Observe the neck for goiter, masses and asymmetries.

Posterior approach: Place your fingers anteriorly (thumbs on the posterior area of the neck).
Anterior Approach ('Lahey'): Palpate the thyroid tissue with the thumb and index fingers.

Normal Gland usually not visible, not palpable. Lies at the level of the 2nd and 3rd tracheal rings.

Thyroid tissue moves up and down considerably with swallowing (sips of water).

Evaluate: Site, position, shape, size, volume, surface, movements, symmetry, consistency, tenderness, temperature, adherence/fluctuation, texture, contours.

Weight (evaluated by size, normally < 25g -10g ea lobe and 5g isthmus).

Goiter

Nodules

Systolic bruit generally indicates diffuse toxic goiter (bell of the stethoscope).

Pemberton's sign: Signs of compression (suffusion of the face, dizziness or syncope) may result when the Patient's arms are raised above the head. In large retrosternal goiter.

Pyramidal lobe (lalouette): it is an extra lobe, has its base in the isthmus and follows the thyroglossal duct.

Delphian node (over the pyramidal lobe in neoplasms).

Thyroglossal duct and Cyst.