The thumb of one hand ought to be resting at the patient’s trachea, while the fingers of the other hand feel for the lobes of the thyroid gland. Palpate for any increase in size or nodularity.

 Ask the Patient to Swallow:Ask the Patient to Swallow:

 On swallowing, the thyroid gland should shift dorsalwards beneath your fingers. This kind of movement is useful to evaluate the dimensions and homogeneity of the gland.

 Voices of Thunder in the Chest

 1. Dullness:

 Description: A particular sound that is relatively brief and carries low frequency.

 Causes: Can suggest the presence of free fluid within the pleural cavity (e. g. , pleural effusion), lung consolidation (e. g. , pneumonia), or a mass within the lung.

 2. Hyperresonance:

 Description: A tone that is extremely bass and can be sustained for quite some time.

 Causes: Traditionally linked with diseases, which lead to excessive intra-thoracic pressure, for instance pneumothorax or emphysema.

 3. Resonance:

 Description: Medium pitched with clear ringing that will give an empty sound like that of striking a metal pipe.

 Causes: Usually audible over the parenchyma and heard in patients with healthy lungs.

 4. Tympany:

 Description: It is a shrill, rhythmic tone that is often like drubbing.

 Causes: Seen in the thorax only very occasionally but may develop if there is relatively more air in the lung, as in a giant pneumothorax.

 Crackles and Coarse Crackles

 Crackles:

 Description: Temporary, hissed or crackling noises, which are most frequently produced during the inspiratory phase of respiration.

 Cause: Outcome from initial inflation of small airways and alveoli which were previously closed or filled with secretion. Frequently present in cases of pneumonia, congestive heart failure, or bronchitis.

 Coarse Crackles:

 Description: Loud crackles that are lower pitched and may be appreciated during both the inspiratory and expiratory phase.

 Cause: Linked with broad airways which have secretions or even fluid to the interior parts. It can frequently represent chronic bronchitis or severe pulmonary edema as the side of the lesion.