https://ideawaza.com/api.php?action=feedcontributions&feedformat=atom&user=198.161.230.10 2026-09-29T13:58:13Z User contributions MediaWiki 1.46.0 https://ideawaza.com/index.php?title=Jugular_venous_pulses&diff=44549 2008-07-03T04:33:40Z

<p>198.161.230.10: /* Procedure */</p> <hr /> <div>==Inspection==<br /> *For cyanosis, periorbital edema and neck masses<br /> <br /> ==Procedure==<br /> #Position the patient with the head on the pillow and sterno cleido mastoid muscles relaxed<br /> #Start with the head of the bed @ 30 degrees. Adjust the bed angle to visualize the JVP in the lower 1/2 of the neck.<br /> #Ask the patient to lift their chin slightly (the traditionally taught method of allowing the head fall to the left mistakenly obscures the pulse beneath a contracted sternocleidomastoid muscle).<br /> #Use tangential lighting, examining both sides of the neck<br /> #Identify the external juglular vein then the internal which pulses through soft tissue.<br /> <br /> ==The 5 ways to distinguish the internal jugular vein (JVP) from the carotid==<br /> <br /> # JVP is not palpable<br /> # JVP is occludable with light pressure above the sternal end of the clavicle<br /> # JVP changes with bed angle<br /> # JVP descends with inspiration<br /> # The JVP is multiphasic while the carotid is monophasic<br /> # Measure the JVP relative to the sternal angle<br /> *&gt; 4cm is abnormal<br /> <br /> ==Components of the JVP==<br /> [http://www.merck.com/media/mmpe/figures/3779CVS70_01.gif Components of the JVP]<br /> *A wave - increase in atrial pressure that reflects atrial contraction (A = Atrial contraction)<br /> *C wave - tricupsid valve closure<br /> *V wave - filling of atrium with tricuspid closed (V = venous filling)<br /> *X descent - atrial relaxation<br /> *X' descent - ventricular emptying pulls down atrium<br /> *y descent - passive flow of blood from atrium to ventricle<br /> <br /> Note: The carotid pulsation generally falls over the c wave<br /> <br /> ==Abdomino jugular reflux (AJR)==<br /> *apply firm pressure to the abdomen for 10 seconds<br /> **normally the JVP will rise transiently then fall back to normal within 10 seconds<br /> **the AJR is positive if the JVP stays elevated for more than 10 seconds then falls to normal when the pressure is removed<br /> *do not do this maneuver if the JVP is already high<br /> <br /> ==Other OSCE modules==<br /> {{OSCE2}}<br /> <br /> [[Category:OSCE]]</div>

198.161.230.10 https://ideawaza.com/index.php?title=Jugular_venous_pulses&diff=44548 2008-07-03T04:33:13Z

<p>198.161.230.10: /* Procedure */</p> <hr /> <div>==Inspection==<br /> *For cyanosis, periorbital edema and neck masses<br /> <br /> ==Procedure==<br /> #Position the patient with the head on the pillow and sterno cleido mastoid muscles relaxed<br /> #Start with the head of the bed @ 30 degrees. Adjust the bed angle to visualize the JVP in the lower 1/2 of the neck.<br /> #Ask the patient to lift their chin slightly (traditionally taught method of allowing the head fall to the left mistakenly obscured the pulse beneath a contracted sternocleidomastoid muscle).<br /> #Use tangential lighting, examining both sides of the neck<br /> #Identify the external juglular vein then the internal which pulses through soft tissue.<br /> <br /> ==The 5 ways to distinguish the internal jugular vein (JVP) from the carotid==<br /> <br /> # JVP is not palpable<br /> # JVP is occludable with light pressure above the sternal end of the clavicle<br /> # JVP changes with bed angle<br /> # JVP descends with inspiration<br /> # The JVP is multiphasic while the carotid is monophasic<br /> # Measure the JVP relative to the sternal angle<br /> *&gt; 4cm is abnormal<br /> <br /> ==Components of the JVP==<br /> [http://www.merck.com/media/mmpe/figures/3779CVS70_01.gif Components of the JVP]<br /> *A wave - increase in atrial pressure that reflects atrial contraction (A = Atrial contraction)<br /> *C wave - tricupsid valve closure<br /> *V wave - filling of atrium with tricuspid closed (V = venous filling)<br /> *X descent - atrial relaxation<br /> *X' descent - ventricular emptying pulls down atrium<br /> *y descent - passive flow of blood from atrium to ventricle<br /> <br /> Note: The carotid pulsation generally falls over the c wave<br /> <br /> ==Abdomino jugular reflux (AJR)==<br /> *apply firm pressure to the abdomen for 10 seconds<br /> **normally the JVP will rise transiently then fall back to normal within 10 seconds<br /> **the AJR is positive if the JVP stays elevated for more than 10 seconds then falls to normal when the pressure is removed<br /> *do not do this maneuver if the JVP is already high<br /> <br /> ==Other OSCE modules==<br /> {{OSCE2}}<br /> <br /> [[Category:OSCE]]</div>

198.161.230.10 https://ideawaza.com/index.php?title=Sexually_transmitted_disease&diff=44826 2007-05-22T22:07:22Z

<p>198.161.230.10: /* Sexual Practices */</p> <hr /> <div>==Patient ID==<br /> *age<br /> *occupation<br /> <br /> ==CC==<br /> <br /> ==Permission==<br /> *&quot;I have some routine questions.&quot;<br /> <br /> ==Partners==<br /> *sexual activity <br /> **currently<br /> **total number of partners<br /> ***risk behaviour of partners<br /> **orientation - men, women, or both<br /> <br /> ==Sexual Practices==<br /> *anal, oral, vaginal<br /> *use of protection<br /> **consistency of use<br /> <br /> ==ROS==<br /> *discharge, bleeding<br /> *pain with intercourse, on urination<br /> *sores, lumps<br /> *itching, genital warts<br /> <br /> ==Risks==<br /> ===Sexual risks===<br /> *Have you or your current partner . . .<br /> **have or ever had an STD<br /> ***diagnosis, treatment<br /> **tested for HIV<br /> **blood transfusion (between 1978-1985)<br /> **multiple partners<br /> **impaired judgement from EtOH or drugs<br /> **sexual contacts during travel<br /> **pay for sex or receive money for sex<br /> <br /> ===Street drugs===<br /> *type, route<br /> *needle care<br /> <br /> ===Miscellaneous===<br /> *needle stick injury (HCW, dentists, dental hygienists)<br /> *tattoo<br /> *sexual abuse<br /> ==Other OSCE modules==<br /> {{OSCE2}}<br /> [[Category:Medicine]][[Category:OSCE]]</div>

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