Anatomy - Venous Ulceration

Question 1

Where are limb superficial veins?

Answer 1

Superficial fascia

Question 2

Describe deep fascia

Answer 2

Relatively tough and has a sheet-like, white sometimes glistening appearance

Question 3

What are the main groups of deep fascia of the upper limb?

Answer 3

Pectoral fascia
deltoid fascia
brachial fascia
antebrachial fascia

Question 4

What are the main groups of deep fascia of the lower limb?

Answer 4

fascia lata
crural fascia
iliotibial tract

Question 5

Which 2 arteries does the brachial artery branch into?

Answer 5

Radial and ulnar arteries

Question 6

What are the arteries found within the wrist and hand?

Answer 6

Deep and superficial palmer arches

metacarpal and digital arteries

Question 7

How many digital arteries supply each digit of both the upper and lower limb?

Answer 7

4

Question 8

Where does blood supply to the lower limb begin?

Answer 8

external iliac artery

Question 9

Name the arteries found within the ankle and foot?

Answer 9

dorsalis pedis artery
medial and lateral plantar arteries 
arcuate artery 
deep plantar arch artery 
metatarsal and digital arteries

Question 10

What are the digital arteries known as?

Answer 10

End arteries

Question 11

What should never be used in end arteries?

Answer 11

adrenaline containing local anaesthetic solution

Question 12

Where does the bifurcation of the common carotid artery occur?

Answer 12

anterior to sternocleidomastoid muscle at the level of upper border of thyroid cartilage

Question 13

Where can the brachial pulse be palpated?

Answer 13

medial to biceps tendon in cubital fossa

Question 14

Where can the radial pulse be palpated?

Answer 14

lateral to tendon of flexor carpi radialis

Question 15

Where can the femoral pulse be palpated?

Answer 15

inferior to midpoint of inguinal ligament

Question 16

Where can the popliteal pulse be palpated?

Answer 16

in popliteal fossa (immediately posterior to knee joint)

Question 17

Where can the posterior tibial pulse be palpated?

Answer 17

between the posterior border of the medial malleolus and achilles tendon

Question 18

Where can the dorsalis pedis pulse be palpated?

Answer 18

medial to tendon of extensor hallucis longus distal to the ankle joint

Question 19

When does the axillary vein become the subclavian vein?

Answer 19

at the lateral border of rib 1

Question 20

Where does the basilic vein drain into?

Answer 20

brachial vein at the level of mid-arm

Question 21

What percentage of patients have no conecting veins in the cubital fossa?

Answer 21

8%

Question 22

What percentage of patients have a median vein of forearm?

Answer 22

20%

Question 23

Where do both the small and great saphenous veins arise from?

Answer 23

dorsal venous arch

Question 24

In the lower limb, what allows the transer of venous blood from superficial to deep veins?

Answer 24

Perforators

Question 25

What clinical sign can incompetent venous valves lead to?

Answer 25

Varicose veins

Question 26

What can chronic venous insufficiency lead to?

Answer 26

thrombosis/embolism

skin ulceration

Question 27

Where is the most common site for venous ulceration?

Answer 27

Gaiter area (medial aspect of distal leg)

Question 28

What can completely occlude the pulmonary trunk arresting the circulation?

Answer 28

saddle embolus

Question 29

What are langer lines?

Answer 29

Lines of skin tension

Question 30

What is the sentinel node?

Answer 30

Te first node that lymph draining from a lesion will hit

Question 31

How may a clinician describe a venous ulcer?

Answer 31

very superficial
tend to have a shallow edge “like a beach”
characterised by lipodermatosclerosis and hyperpigmentation

Question 32

What is lipodermatosclerosis?

Answer 32

chronic skin changes with chronic venous insufficiency

Question 33

What ABPI means the ulcer is venous?

Answer 33

<0.8

Question 34

What is a normal ABPI?

Answer 34

0.8 - 1.3