PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir...

51
2009 1982

Transcript of PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir...

Page 1: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

2009

1982

Page 2: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

Chapter 4 The Jugular and Peripheral Veins

Page 3: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

Examining the Jugular Vein

Page 4: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

Physical Examination of the Heart and Circulation

Physical appearance

Arterial pulse Jugular venous pulse

Precordial percussion and palpation Auscultation

_______________________________ Chest and abdomen

_______________________________ Coexisting noncardiac diseases

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Examination of the Jugular Vein

Is Never in Vein

Page 6: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

Internal and external jugular veins are sources of anatomic, hemodynamic and

electrophysiologic information within the chambers of the heart--the right atrium and

right ventricle.

Page 7: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

Sir James Mackenzie Born 1853 Scone Scotland

Simultaneous records of the arterial and jugular venous pulse

Page 8: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

In 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the cardiovascular physical examination.

“We come now to the study of a subject which gives far more information of what is actually going on within the chambers of the heart. In the venous pulse we have often the direct means of observing the effects of the systole and diastole of the right auricle, and of the systole and diastole of the right ventricle.”

Page 9: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

Mackenzie’s Polygraph 1910

Page 10: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

James Mackenzie The Study of the Pulse,

Arterial, Venous and Hepatic and of the

Movements of the Heart Edinburgh, Young & Pentland

1902

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1) Waveform and pressure 2) Anatomic and physiologic inferences 3) Arrhythmias and conduction defects.

Information from the Jugular Venous Pulse

Page 12: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

External Jugular Vein

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The trunk should be elevated above the horizontal to an angle that coincides with the maximum excursions of the A and V waves of the internal jugular vein.

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Page 14: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the
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Page 15: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

Centimeters Above the Sternal Angle

Page 16: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

Internal Jugular Right/Atrial Connection

Page 17: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

Internal Jugular/Right Atrial Connection

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Sternocleidomastoid

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Page 19: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the
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Page 20: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the
Page 21: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

Normal JVP & Carotid Mackenzie

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Page 22: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the
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Page 23: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

Transmission to Distended Leg Veins

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Page 24: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

Cannon Waves

Junctional Beat

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Giant A Wave Mackenzie

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A Story From Paul Wood’s Clinic

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Page 27: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

Tricuspid Stenosis

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Page 28: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the
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Page 29: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the
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Page 30: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

Ventricular Tachycardia

Arial Flutter

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2/1 Heart Block 2/1 Heart Block

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Page 32: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

Complete Heart Block

Page 33: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the
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Page 34: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

Abdomino-Jugular Reflux

Page 35: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

Normal Response

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Page 36: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

Abnormal Response

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Page 37: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

Kaussmaul’s Sign Jugular Venous Pressure Rises With

Inspiration

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High Nonpulsatile A and V Crests Punctuated by Rapid X and Y Descents

Chronic Constrictive Pericarditis

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Page 39: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

The changes in the volume of the liver offer a most instructive

indication of the condition of the circulation.

James Mackenzie Chapter XXI

Pulsation of the Liver

Page 40: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

Examination of the Liver

Page 41: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the
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Page 42: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

A Landmark Paul Hamilton Wood

Director Institute of Cardiology

London

1956

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Ahmanson/UCLA Adult Congenital Heart Disease Center

Paul Wood Portrait by his daughter,

Juliet

Page 44: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the
Page 45: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

Ahmanson/UCLA Adult Congenital Heart Disease Center

London 1954-55

Page 46: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

To Paul Wood From Whom I Learned Congenital Heart Disease

Page 47: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

Wellcome Foundation Audiovisual Tape: The Jugular Venous Pulse.

Commentary

written and spoken by Paul Wood 1957.

Page 48: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

Paul Wood Audio Visual Tape

http://video.google.com/videoplay?docid=-7709122458041607370
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Ritual Examination of the Liver 1900 t0 1600 BCE

Page 51: PowerPoint Presentationheart.ucla.edu/workfiles/Adult_Congenital/JugularVenusPulse.pdfIn 1902, Sir James Mackenzie established the jugular venous pulse as an important part of the

Normal JVP & Carotid

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