Anatomy - Venous Ulceration Flashcards
Where are limb superficial veins?
Superficial fascia
Describe deep fascia
Relatively tough and has a sheet-like, white sometimes glistening appearance
What are the main groups of deep fascia of the upper limb?
Pectoral fascia
deltoid fascia
brachial fascia
antebrachial fascia
What are the main groups of deep fascia of the lower limb?
fascia lata
crural fascia
iliotibial tract
Which 2 arteries does the brachial artery branch into?
Radial and ulnar arteries
What are the arteries found within the wrist and hand?
Deep and superficial palmer arches
metacarpal and digital arteries
How many digital arteries supply each digit of both the upper and lower limb?
4
Where does blood supply to the lower limb begin?
external iliac artery
Name the arteries found within the ankle and foot?
dorsalis pedis artery medial and lateral plantar arteries arcuate artery deep plantar arch artery metatarsal and digital arteries
What are the digital arteries known as?
End arteries
What should never be used in end arteries?
adrenaline containing local anaesthetic solution
Where does the bifurcation of the common carotid artery occur?
anterior to sternocleidomastoid muscle at the level of upper border of thyroid cartilage
Where can the brachial pulse be palpated?
medial to biceps tendon in cubital fossa
Where can the radial pulse be palpated?
lateral to tendon of flexor carpi radialis
Where can the femoral pulse be palpated?
inferior to midpoint of inguinal ligament
Where can the popliteal pulse be palpated?
in popliteal fossa (immediately posterior to knee joint)
Where can the posterior tibial pulse be palpated?
between the posterior border of the medial malleolus and achilles tendon
Where can the dorsalis pedis pulse be palpated?
medial to tendon of extensor hallucis longus distal to the ankle joint
When does the axillary vein become the subclavian vein?
at the lateral border of rib 1
Where does the basilic vein drain into?
brachial vein at the level of mid-arm
What percentage of patients have no conecting veins in the cubital fossa?
8%
What percentage of patients have a median vein of forearm?
20%
Where do both the small and great saphenous veins arise from?
dorsal venous arch
In the lower limb, what allows the transer of venous blood from superficial to deep veins?
Perforators
What clinical sign can incompetent venous valves lead to?
Varicose veins
What can chronic venous insufficiency lead to?
thrombosis/embolism
skin ulceration
Where is the most common site for venous ulceration?
Gaiter area (medial aspect of distal leg)
What can completely occlude the pulmonary trunk arresting the circulation?
saddle embolus
What are langer lines?
Lines of skin tension
What is the sentinel node?
Te first node that lymph draining from a lesion will hit
How may a clinician describe a venous ulcer?
very superficial
tend to have a shallow edge “like a beach”
characterised by lipodermatosclerosis and hyperpigmentation
What is lipodermatosclerosis?
chronic skin changes with chronic venous insufficiency
What ABPI means the ulcer is venous?
<0.8
What is a normal ABPI?
0.8 - 1.3
