I appreciate everyone's patience for this video! It took an unusually long time to edit, and came at an unusually busy period for me for patient care. A few additional comments: - Unfortunately, my patient was an example of how not everyone's JVP is equally clear as a demonstration of how JVP is "supposed to" look like. For some great examples of both normal and abnormal JVP, I suggest: physicaldiagnosispdx.com/card-tutorial/#Jugular_Venous_Pulse - I appreciate that some clinicians argue for carotid auscultation to be relegated to the "archaic" maneuver category that we should no longer be teaching everyone. This position is most succinctly outlined in the Aronson paper listed in the above references. In extreme brief, the argument is basically that screening for, confirming via ultrasound or CT angiogram, and "fixing" asymptomatic carotid obstructions initially identified via hearing bruits leads to only small, non-cost-effective benefit. I don't know if the evidence fully supports that position. However, even if it does, patients with carotid bruits do have significantly increased rates of overall cardiovascular death, demonstrating that it's a general marker for atherosclerosis. Therefore, the presence of a carotid bruit could reasonably shift one's threshold for more aggressively treating hypertension or hyperlipidemia in a similar way to prediabetes, obesity or a sedentary lifestyle.
Respiratory (i.e. pulmonary) exam is already posted. The others will be a while since our med school is currently enforcing face masks for all patient and standardized patient encounters.
