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Jugular Venous DistentionAka: Jugular Venous Pulse, Jugular Venous Pulsation, Jugular Venous Pressure, Kussmaul's Sign, JVD, JVP, Hepatojugular Reflux, Abdominojugular Test, HJR
- Technique: Jugular Venous Pressure measurement
- Examine position
- Head of bed elevated at 45 degree angle
- Head turned to right
- Identify top of venous pulsation in neck (JVP)
- Jugular venous pulsations are inward
- Contrast with outward carotid artery pulsations
- Identify the sternal angle (Angle of Louis)
- Located at superior edge or notch of sternum
- Measure distance between top of pulsation and sternum
- Measured in centimeters
- Examine position
- Interpretation: Distance between JVP and Sternum
- Normal: 4 cm or less
- Increased >4 cm (Jugular Venous Distention)
- Right-sided Heart Failure (most common)
- Increased right atrial pressure
- Constrictive Pericarditis
- Tricuspid stenosis
- Superior Vena Cava Obstruction
- Valsalva phenomenon (laughing, coughing)
- Right-sided Heart Failure (most common)
- Provocative: Hepatojugular Reflux
- Apply firm pressure to midabdomen for 30 seconds
- Apply 20-30 mmHg of pressure
- Positive test: >4 cm JVP rise for >10 seconds
- Suggests CHF (right or left sided failure)
- Falsely positive if Valsalva (abdominal guarding)
- Apply firm pressure to midabdomen for 30 seconds
- Kussmaul's Sign
- Paradoxical rise in JVP with inspiration
- JVP normally falls with inspiration
- Causes
- Constrictive Pericarditis
- Cardiac Tamponade
- Paradoxical rise in JVP with inspiration
- Efficacy in CHF diagnosis
- Jugular Venous Distention (JVD) alone
- Test Sensitivity: 17%
- Test Specificity: 98%
- JVD with Hepatojugular reflex (provocative)
- Test Sensitivity: 33%
- Test Specificity: 94%
- Jugular Venous Distention (JVD) alone
- References
- Bates (1991) Physical Exam, p. 287-8
- Timmis (1988) Cardiology, p. 12
- Degowin (1987) Bedside Exam, p. 409-15
- Dosh (2004) Am Fam Physician 70:2145
Hepatojugular reflux (C0239949) | |
|---|---|
| Concepts | Finding (T033) |
| English | Hepatojugular reflux, HJR |
| Spanish | reflujo hepatoyugular |
| Parent Concepts | Blood vessel finding (C0425654) |
| Sources | DXP, SCTSPA, SNOMEDCT Derived from the NIH UMLS (Unified Medical Language System) |
Paradoxical inspiratory filling of neck veins (C0240101) | |
|---|---|
| Concepts | Sign or Symptom (T184) |
| English | JUGULAR VENOUS DISTENTION WITH INSPIRATION, KUSSMAUL SIGN, Kussmaul's sign, Paradoxical inspiratory filling of neck veins |
| Spanish | signo de Kussmaul |
| Parent Concepts | Finding of head and neck region (C0575141), Finding of appearance of vein (C0577862) |
| Sources | DXP, SCTSPA, SNOMEDCT Derived from the NIH UMLS (Unified Medical Language System) |
Jugular venous engorgement (C0425687) | |
|---|---|
| Concepts | Finding (T033) |
| English | Jugular venous distension, JUGULAR VENOUS DISTENTION, Jugular venous engorgement, JVD, Venous congestion of neck |
| Spanish | ingurgitacion venosa yugular |
| Parent Concepts | Finding of neck region (C0575155), Engorgement of vein (C1959622) |
| Sources | DXP, SCTSPA, SNOMEDCT Derived from the NIH UMLS (Unified Medical Language System) |
Jugular venous pressure (C0428897) | |
|---|---|
| Concepts | Finding (T033) |
| English | Jugular venous pressure, JVP - Jugular venous pressure |
| Spanish | presion venosa yugular |
| Parent Concepts | Central venous pressure (C0428640) |
| Sources | SCTSPA, SNOMEDCT Derived from the NIH UMLS (Unified Medical Language System) |
Jugular venous pulse characteristics - finding (C1287739) | |
|---|---|
| Concepts | Finding (T033) |
| English | Jugular venous pulse characteristics - finding |
| Spanish | caracteristicas del pulso venoso yugular - hallazgo |
| Parent Concepts | Finding of jugular venous pulse (C0577863) |
| Sources | SCTSPA, SNOMEDCT Derived from the NIH UMLS (Unified Medical Language System) |
