Examination is performed in good lighting with the patient semi-recumbent at an angle of 45 degrees. Their head should be supported on a pillow and turned slightly away from the midline.
The internal jugular vein runs along a line joining the depression between the sternal and clavicular heads of the sternomastoid muscle, up behind the angle of the jaw, and towards the ear lobe. It is therefore observed medial to the sternomastoid muscle.
On the left, the JVP may appear elevated and damped due to compression of the innominate vein by the aortic arch.
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