Stand behind the patient and place the middle three fingers of either hand along the mid-line of the neck, just below the chin. Gently walk them down until you reach the top of the thyroid cartilage, the first firm structure with which you come into contact. Use gentle pressure, otherwise this can be uncomfortable. Make sure that you tell your patients what you're doing so they know you're not trying to choke them! The cartilage has a small notch in its top and is approximately 1.5-2 cm in length. As you cannot actually see the area that you're examining, it may be helpful to practice in front of a mirror. You can also try to identify and feel the structures from the front while looking at the area in question before performing the exam from behind.