Neck vein
Protocols
Neck Vein:
Engorged/Not engorged
- Examine the neck veins with the patient in a good light and head side of the bed at 45° angle, if the ulsation in the Internal Jugular vein is seen called engorged.
Character of venous pulse or why it is neck vein or difference
from carotid pulse:
- 1. Neck vein has got a definite upper limit
- 2. Upper limit changes with respiration and posture
- 3. Neck vein is not usually palpable
- 4. Movement is inward in contrast to arterial i.e. outward .
- 5. Pressure over root of the neck will abolish the venous pulse
- 6. Presence of hepatojugular reflux - pressure over the abdomen (liver) mcrease the upper limit of pulsation.
- 7.Venous pulse has got 2 waves in contrast to arterial.
Sign of Superior vena caval obstruction:
- 1. No-pulsatile engorged Neck vein.
- 2.Swelling of face neck & upper limb
- 3.cyanosis of face .
- 4. Visible coletral vein.
Causes of raised JVP:
• CCF (right heart failure).
• Pericardial effusion.
• Chronic constrictive pericarditis.
• Pulmonary embolism.
• Tricuspid regurgitation (TR) and tricuspid stenosis (TS).
• Pulmonary regurgitation (PR) and pulmonary stenosis (PS).
• Superior vena caval obstruction (non-pulsatile).
• Others: Occasionally may occur in pregnancy, exercise, anxiety and anaemia.
Causes of prominent ‘a’ wave in JVP (comes just before carotid pulse):
• Pulmonary hypertension (PH).
• Pulmonary embolism.
• Tricuspid regurgitation (TR) and tricuspid stenosis (TS).
• Pulmonary stenosis (PS).