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Abdominojugular testThe abdominojugular test (AJR), also known as hepatojugular reflux, is used as an alternate test for measuring jugular venous pressure (JVP) through the distension or swelling of the jugular vein. A positive AJR best correlates with the pulmonary capillary wedge pressure although it also correlates with the right heart pressure and the left heart ejection fraction [1]. ProcedureThe doctor presses firmly over either the Right Upper Quadrant (liver) or over the center of the abdomen [1] for 10-60 seconds with a pressure of 20 to 35 mm Hg while observing the internal jugular vein in the neck and also observing to be sure the patient does not Valsalva [2]. The internal jugular vein can be distinguished from the carotid artery by 1) having a biphasic waveform 2) falling pressure during inspiration 3) rising with abdominal pressure, 4) increasing and decreasing with lowering and elevation of the head of the bed, respectively, and 5) being compressible with direct pressure [2]. When the meniscus of the internal jugular vein cannot be determined, one study found the height of the meniscus in the external jugular vein correlated with the right atrial pressure [3].
References
Categories: Medical tests | Medical signs |
This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Abdominojugular_test". A list of authors is available in Wikipedia. |