10.李先生因呼吸困難而到醫院就診，在診間醫師問完病史後，就作身體診察，其中包括了abdominojugular reflex，結果發現原本無異樣的頸靜脈有明顯的鼓漲，至少在鎖骨上超過5公分。下列敘述何者最恰當：
(A)大血管動脈端有pressure overload
(B)有volume overload
(C)為紐約心臟協會的心衰竭功能分類（NYHA functional classification）的第四級
(D)有左側心衰竭

The abdominojugular test, also known as abdominojugular reflux (AJR), is a physical examination test useful in diagnosing right ventricle dysfunction, particularly right ventricular failure

肝頸靜脈回流徵，病症名，是指右心衰竭的病人，如按壓其腫大的肝臟時，則頸靜脈充盈更為明顯，稱肝頸靜脈回流徵，最常見的原因就是右心功能不全、右心衰。右心衰時，因右心房淤血或右心室舒張受限，不能完全接受回流血量，而致頸靜脈充盈更為明顯。

The patient is asked to lie down at 30 degrees with his/her head tilted 45 degrees to the left. Then an oblique light is used to illuminate the jugular region of the neck to help in identifying the inner jugular vein. Care must be taken not to confuse it with the external jugular, whose beating is more easily seen under the skin due to it being more superficial. In patients with severe right heart congestion, observation of the inner jugular might not be feasible due to its distention all the way into the upper neck and skull.

The clinician presses firmly over either the right upper quadrant of the abdomen (i.e., over the liver) or over the center of the abdomen ^[2] for 10 seconds with a pressure of 20 to 35 mm Hg while observing the swelling of the internal jugular vein in the neck and also observing to be sure the patient does not perform a Valsalva maneuver.

A positive result is variously defined as either a sustained rise in the JVP of at least 3 cm or more  or a fall of 4 cm or more  after the examiner releases pressure.