Jugular venous pulsations (patient 2)
by Franklin B Saksena, Ranganathan Narasimhan, Sivaciyan Vahe

The Art and Science of Cardiac Physical Examination (With Heart Sounds, Jugular and Precordial Pulsations)

by Narasimhan Ranganathan, Vahe Sivaciyan, Franklin B Saksena
About Video

This video is from a young boy. The head is towards your left side of the screen. Simultaneous recordings of the heart sounds provide for timing of the jugular movements. Note the jugular movements are best visible more anteriorly over the neck. The varying light intensity over this region with each cardiac cycle shows the jugular column movements. Imitate the S1 and S2 cycles by saying Lubb ……..Dup Lubb……..Dup. One can easily see one rapid downward movement with each cardiac cycle. The rapid downward movement or the descent will be seen to coincide with the timing of the sharper second heart sound with each cycle. Since there is some transmission delay of the jugular events to the neck, the descent coinciding with the S2 is systolic. Therefore the single descent seen here is the x' descent. Respiratory sounds are audible only during inspiration. Occasionally a discerning eye can recognize a smaller fall to follow the dominant systolic descent during inspiration. This represents the smaller non-dominant normal y descent sometimes seen in the young patients.

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