Jugular Veins
The most accessible veins for examination are the internal and external jugular veins in the neck. Both veins drain bilaterally from the head and neck into the superior vena cava. The external jugular vein lies superficially and is just above the clavicle. The internal jugular vein lies deeper, along the carotid artery.
It is best to examine the right internal jugular vein because it follows a more direct anatomical path to the right atrium of the heart. The column of blood inside the internal jugular vein serves as a manometer, reflecting pressure in the right atrium. The higher the column, the greater the venous pressure. Raised venous pressure reflects right-sided heart failure.
Normally, when a patient lies in the supine position, the …show more content…
To measure venous pressure, inspect the jugular veins. Blood volume, the capacity of the right atrium to receive blood and send it to the right ventricle, and the ability of the right ventricle to contract and force blood into the pulmonary artery all influence venous pressure. Any factor resulting in greater blood volume within the venous system results in elevated venous pressure. Assess venous pressure by using the following steps:
1. Ask the patient to lie supine with the head elevated 30 to 45 degrees (semi-Fowler's position).
2. Expose the neck and upper thorax. Use a pillow to align the head. Avoid neck hyperextension or flexion to ensure that the vein is not stretched or kinked ( Figure 31 - 44).
3. Usually pulsations are not evident with the patient sitting up. As the patient slowly leans back into a supine position, the level of venous pulsations begins to rise above the level of the manubrium as much as 1 or 2 cm as the patient reaches a 45-degree angle. Measure venous pressure by measuring the vertical distance between the angle of Louis and the highest level of the visible point of the internal jugular vein
The most accessible veins for examination are the internal and external jugular veins in the neck. Both veins drain bilaterally from the head and neck into the superior vena cava. The external jugular vein lies superficially and is just above the clavicle. The internal jugular vein lies deeper, along the carotid artery.
It is best to examine the right internal jugular vein because it follows a more direct anatomical path to the right atrium of the heart. The column of blood inside the internal jugular vein serves as a manometer, reflecting pressure in the right atrium. The higher the column, the greater the venous pressure. Raised venous pressure reflects right-sided heart failure.
Normally, when a patient lies in the supine position, the …show more content…
To measure venous pressure, inspect the jugular veins. Blood volume, the capacity of the right atrium to receive blood and send it to the right ventricle, and the ability of the right ventricle to contract and force blood into the pulmonary artery all influence venous pressure. Any factor resulting in greater blood volume within the venous system results in elevated venous pressure. Assess venous pressure by using the following steps:
1. Ask the patient to lie supine with the head elevated 30 to 45 degrees (semi-Fowler's position).
2. Expose the neck and upper thorax. Use a pillow to align the head. Avoid neck hyperextension or flexion to ensure that the vein is not stretched or kinked ( Figure 31 - 44).
3. Usually pulsations are not evident with the patient sitting up. As the patient slowly leans back into a supine position, the level of venous pulsations begins to rise above the level of the manubrium as much as 1 or 2 cm as the patient reaches a 45-degree angle. Measure venous pressure by measuring the vertical distance between the angle of Louis and the highest level of the visible point of the internal jugular vein