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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).