A beginner’s guide to measuring the JVP — perfect for the medical student on their first placement. Far from comprehensive, but an excellent starting point if you’re not quite sure what approach to take. Part of our series on basic clinical examination.
The jugular venous pressure (JVP, sometimes referred to as jugular venous pulse) is the indirectly observed pressure over the venous system via visualization of the internal jugular vein. It can be useful in the differentiation of different forms of heart and lung disease.
1. Patient reclining with head elevated 45°
– Measure elevation of neck veins above the sternal angle.
– Add 5 cm to measurement since right atrium is 5 cm below the sternal angle.
Normal CVP ≤ 8 cm H2O
2. Light should be tangential to illuminate highlights and shadows.
3. Neck should not be sharply flexed.
4. Using a centimeter ruler, measure the vertical distance between the angle of Louis (manubrio sternal joint) and the highest level of jugular vein pulsation. A straight edge intersecting the ruler at a right angle may be helpful.
5. If the internal jugular vein is not detectable, use the external jugular vein. The internal jugular vein is the preferred site.
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