JUGULAR VENOUS PRESSURE(J.V.P)

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setelah lama menyepi hari ni tiba2 terasa nak menulis...

semalam aku baru baca PHYSIOLOGY...T_T



jadi..nak tulis pasai physio la kut hari ni sebab tengah dalam mode exam la ni...^_^



JUGULAR VENOUS PULSE(J.V.P)


Def: it is a record of pressure changes that occur in jugular veins
transmitted from the rigth atrium
during cardiac cycle.


Recorded by: Phlebograph


Composed: Each cycle has

3(+ve) waves-a,c,v(look at the graph above)

2(-ve) waves-x and y



a wave- caused by:transient rise of jugular pressure
due to :atrial systole
leads to :contraction of circular muscle sleeve surrounding opening of venae cavae.
mechanism : this events prevent venous blood flow from the jugular veins to the rigth
atrium
leading to accumulation of blood and thus pressure rises producing a-wave

the descending limb: due to relaxation of muscle sleeve during atrial diastole
leads to rush of accumulated blood from venae cavae and jugular
veins to rigth atrium.



c wave- due to : bulging of closed tricuspid valve into rigth atrium at the start of ventricular
systole.(ISOMETRIC CONTRACTION PHASE)
lead to: rise rigth atrial pressure.
caused: rise pressure in venae cavae and jugular veins producing c wave.



x wave- due to : downward displacement of AV ring during MAX.EJECTION PHASE.
caused: atrial capacity increase,
lead to : decrease pressure in Rt atrium and jugular veins.



v wave- due to : accumulation of venous return in Rt atrium, during closed of AV valve.
(late part of VENTRICULAR SYSTOLE and early part of DIASTOLE)
caused: upward displacement of AV ring to its original site.
lead to: increase pressure Rt atrium, jugular veins and venae cavae.




y wave- due to : rapid flow of accumulated blood from Rt atrium into Rt ventricle after opening
of AV valve at the end of ISOMETRIC RELAXATION PHASE.
lead to : decreased pressure in Rt atrium and jugular veins.



CLINICAL SIGNIFICANCE OF J.V.P.

variations in shape of jugular venous pulse waves are helpful in diagnosis of some cardiac disorders:




1.HUGE a-waves

a.during tricuspid stenosis
due to-high resistence of blood flow from Rt atrium to ventricle during atrial systole.

mechanism- during atrial systole, Rt atrium contracts against higth resistence in Rt ventricle causing high atrial pressure and a huge strong a wave.

b.during pulmonary hypertension
due to- increase intraventricular pressure



2.CANNON waves


during VENTRICULAR EXTRASYSTOLE, COMPLETE HEART BLOCK
huge wave created by overlap of a and c waves
occur when both Rt atrium and Rt ventricle contracts at the same time.



3.In HEART BLOCK

a.1st degree AV block
a-c interval prolonged, >0.2s

b.2nd degree AV block
a-wave more than number c-v waves
ratio 2:1 or 3:1


c. 3rd degree AV block
cannon waves appear..













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