How to examine the neck and thyroid
Other platforms explain it with text and video. In VMS you practice it on the patient.
The thyroid moves up when the patient swallows: that is the key to finding it.
What you need
- Glass of water
Step by step
Prepare
Clean your hands, introduce yourself, get consent and expose the neck. [1]
Look
From the front with the head slightly back. Ask the patient to sip water and swallow: watch for a swelling that moves up. [1]
Lymph nodes
In order: in front of and behind the ear, back of the head, under the chin, under the jaw, angle of the jaw, front and back of the neck, above the collarbone. [1]
Find the thyroid
Stand behind the patient. Find the cricoid cartilage; the isthmus is just below it, the lobes on each side. [1]
Palpate while swallowing
Feel size, texture, nodules and tenderness as the patient swallows. [1]
Trachea and bruit
Check the trachea is in the middle. Listen over an enlarged gland for a bruit. [2]
Signs of thyroid function
Pulse, tremor, skin, reflexes and the eyes (staring, bulging). [2]
Common errors
- Pressing too hard (the gland slips away).
- Forgetting the swallow.
- Not checking the nodes above the collarbone.
Practice it in VMS
In VMS you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
VMS cases that train this skill
Sources
- Open RN, Nursing Skills 2e (Chippewa Valley Technical College) (CC BY 4.0)
- NCCPA PANCE Content Blueprint
Steps adapted from Open RN, Nursing Skills 2e (Chippewa Valley Technical College), licensed under CC BY 4.0. Facts and steps also follow NCCPA PANCE Content Blueprint. VMS is not affiliated with these organizations. Updated: 2026-10-11.