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The waveform consists of a, x descent, c, v, and y descent.
a is for atria. a wave is atrial contraction, the last phase of ventricular diastole, it precedes ventricular systole.
c is for closure. c wave is closure of the tricuspid valve
x is for relaXXXXX of the atria. x descent is the fall in atrial pressure at the onset of ventricular systole
V is for valve and ventricular systole. v wave is atrial filling against a closed tricsupid valve in ventricular systole
y is for diYYYYastolic. y descent is the opening of the tricuspid and the first phase of ventricular diastolic filling preceding diastasis (the middle of ventricular diastole).
On gross inspection, the timing is as follows. The flicker you see before the transmitted pulse is an "a" wave. The flicker you see after the transmitted pulse is a "v" wave.
Feel the pulse. Look at the JVP. If the flicker BEFORE the pulse is big, these are A waves, and represent the atria contracting against a closed tricuspid valve in electromechanical dissociation, or they can represent pulmonary hypertension because the atrial contraction cannot force the last bit of blood into the right ventricle.
If the flicker AFTER or WITH the palpated pulse is big, these are V waves, which represent tricuspid regurgitation in ventricular systole.
tricuspid regurg: big v waves (after/with the palpated pulse), high pressure, separate c and v waves, big x and y descents. if accompanied by RV Failure, may be associated with big A waves.
pulmonary htn: big a waves
RV failure: CV waves (after or with the palpated pulse).
Electromechanical dissociation: Giant cannon A waves before pulse.