What can the JVP be used to do?
Assess the condition of the CVS
Give two examples of where JVP can be used to assess the condition of the CVS
- Cardiac failure
- Cardiac tamponade
What are the two types of JVP?
- EJV (External jugular vein)
- IJV (Internal jugular vein)
What is the advantage of using the EJV to assess JVP?
It is much easier to see
Why is the EJV much easier to see?
Because it courses superficially under the sternocleidomastoid
What is the advantage of using IJV to assess JVP?
It is a better indication of pressure in the right atrium
Why is the IJV a better indication of pressure in the right atrium?
Because on the right hand side, it is in direct communication with the right atrium. There are no valves, so the pressure is the same
What is the disadvantage of using the IJV to assess JVP?
It is largely hidden by the sternocleidomastoid, so the pulsations have to be observed through the muscle
What position must the patient be in to use the IJV to assess the JVP?
Patient at 45 degree angle, with head faced to left
What is JVP measured as?
The height that pulsations can be seen above the sternal angle + 5cm
Can you see the JVP in a healthy person?
May or may not be able too
How can the pulse of the carotid and the pulse of the IJV be distinguished?
If, when pressed, it is palpable, it is the carotid pulse
Where cant the carotid pulse be felt?
In the carotid triangle, but may also be palpated more inferiorly
What are the boundaries of the carotid triangle?
- Superior - posterior belly of digastric
- Lateral - Sternocleidomastoid
- Medial - Superior belly of omohyoid
What are the contents of the carotid triangle?
- Internal jugular vein
- Bifurcation of the common carotid - external and internal carotid arteries
What is the clinical relevance of the carotid triangle?
- Surgical approach
- Location of carotid sinus massage
What can be surgically accessed through the carotid triangle?
- Carotid arteries
- Internal jugular vein
- Vagus and hypoglossal nerves
What is the function of a carotid sinus massage?
Can revert supraventricular tachycardia
Why can a carotid sinus massage revert supraventricular tachycardia?
Due to baroreceptor stimulation
What happens if a person has a very sensitive carotid sinus?
They faint if any pressure is put on the carotid sinus
Where can the facial artery pulse be felt?
At the inferior border of the mandible, anterior to the masseter muscle