Distinguishing venous from arterial pulsations

	Venous pulsations	Arterial pulsations
Characteristics of pulse
Movement	Soft, diffuse, and undulant	Discrete and robust
Number of pulsations	Two crests and two troughs*	Single
Effect of inspiration	Respirophasic	No change
Position of body	Higher in horizontal position and lower in vertical position	No significant change
Abdominal compression	May increase	No change
Compression at root of neck	Pulsations cease	Maintained

* The venous pulse is recognized by its double undulation (a and v waves), frequently associated with relatively sharper inward movement (the x descent following the a wave and y descent following the v wave). A c wave on the downstroke of the x descent is also commonly identified on venous pressure tracings but is generally not discerned by physical examination.

Graphic 111974 Version 3.0

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Distinguishing venous from arterial pulsations