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To revise the anatomy lessons, this is the external jugular vein and this is the internal jugular vein. And that will be the approximate level of the tricuspid valve, the reference point for measuring right atrial pressure. The X prime descent is absent in tricuspid regurgitation in which, C and V waves fuse together.
A good knowledge of the anatomy of the heart is needed for interpretation of images from each view. This becomes more difficult in complex congenitalheartdiseases where the cardiac chamber positions and size may vary. Parasternal views are often obtained first, followed by apical, subcostal, and suprasternal.
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Anatomy 
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