Physical examination maneuver
Physical Exam
Neck Vein Inspection
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Video coming September 2026
How to Perform
With the patient reclining initially at about 30° to 45°, the head turned slightly away, and the neck muscles relaxed, use tangential lighting to inspect the right internal jugular venous pulsations. Adjust the degree of recline as needed to bring the top of the venous column into view. Identify the venous pulsation by its soft, undulating, multiphasic character that is not palpable and that varies with respiration and position. Note the height of the venous column and its waveform.
How to Interpret
Showing 3 of 5 findings
Heart Failure
Elevated jugular venous pressure (>3 cm above the sternal angle)
Rule in
Helpful
Rule out
Minimally helpful
Evidence:Strong
Abdominojugular reflux positive
Rule in
Somewhat helpfulDerived CI
Rule out
Not helpfulDerived CI
Evidence:Strong
Shock
Elevated neck veins (jugular venous pressure >7 cm H2O) in a hypotensive patient
Rule in
Somewhat helpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:Limited