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Examination of the cardiovascular system

Examination of the jugular venous pulse (JVP) There is no valve between the right heart and the large vessels supplying it, therefore the filling and contracting of the right atrium causes a pressure wave to travel back through the veins feeding it. This can be seen in the neck at the internal jugular vein. • The patient should be in a supine position of 30-45° • This is commonly used to assess the presence of right

heart failure • The vertical height of the internal jugular vein above the

manubriosternal angle is measured – it starts between the two heads of the sternocleidomastoid and heads towards the angle of the jaw and the earlobe

• It should not be raised more than 3-4 centimetres.