JVP Examination Explained - Clinical Skills Deep Dive - Medical School Revision - Dr Gill

Abdominal Examination Explained - Clinical Skills Deep Dive - Medical School Revision - Dr Gill

The Jugular Venous Pressure

It doesn't matter how many times I had the JVP explained to me in medical school lectures, or in medical school revision sessions after class, it always was a major challenge for me to understand.

However, if looked at carefully, and slowly, the JVP waveform, isn't actually impossible to understand, but does quite reasonably have a reputation as one of the more difficult clinical skill revision challenges

In this video, we will try to carefully go over graphs of the venous pulsation to allow easy comprehension of the JVP waveform explained

#drgill # jvp #clinicalskills

0:00 start
00:20 – Contents
00:50 – What is the JVP
01:03 – Internal Jugular Vein Anatomy
01:40 – Going for the Jugular
01:58 – Challenges with the JVP
02:56 – How to examine the JVP
03:18 – Where to look
03:38 – How to measure the JVP
03:46 – Patient Example
04:06 – How to get the best view
04:38 – The Three Golden Giveways
04:45 – Check the pulse
05:15 – Palpate the visible pulsation
05:33 – Hepatojugular Reflux (Yes, REFLUX)
05:53 – Hepatojugular Reflux Patient Example
06:30 – The reflux manoeuvre explained
07:12 – What you should see in healthy patients
07:28 – How to tell if it's abnormal
07:53 – The manubriosternal angle (angle of Louis)
08:18 – Using the ruler
08:54 – The ruler explained in the diagram
09:03 – Normal and Absent JVP
09:31 – Why you should check the JVP is below the clavicle (Severe Tricuspid Regurgitation)
09:59 – Causes of a raised JVP
10:07 – Cardiac Causes
11:12 – Pulmonary Causes
11:33 – Fluid Overload
11:54 – Mnemonic for raised JVP causes
13:11 – The JVP wave form
13:40 – 5 (ish) Sections of the JVP Wave form
14:34 - A
15:20 - X
15:47 – C
16:27 – X Again
17:25 - V
17:50 – Y
18:37 – Re-cap of the JVP wave
19:09 – Additional Pathologies seen in the Wave Form
19:52 – Summary
20:06 – Remember your history!
20:24 – Remember to like and Subscribe!

[MedbeeMedic]

Deep Dive Time Stamps

00:20 – Contents
00:50 – What is the JVP
01:03 – Internal Jugular Vein Anatomy
01:40 – Going for the Jugular
01:58 – Challenges with the JVP
02:56 – How to examine the JVP
03:18 – Where to look
03:38 – How to measure the JVP
03:46 – Patient Example
04:06 – How to get the best view
04:38 – The Three Golden Giveways
04:45 – Check the pulse
05:15 – Palpate the visible pulsation
05:33 – Hepatojugular Reflux (Yes, REFLUX)
05:53 – Hepatojugular Reflux Patient Example
06:30 – The reflux manoeuvre explained
07:12 – What you should see in healthy patients
07:28 – How to tell if its abnormal
07:53 – The manubriosternal angle (angle of Louis)
08:18 – Using the ruler
08:54 – The ruler explained in diagram
09:03 – Normal and Absent JVP
09:31 – Why you should check the JVP is below the clavicle (Severe Tricuspid Regurgitation)
09:59 – Causes of a raised JVP
10:07 – Cardiac Causes
11:12 – Pulmonary Causes
11:33 – Fluid Overload
11:54 – Mnemonic for raised JVP causes
13:11 – The JVP wave form
13:40 – 5 (ish) Sections of the JVP Wave form
14:34 - A
15:20 - X
15:47 – C
16:27 – X Again
17:25 - V
17:50 – Y
18:37 – Re-cap of the JVP wave
19:09 – Additional Pathologies seen in the Wave Form
19:52 – Summary
20:06 – Remember your history!
20:24 – Remember to like and Subscribe!

[atlasbutnotthetitan]

I'm not studying to be in medicine at all but I find it very interesting, so these videos are great!

[kuikyroje]

Hi Dr Gill, Law student here who is fascinated by your videos!

Perhaps you could do a series of story-time esque videos which talk about some of the most complex, strange, whacky, or otherwise interesting cases you have encountered or have heard of? Could talk about the case itself, problems you / the doctor had, how you/they addressed it etc etc. Would prove fascinating to a lay mind such as mine, and could offer some educational value to aspiring doctors out there.

Love your stuff mate

[Clickerbarmicker]

Dramatic turns are my new fave, absolutely killing the editing game

[harryjames]

Genuinely wish my lecturers were half as good as Dr. Gill. Cannot explain how much you’ve helped

[ASMRIrish]

I can happily watch good teachers all the time. Dr Gill is a great teacher. He's getting an electronic engineering student to watch medicine videos 😊

[jamiel]

Best explanation/instruction I've found to describe this. Thank you very much for creating and sharing!

[benisaten]

James, you are first class. Great video as always. You're ability to communicate and explain things is incredible. You have the knowledge and wisdom of a man many times your age. Keep it up brother!

[estelwenethiriel]

thank you soooo much for this!! waveforms have always confused me but this makes sense 😁

[rogermoore]

WOW!! AMAZING!!! This is by far the Best Explanation on JVP. Excellent! thank you so much!

[unleadedpetrol]

Loving the content Dr Gill! Keep up the good work (and thank you for your services to the medical profession!)

[dailydoseofmedicinee]

Causes of raised jugular venous pressure
👍


Constrictive pericarditis (JVP increases on inspiration - called Kussmaul's sign). Cardiac tamponade. Fluid overload - eg, renal disease. Superior vena cava obstruction (no pulsation).

[CarlosGutierrez-zjip]

I'm not lying when I tell you sir that, I was studying jaundice and, in the congestive hepatopathy related jaundice, I saw once again the HJR thing and it took me about an hour to find something to understand the whole deal including anatomy and PE, and I found this video. I wish I found this earlier during my med preparation or at least, earlier in the night LOL. Incredible teaching skills, I will definitively keep looking at your work from now on. Thank you so much for what you do. Greetings from an IMG from Mexico preparing for step 1!!!

[musicbeachdance]

Dr. Gill, these videos are amazing concise, comprehensive time-savers. They have already influenced my entire clinical experience so far! Thank you for taking the time to make these 😊! I've learned so much

[RUNCUZIKILLU]

Thank you so much, failed the JVP exam on my clinical after having the most confusing JVP explanation ever by a preceptor, but now I actually understand. Will be subbing and watching more!

[infiniteascensionn]

Another phenomenal video Dr Gill, you have a way with words that truly helps one understand. Hope you have an amazing day!

[tgzmrhat]

Thank you for this I was reading the textbook and was confused your teaching was simple to understand and now I know it.

[Inverter]

I’d love a video on Vasovagal syncope. Lots of people feels woozy from needles and blood draws and don’t know why.

[kittymervine]

my brother and I as children were sure this is where you applied pressure to do that Spock Star Trek thing. We spent hours trying it out on each other, with the result we had a lot of bruises and a very angry mother. No one thankfully did pass out as it was supposed to work VERY quickly. I'm glad to know what the name of "that place" is and not so sure we were as safe as we thought we were!

[AleenaHamid-tv]

Thank you so much, wonderful explanation 🎉