JVP

Question 1

How do you begin the JVP Exam?

Answer 1

1)Demonstrate periperal palpable blood pressure and ausculatory blood pressure

2)Postition patient for JVP exam

supine with back of table lifted to 45 degrees

(the higher the angle the less the JVP, the lower the angle the higher the JVP)

expose the neck and pericardium until the sternal angle

3)inspection and identification of surface anatomy

Question 2

What differentiates the carotid pulse from the JVP (5 features of the JVP)?

Answer 2

the JVP is

1) Palpable
2) occludable
3) biphasic
4) varries with position
4) Increases with respiration ( increase with Valsalva, decrease with inspiration)
5) increases with hepatojugular reflex

Question 3

How do you measure the JVP?

Answer 3

vertically from sternal angle to the top of the internal jugular wave form

Normal JVP should be less than 3cm

Question 4

How do you do the hepatojugular reflex (abdominal jugular reflex)?

Answer 4

Patient breathes with mouth open

Ensure no abdominal tenderness

Apply moderate pressure over RUQ until you see the JVP fall for 15 seconds

Should return to normal after 2 respiratory cycles

Sustained elevation >4cm for over 10 seconds is pathological

Question 5

What does each part of the JVP waveform mean?

Answer 5

Question 6

What is the JVP waveform?

Answer 6

Question 7

What is Kussmaul’s sign?

Answer 7

Rise in JVP with inspiration (this is not normal)

Suggests impaired filling of the RV