The normal jugular venous wave form includes the dominant “a” wave that reflects right atrial contraction; the “x” descent that reflects right atrial relaxation; the smaller “v” wave that reflects right atrial filling; and the “y" descent that reflects right atrial emptying. In the video that follows, note the “a” wave occurs just before the carotid impulse and the “v” wave occurs just after. The cotton swab reflects the carotid impulse.