|Heart Sounds & Murmurs|||||Liver & Ascites|||||[Neck Veins]|||||Pulmonary|||||Thyroid|
Neck & Veins Examination
Physical Exam: Neck Veins
Technique for Examining Hepatojugular Reflux (HJR)
Hepatojugular reflux is the distension of the neck veins precipitated by the maneuver of firm pressure over the liver. It is seen in tricuspid regurgitation, heart failure due to other non-valvular causes, and other conditions including constrictive pericarditis, cardia tamponade, and inferior vena cava obstruction. The HJR maneuver may be performed as follows:
Note: Normal subjects will have a decrease in JVP with this maneuver since venous return to the heart will be reduced. The jugular venous pressure may transiently rise and then return to normal or decrease within 10 seconds.
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