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How to measure jugular venous pressure?

Jugular Venous Pulse defined as the oscillating top of vertical column of blood in right IJV that reflects pressure changes in Right Atrium in cardiac cycle.
Jugular Venous Pressure is the vertical height of oscillating column of blood
  • The patient should lie comfortably during the examination.
  • Clothing should be removed from the neck and upper thorax.
  • Patient reclining with head elevated 45 °
  • Neck should not be sharply flexed.
  • Examined effectively by shining a light tangentially across the neck.
  • There should not be any tight bands around abdomen
Observe the following
The level of venous pressure.
The type of venous wave pattern.
The level of venous pressure is measured using a centimeter ruler, measure the vertical distance between the angle of Louis (manubrio sternal joint) and the highest level of jugular vein pulsation.The upper limit of normal is 4 cm above the sternal angle.Add 5 cm to measure central venous pressure since right atrium is 5 cm below the sternal angle.
Normal CVP is < 9 cm H2O