Examination sequence

□ Position the patient reclining supine at 45 degrees in good light.

Carotid

Jugular

Rapid outward movement One peak per heartbeat

Palpable

Pulsation unaffected by pressure at the root of the neck Independent of respiration

Independent of position Independent of abdominal pressure

Rapid Inward movement Two peaks per heartbeat (In sinus rhythm) Impalpable

Pulsation diminished by pressure at the root of the neck Height ol pufsation varies with respiration

Varies with position of patient Rises with abdominal pressure

Ventricular

Jugular pulse

Ventricular

Jugular pulse

Systole

Diastole

a

c

V

c

V

X

y

X

y

Fig. 3.20 Form of the venous pulse wave tracing from internal jugular vein, a = atrial systole; c = transmitted pulsation of carotid artery at onset of ventricular systole; v = peak pressure in right atrium immediately prior lo opening of tricuspid valve; a - x = descent, due to atrial relaxation; v - y = descent at commencement ol ventricular filling.

Internal Jugular Vein Pulsations

Fig. 3.21 Inspecting the jugular venous pressure from the side.

[The internal jugular vein lies deep to the sternomastoid muscle.)

Fig. 3.21 Inspecting the jugular venous pressure from the side.

[The internal jugular vein lies deep to the sternomastoid muscle.)

□ Ensure that the neck muscles are relaxed by resting the back of the head on a pillow.

□ Inspect by looking across the neck from the side of the patient (Fig. 3.21).

□ Identify the internal jugular pulsation, if necessary, by means of abdominojugular reflux.

□ Measure the vertical height in centimetres between the top of the venous pulsation and the sternal angle to give the venous pressure (Fig. 3.22).

□ If necessary, readjust the position of the patient until the waveform is clearly visible.

□ Now identify the pattern of the pulsation and note any abnormality.

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Responses

  • pamphila boffin
    Where is INTERNAL jugular vein?
    8 years ago
  • michelle
    How deep is the jugular vein?
    8 years ago

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