How To Tell Jugular From Carotid Pulsations

1. How can you tell a jugular from a carotid pulsation by palpation?

ANS: Normal jugulars are not palpable. If the venous pressure is very high, you will occasionally feel an easily compressible, gentle undulation. The carotids produce a strong, almost incompressible impulse. Carotids are palpable as either a sharp tap if normal, or a push or nudge if there is aortic stenosis.

2. How can supraclavicular pressure help to separate jugular from carotid pulsations?

ANS: Since jugular pulsations arise from right atrial pulsations, supraclavicular pressure can eliminate jugular but never carotid pulsations. There is, however, a caution here. When internal jugular pulsations are very high and strong, they will not be eliminated by low supraclavicular compression. You must instead apply pressure at least halfway up the neck or even higher to eliminate these high-pressure jugular movements.

3. How can a sudden abdominal thrust help separate jugulars from carotids?

ANS: A sudden abdominal compression thrust will make the jugulars momentarily more visible but will have no effect on carotids.

A very strong jugular pulsation with a high venous pressure will not be eliminated by pressure just above the clavicle, probably because the ster-nomastoid tendons prevent adequate pressure against the vein.

4. How can the contour of jugular movements help differentiate them from carotids?

ANS: If the largest, fastest movement is inward, i.e., a collapse, then it is a jugular pulsation. The largest, fastest carotid movements are outward.

5. How does chest position help to distinguish jugulars from carotids?

ANS: The more upright the chest, the lower the jugular pulsations are in relation to the clavicle because the right atrium becomes lower in relation to the clavicle in the upright position. The carotids, on the other hand, appear higher in the neck as the chest becomes more upright.

Visible Carotid Pulsations
(RA)

The horizontal line represents the top level of jugular pulsations. Note that jugular pulsations fall relative to the clavicle with a subject in the upright position. Visible carotid pulsations remain the same distance superior to the clavicle in all chest positions.

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Responses

  • ruta yonas
    How to tell carotid vs internal jugular?
    3 months ago
  • elisabeth tukio
    How to distinguish jugular pulsation from carotid?
    2 months ago

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