On the wiggers diagram, the 'c' wave of the central venous pressure (JVP) trace corresponds to which event?

• A Atrial contraction
• B Venous filling during ventricular systole
• C Opening of the tricuspid valve
• D Tricuspid valve closure bulging into the right atrium during early systole ✓

Explanation

The JVP has three positive waves (a, c, v) and two descents (x, y). The 'a' wave is from atrial contraction; the 'c' wave is caused by slight bulging of the tricuspid valve cusps back into the right atrium as the valve closes at the onset of ventricular systole (and also some transmission from carotid arterial pulsation — the 'c' in 'c-wave' refers partly to 'carotid'). The 'v' wave represents venous filling of the right atrium during ventricular systole when the tricuspid is still closed.

Reference: Guyton & Hall, Textbook of Medical Physiology, 14th ed.

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