Deep Dive Time Stamps 00:20 - Contents 00:50 - What is the JVP 01:03 - Internal Jugular Vein Anatomy 01:40 - Going for the Jugular 01:58 - Challenges with the JVP 02:56 - How to examine the JVP 03:18 - Where to look 03:38 - How to measure the JVP 03:46 - Patient Example 04:06 - How to get the best view 04:38 - The Three Golden Giveways 04:45 - Check the pulse 05:15 - Palpate the visible pulsation 05:33 - Hepatojugular Reflux (Yes, REFLUX) 05:53 - Hepatojugular Reflux Patient Example 06:30 - The reflux manoeuvre explained 07:12 - What you should see in healthy patients 07:28 - How to tell if its abnormal 07:53 - The manubriosternal angle (angle of Louis) 08:18 - Using the ruler 08:54 - The ruler explained in diagram 09:03 - Normal and Absent JVP 09:31 - Why you should check the JVP is below the clavicle (Severe Tricuspid Regurgitation) 09:59 - Causes of a raised JVP 10:07 - Cardiac Causes 11:12 - Pulmonary Causes 11:33 - Fluid Overload 11:54 - Mnemonic for raised JVP causes 13:11 - The JVP wave form 13:40 - 5 (ish) Sections of the JVP Wave form 14:34 - A 15:20 - X 15:47 - C 16:27 - X Again 17:25 - V 17:50 - Y 18:37 - Re-cap of the JVP wave 19:09 - Additional Pathologies seen in the Wave Form 19:52 - Summary 20:06 - Remember your history! 20:24 - Remember to like and Subscribe!
Hi Dr Gill, Law student here who is fascinated by your videos! Perhaps you could do a series of story-time esque videos which talk about some of the most complex, strange, whacky, or otherwise interesting cases you have encountered or have heard of? Could talk about the case itself, problems you / the doctor had, how you/they addressed it etc etc. Would prove fascinating to a lay mind such as mine, and could offer some educational value to aspiring doctors out there. Love your stuff mate
James, you are first class. Great video as always. You're ability to communicate and explain things is incredible. You have the knowledge and wisdom of a man many times your age. Keep it up brother!
my brother and I as children were sure this is where you applied pressure to do that Spock Star Trek thing. We spent hours trying it out on each other, with the result we had a lot of bruises and a very angry mother. No one thankfully did pass out as it was supposed to work VERY quickly. I'm glad to know what the name of "that place" is and not so sure we were as safe as we thought we were!
Hi Dr. James! I've really enjoy your lesson. However, I don't understand why in cardiac tamponade the x descent is more pronounced. If there's increased pressure surrounding the heart, shouldn't it make it more difficult for the atria to relax, making the x descent less pronounced? I'm sure I'm missing something :) Thank you for your awesome explanation!
As someone with zero memory (especially names of people, let alone organs/veins/muscles), I always wonder how much of this Doctors can actually keep in their heads, and how often they have to go back to resource materials to shore up their knowledge, if they have to at all. Anywho, another lovely video :D
I saw pulmonary hypertension as one of the causes of an increased JVP; with so many other causes however, does that mean that the JVP is independent from blood pressure or is it loosely associated? Could someone with a SBP of 140 have a JVP only visible with a test of the hepatojugular reflux? Is it also possible in obese patients that you may not be able to see the JVP at all?
Dr. Gill, has the increase in popularity of your channel and you becoming somewhat of a sensation amongst the ASMR fanbase affected your career or interactions with your students at all?
I was painting a study of an old Picasso and needed something to tag along. Yep, listening to Dr Gill while painting :) (im in no medical field at all btw)
How the waveforms are plotted on graph? Is it just by doing the clinical examination or do we use an instrument/machine for that? I can’t find the answer anywhere
Hi dr. Gill! Cheers from Argentina. I was wondering if you (and by you I mean the md's of your country) use inhaled ibuprofen, sodium ibuprofenate if i translated it correctly, to treat the symptoms of covid or if you are even aware of the possible use of this drug. Here in Argentina it's had a positive effect in patients, to avoid them from reaching the instance of intubation for oxygen. Sorry for my lack of knowledge on medical terms and if I deviated the topic of your video!
@@DrJamesGill I wanted to know if it was widely spread or if it was something that was only tried here. It is a new treatment that is being researched at the moment. clinicaltrials.gov/ct2/show/NCT04382768 this is what I could find as something official. Sorry to have alarmed you! Wouldn't want you to lose your calm. The asmr community wouldn't forgive me for it jajaja
Dr. Gill, these videos are amazing concise, comprehensive time-savers. They have already influenced my entire clinical experience so far! Thank you for taking the time to make these 😊! I've learned so much
Hour videos are wonderful. I just wish you would go back to your settings and have the ads at the beginning and end instead of 4 or 5 ads interrupting the video.
I only put the middle adverts on the longer videos now as I’ve swapped one of my non-clinical sessions to dedicated time for the recording and editing to try and put things out more regularly. It’s a balance, I’m still trying to find it
I'm not lying when I tell you sir that, I was studying jaundice and, in the congestive hepatopathy related jaundice, I saw once again the HJR thing and it took me about an hour to find something to understand the whole deal including anatomy and PE, and I found this video. I wish I found this earlier during my med preparation or at least, earlier in the night LOL. Incredible teaching skills, I will definitively keep looking at your work from now on. Thank you so much for what you do. Greetings from an IMG from Mexico preparing for step 1!!!
hello, thanks dr. gill for this topic and other topics but where can I found this as pdf or writing by anywhere? for revision to the final ... again thank you
Thank you so much, failed the JVP exam on my clinical after having the most confusing JVP explanation ever by a preceptor, but now I actually understand. Will be subbing and watching more!
I’m really glad it helped you. The JVP was always a challenge for me - which I think helps me explain it to my students now! Any other areas we could look to help you with?
Deep Dive Time Stamps
00:20 - Contents
00:50 - What is the JVP
01:03 - Internal Jugular Vein Anatomy
01:40 - Going for the Jugular
01:58 - Challenges with the JVP
02:56 - How to examine the JVP
03:18 - Where to look
03:38 - How to measure the JVP
03:46 - Patient Example
04:06 - How to get the best view
04:38 - The Three Golden Giveways
04:45 - Check the pulse
05:15 - Palpate the visible pulsation
05:33 - Hepatojugular Reflux (Yes, REFLUX)
05:53 - Hepatojugular Reflux Patient Example
06:30 - The reflux manoeuvre explained
07:12 - What you should see in healthy patients
07:28 - How to tell if its abnormal
07:53 - The manubriosternal angle (angle of Louis)
08:18 - Using the ruler
08:54 - The ruler explained in diagram
09:03 - Normal and Absent JVP
09:31 - Why you should check the JVP is below the clavicle (Severe Tricuspid Regurgitation)
09:59 - Causes of a raised JVP
10:07 - Cardiac Causes
11:12 - Pulmonary Causes
11:33 - Fluid Overload
11:54 - Mnemonic for raised JVP causes
13:11 - The JVP wave form
13:40 - 5 (ish) Sections of the JVP Wave form
14:34 - A
15:20 - X
15:47 - C
16:27 - X Again
17:25 - V
17:50 - Y
18:37 - Re-cap of the JVP wave
19:09 - Additional Pathologies seen in the Wave Form
19:52 - Summary
20:06 - Remember your history!
20:24 - Remember to like and Subscribe!
Thanks Abbie. As ever, you are a champion
I'm not studying to be in medicine at all but I find it very interesting, so these videos are great!
Glad you like them!
Hi Dr Gill, Law student here who is fascinated by your videos!
Perhaps you could do a series of story-time esque videos which talk about some of the most complex, strange, whacky, or otherwise interesting cases you have encountered or have heard of? Could talk about the case itself, problems you / the doctor had, how you/they addressed it etc etc. Would prove fascinating to a lay mind such as mine, and could offer some educational value to aspiring doctors out there.
Love your stuff mate
Causes of raised jugular venous pressure
👍
Constrictive pericarditis (JVP increases on inspiration - called Kussmaul's sign). Cardiac tamponade. Fluid overload - eg, renal disease. Superior vena cava obstruction (no pulsation).
thank you soooo much for this!! waveforms have always confused me but this makes sense 😁
I'm so glad!
I wouldn't want to attend Dr Gill's lectures, I would just be falling asleep constantly and fail the exam in the end lol
🤣🤣 my students wouldn’t dare fall asleep in my lecture
I can happily watch good teachers all the time. Dr Gill is a great teacher. He's getting an electronic engineering student to watch medicine videos 😊
Wow, thanks!
I’d love a video on Vasovagal syncope. Lots of people feels woozy from needles and blood draws and don’t know why.
I work with taxes for a living, but I find these clinical skills videos fascinating. I watch these instead of watching tv. Is that weird??
James, you are first class. Great video as always. You're ability to communicate and explain things is incredible. You have the knowledge and wisdom of a man many times your age. Keep it up brother!
thank you!
my brother and I as children were sure this is where you applied pressure to do that Spock Star Trek thing. We spent hours trying it out on each other, with the result we had a lot of bruises and a very angry mother. No one thankfully did pass out as it was supposed to work VERY quickly. I'm glad to know what the name of "that place" is and not so sure we were as safe as we thought we were!
🤣🤣🤣 that’s brilliant. Glad it didn’t work though!
Loving the content Dr Gill! Keep up the good work (and thank you for your services to the medical profession!)
👍
Best explanation/instruction I've found to describe this. Thank you very much for creating and sharing!
Thank you Jamie. I always found it a very difficult thing to get my head around 😊
Thanks very much. You are wonderful in explaining this concept!
👍
Dramatic turns are my new fave, absolutely killing the editing game
Genuinely wish my lecturers were half as good as Dr. Gill. Cannot explain how much you’ve helped
Thank you so much, wonderful explanation 🎉
Glad it was helpful. Any other areas we could help with?
Hi Dr. James! I've really enjoy your lesson. However, I don't understand why in cardiac tamponade the x descent is more pronounced. If there's increased pressure surrounding the heart, shouldn't it make it more difficult for the atria to relax, making the x descent less pronounced? I'm sure I'm missing something :) Thank you for your awesome explanation!
Who’s down with JVP? Yeah, you know me
As someone with zero memory (especially names of people, let alone organs/veins/muscles), I always wonder how much of this Doctors can actually keep in their heads, and how often they have to go back to resource materials to shore up their knowledge, if they have to at all. Anywho, another lovely video :D
repetition
@@DrJamesGill Then that's amazing, thank you :D
Another phenomenal video Dr Gill, you have a way with words that truly helps one understand. Hope you have an amazing day!
Thanks, you too!
Fantastic explanation. I found the little tricks (e.g. keeping SCM m relaxed) and the waveform explanation particularly helpful!
Hope you’ll find it helpful clinically 😊
I saw pulmonary hypertension as one of the causes of an increased JVP; with so many other causes however, does that mean that the JVP is independent from blood pressure or is it loosely associated? Could someone with a SBP of 140 have a JVP only visible with a test of the hepatojugular reflux? Is it also possible in obese patients that you may not be able to see the JVP at all?
Dr. Gill, has the increase in popularity of your channel and you becoming somewhat of a sensation amongst the ASMR fanbase affected your career or interactions with your students at all?
Thank you for this I was reading the textbook and was confused your teaching was simple to understand and now I know it.
You're very welcome! Any other areas we can help with?
Dr .. are JVP waves distinguishable on clinical examination?
They can be yes - you can actually see it here in the cardiology deep dive
th-cam.com/video/dxUHp85M8kQ/w-d-xo.html
WOW!! AMAZING!!! This is by far the Best Explanation on JVP. Excellent! thank you so much!
I was painting a study of an old Picasso and needed something to tag along. Yep, listening to Dr Gill while painting :) (im in no medical field at all btw)
How the waveforms are plotted on graph? Is it just by doing the clinical examination or do we use an instrument/machine for that? I can’t find the answer anywhere
JVP wave form isn’t often measures - the height is, but not the wave form. If you did want to produce the wave form it would be Doppler ultra sound.
Dr James Gill thank you for the reply and the answer. I got it now!
Hernandez William Thompson David Harris Scott
Hi dr. Gill! Cheers from Argentina. I was wondering if you (and by you I mean the md's of your country) use inhaled ibuprofen, sodium ibuprofenate if i translated it correctly, to treat the symptoms of covid or if you are even aware of the possible use of this drug. Here in Argentina it's had a positive effect in patients, to avoid them from reaching the instance of intubation for oxygen. Sorry for my lack of knowledge on medical terms and if I deviated the topic of your video!
INHALED?!? No I havnt heard about that, but sounds alarming
Do you have any research papers on it?
@@DrJamesGill I wanted to know if it was widely spread or if it was something that was only tried here. It is a new treatment that is being researched at the moment. clinicaltrials.gov/ct2/show/NCT04382768 this is what I could find as something official.
Sorry to have alarmed you! Wouldn't want you to lose your calm. The asmr community wouldn't forgive me for it jajaja
Dr. Gill, these videos are amazing concise, comprehensive time-savers. They have already influenced my entire clinical experience so far! Thank you for taking the time to make these 😊! I've learned so much
Thanks! Where are you clinically at the moment?
@@DrJamesGill I’m in my second year and have begun shadowing GP’s and internists. I’m currently preparing for my board exams
رحم الله والديك ، ونعم منك
Thomas Steven Taylor Edward Martin Kimberly
Thompson Michael Perez Kevin Walker Brenda
White Kimberly Walker Eric Thomas Ronald
Young Thomas Miller Frank Gonzalez Susan
Martin Richard Young David Hernandez Carol
Lopez Elizabeth Hall James Miller Steven
Williams Susan Martin Michelle Martinez Timothy
Big Gill the high roller
Strolling through with an entourage
Hard to camouflage
when you livin’ this ASMR 🎼🎼
Martin Richard Perez Dorothy Clark Sandra
Lee Edward White Patricia Hall Margaret
Brown Mary Johnson Ruth Lee Michael
Harris Karen Johnson Frank Gonzalez David
Robinson William Lopez Shirley Johnson Lisa
Hall Gary Martinez Shirley Thomas Mark
Young Robert Perez William Allen Ruth
Moore Margaret Jackson Carol Williams Larry
Hour videos are wonderful. I just wish you would go back to your settings and have the ads at the beginning and end instead of 4 or 5 ads interrupting the video.
I only put the middle adverts on the longer videos now as I’ve swapped one of my non-clinical sessions to dedicated time for the recording and editing to try and put things out more regularly.
It’s a balance, I’m still trying to find it
@@DrJamesGill that makes sense. Thanks.
I'm not lying when I tell you sir that, I was studying jaundice and, in the congestive hepatopathy related jaundice, I saw once again the HJR thing and it took me about an hour to find something to understand the whole deal including anatomy and PE, and I found this video. I wish I found this earlier during my med preparation or at least, earlier in the night LOL. Incredible teaching skills, I will definitively keep looking at your work from now on. Thank you so much for what you do. Greetings from an IMG from Mexico preparing for step 1!!!
Thank you. That is incredible feedback. Maybe there are colleagues you could share the video with?
Are there any other areas I can help you with?
Jackson Anthony Johnson Maria Garcia Gary
Moore Charles Walker Laura Hall Jeffrey
Miller Mark Garcia Mary Jackson Michelle
Davis Betty Lee Ruth Johnson Jose
Martinez Kevin Miller Linda Clark Karen
Wow I am studying biology only 3 weeks in and I can kind of understand what you are saying with certain terms you are using
perfect :)hopefully these will help you 😊
@@DrJamesGill it will thank you
This is the definition of teaching... especially that mnemonic, PQRST..wow 😘
Thank you. I find mnemonics useful
Hernandez Laura Davis Sandra Garcia Maria
Can u speak louder ? You are talking in a suppressed voice . A
Bro is speaking language of asmr
What an incredible tone of voice 👌
Brilliant videos and explanations. Paramedic studying crit care here. Superb learning aids, please keep up the good work Dr. 👍🏴
Thankyou good lecture
You are the best
hello,
thanks dr. gill for this topic and other topics
but where can I found this as pdf or writing by anywhere?
for revision to the final ...
again thank you
Amazing video! it made understanding discussions during ward rounds MUCH easier! much appreciated
I love a good cardiac tamponade, especially with a baguette and some chardonnay. 😉
Perfect!
This was really educating and helped a lot . Thank you Sir.
Thank you so much, failed the JVP exam on my clinical after having the most confusing JVP explanation ever by a preceptor, but now I actually understand. Will be subbing and watching more!
I’m really glad it helped you. The JVP was always a challenge for me - which I think helps me explain it to my students now!
Any other areas we could look to help you with?