JVP

Question 1

What is the jugular venous pressure and where is it seen?

Answer 1

Double wave form in internal jugular vein, located on the right hand side between the two heads of sterncleidomastoid and detectable 2cm above the sternal angle when sat at 45 degrees and looking to the left in a healthy patient

Question 2

How can you differentiate the JVP from the carotid pulse?

Answer 2

Differentiate from carotid as is non palpable, obliterated by pressure, a double wave form, decreases with inspiration and enhanced by hepatojugular reflux

Question 3

What are some causes of raised JVP?

Answer 3

Heart failure
i) If elevated then patient associated with increased risk of hospital admission for HF
Fluid overload i.e. in renal disease
Constrictive pericarditis
i) JVP increases on inspiration = Kussmaul’s sign
Cardiac tamponade
SVC obstruction – but doesn’t pulse

Question 4

How do you accentuate a low JVP?

Answer 4

Lower the bed to 180 degrees and press on the liver - hepatojugular reflux