Answer: The height of the JVP is below the level of the probe

First you must recognize that in an image of the LEFT IJ, the IJ generally sits just to the right of the screen from the Carotid.

This is a slit-like IJ with a size less than that of the carotid. This is likely above the level of the pressure column. The tapering of the IJ may be seen if the probe is slid towards the clavicle or if the head of the bed is lowered.

Answer: The CVP is very likely elevated

This is an example of an IVC at the extreme of the spectrum. It is round, ~ 2xm in diameter, and there is no collapse even with a sniff.

Answer: All of the above.

Anything that raises intrathoracic pressure or intracardiac pressure can increase RAP.

Answer: Increased respiratory effort (forced expiration)

Forced expiration results in a Valsalva like effect with an increase in intrathoracic pressure during expiration. As such there is considerable variability in the appearance of the IJ.

Under these circumstances, the height of the column should be assessed in early rather than late expiratory phase.

Answer: Fanning

The cylinder effect is when the plane of the beam slices through the narrow edge of the cylinder. Fanning the transducer will move the beam towards the centre of the cylinder which will be representative of the true diameter of the vessel.

You can artificially make the diameter of a cylinder look narrower than it truly is, but you can’t make it look wider than it truly is