肝頚静脈逆流
WordNet
- an abnormal backward flow of body fluids
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2014/04/08 16:57:44」(JST)
[Wiki en表示]
The 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 internal jugular vein. A positive AJR best correlates with the pulmonary artery pressure and thus is a marker for right heart dysfunction.[1]
Procedure
The doctor presses firmly over either the right upper quadrant of the abdomen (i.e., over the liver) or over the center of the abdomen [1] for 10 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 perform a Valsalva maneuver.[2]
On an otherwise healthy individual, the jugular venous pressure remains constant or temporarily rises for a heartbeat or two, before returning to normal. This negative result would be indicated by a lack of swelling of the jugular vein. Negative hepatojugular reflux is seen in Budd-Chiari syndrome.
A positive result is variously defined as either a sustained rise in the JVP of at least 4 cm or more [2] or a fall of 4 cm or more [1] after the examiner releases pressure. The AJR has a reported sensitivity of 24% [3] to 72% [1] and a specificity of 93% to 96%. The large discrepancy in sensitivity may be explained by the higher value being reported during performance in optimal conditions of a cardiac lab while the lower value was from a study in an emergency room.
References
- ^ a b c d Ewy G (1988). "The abdominojugular test: technique and hemodynamic correlates". Ann Intern Med 109 (6): 456–60. PMID 3415106.
- ^ a b Cook D, Simel D (1996). "The Rational Clinical Examination. Does this patient have abnormal central venous pressure?". JAMA 275 (8): 630–4. doi:10.1001/jama.1996.03530320054034. PMID 8594245.
- ^ Marantz P, Kaplan M, Alderman M (1990). "Clinical diagnosis of congestive heart failure in patients with acute dyspnea". Chest 97 (4): 776–81. doi:10.1378/chest.97.4.776. PMID 2182296.
Medical examination and history taking
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Medical history |
- Chief complaint
- History of the present illness
- Systems review
- Allergies
- Past medical history
- Family history
- Social history
- Psychiatric history
- Progress notes
- Mnemonics
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Physical examination |
General/IPPA
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- Inspection
- Auscultation
- Palpation
- Percussion
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Vital signs
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- Temperature
- Heart rate
- Blood pressure
- Respiratory rate
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HEENT
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Oral mucosa · TM · Eyes (Ophthalmoscopy, Swinging-flashlight test) · Hearing (Weber, Rinne)
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Respiratory
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- Respiratory signs and symptoms
- Respiratory sounds
- Cyanosis
- Clubbing
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Cardiovascular
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- Precordial examination
- Peripheral vascular examination
- Cardiovascular signs and symptoms
- Other
- Jugular venous pressure
- Abdominojugular test
- Carotid bruit
- Ankle brachial pressure index
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Abdominal
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Digestive
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Liver span · Rectal · Murphy's sign · Bowel sounds
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Urinary
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Murphy's punch sign
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Extremities/Joint
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Back (Straight leg raise) · Knee (McMurray test) · Hip · Wrist (Tinel sign, Phalen maneuver) · Shoulder (Adson's sign) · GALS screen
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Neurological
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- Mental state
- Mini–mental state examination
- Cranial nerve examination
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Neonatal
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- Apgar score
- Ballard Maturational Assessment
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Gynecological
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- Well-woman examination
- Vaginal examination
- Breast examination
- Cervical motion tenderness
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L/I |
Labs (Electrolytes, ABG, LFT) · Medical imaging (EKG, CXR, CT, MRI)
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A/P |
Medical diagnosis · Differential diagnosis
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UpToDate Contents
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- 1. 頚静脈波の検討 examination of the jugular venous pulse
- 2. うっ血肝 congestive hepatopathy
- 3. 石綿肺症 asbestosis
- 4. 心不全が疑われる患者の評価 evaluation of the patient with suspected heart failure
- 5. 救急外来における胸痛を有する成人の評価 evaluation of the adult with chest pain in the emergency department
English Journal
- Assessing for hepatojugular reflux.
- Pullen RL Jr.SourceAmarillo College, Amarillo, TX, USA.
- Nursing.Nursing.2006 Feb;36(2):28.
- PMID 16462243
- Emergency diagnosis of congestive heart failure: impact of signs and symptoms.
- Mueller C, Frana B, Rodriguez D, Laule-Kilian K, Perruchoud AP.SourceUniversity of Basel, University Hospital, Department of Internal Medicine, Basel, Switzerland. chmueller@uhbs.ch
- The Canadian journal of cardiology.Can J Cardiol.2005 Sep;21(11):921-4.
- BACKGROUND: The most useful features in the diagnosis of congestive heart failure (CHF) have been poorly investigated.OBJECTIVE: To determine the utility of signs and symptoms in the diagnosis of CHF in the emergency department.METHODS: Detailed clinical data were collected prospectively from 452 co
- PMID 16239975
Related Links
- 12 May 2010 ... The hepatojugular reflux sign, also known as abdominojugular reflux sign, is showed in an adult patient with tuberculous restrictive pericarditis. A gentile ...
- 11 Sep 2010 ... The technique shown in this video tests the hepatojugular reflux, so the hand is positioned in the right site. I think enremkemi in the previous comment refers to the abdominojugular reflux technique, in which, as rightfully said, ...
Related Pictures
![Hepatojugular Reflux](https://1mg.info/0/2/z/1924.jpg)
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![Hepatojugular reflux](https://1mg.info/0/2/z/1927.jpg)
![Hepatojugular Reflux](https://1mg.info/0/2/z/1928.jpg)
★リンクテーブル★
[★]
- 英
- hepatojugular reflux
- 同
- 肝頸静脈逆流
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- 関
- backflush、regurgitate、regurgitation
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- 関
- regurgitant