Jugular venous pulsations (patient 4)
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

The recording is from an adult woman. Two clips are shown one following the other. The head of the patient is towards observer's left side. The pulsations are hard to see unless one pays attention to the shadow cast by the chin of the patient over the sternomastoid muscle and the overlying skin. The edge of the shadow shows the rapid movement. With each cardiac cycle, if one imitates the S1 and S2 with syllables of Lubb……. Dup, the movement is clearly seen to coincide with the Dup. In a group teaching, if one student is made to call out the downward movement of the edge of the shadow of the chin as "Down" every time it is seen and the teacher keeps timing of the heart sounds by repeating Lubb……. Dup, it will be quickly obvious that the student's timing of "Down" will coincide with the teacher saying Dup. This will confirm it to be a single systolic descent (x' descent) and therefore the jugular contour will be considered normal.

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