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Review
of Clinical Signs

Inspection of Neck Veins

Series Editor and Author: Bernard Karnath, MD

1. If the vertical distance between the sternal angle and the highest point of pulsation of the jugular vein is 5 cm—with respect to a patient whose trunk is elevated 30 degrees—what, approximately, is the patient’s central venous pressure in cm H2O and mm Hg?
  1. 5 cm H2O; 5 mm Hg
  2. 10 cm H2O; 7 mm Hg
  3. 15 cm H2O; 9 mm Hg
  4. 20 cm H2O; 11 mm Hg
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2. Which of the following statements best describes the timing of the a wave and v wave of the jugular venous pulse?

  1. The a wave closely follows the carotid pulse, whereas the v wave precedes the carotid pulse
  2. The a wave follows the carotid pulse, whereas the v wave occurs simultaneously with the carotid pulse
  3. The a wave occurs simultaneously with the carotid pulse, whereas the v wave closely follows the carotid pulse
  4. The a wave precedes the carotid pulse, whereas the v wave closely follows the carotid pulse
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3. A patient whose jugular venous pulse is characterized by a large v wave most likely has which of the following conditions?
  1. Pulmonic regurgitation
  2. Pulmonic stenosis
  3. Tricuspid regurgitation
  4. Tricuspid stenosis
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4. A positive result on elicitation of the abdominojugular reflux sign is best described by which of the following statements?

  1. An increase in jugular venous pressure greater than 3 cm H2O that is sustained for longer than 15 seconds
  2. The presence of large a waves
  3. The presence of large v waves
  4. A rapid nonsustained increase in jugular venous pressure greater than 3 cm H2O
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