Ch 6 Duplex Imaging of UEVs Flashcards
Are the superficial veins more affected in the arms or legs?
Arms
Do veins in the legs or arms have more variability?
Arms
What is primary UEV thrombosis?
Pt’s that have no history of a venous puncture, known as effort thrombosis or paget-schroetter syndrome
What is secondary UEV thrombosis?
-Associated with the use of central venous catheters or malignancy
-Is m/c encountered
Why is thrombosis in the UEVs now more common?
B/c there is an increase in injury to the vein walls, due to frequent intro of needles + catheters into arm veins
Which 2 veins are commonly used for catheter insertion or drug administration?
Subclavian + IJV
List symptoms of SVC thrombosis?
Facial swelling or dilated chest wall venous collaterals
What is the pt prep + positioning for a UEV exam?
-Clothing + jewelry around arm removed
-Pt gown provided
-When imaging the subclavian + jugular veins, the bed must be flat with arm at side + head turned in opposite direction
-Imaging reset of veins can be done with bed flat or with head elevated
-The arm may be abducted to allow access to view the axillary vein
Do we perform compressions on the arm veins?
Yes! Every 2-3cm, same as with leg veins
PW doppler is performed on which arm veins?
IJV, brachiocephalic, subclavian, cephalic, axillary, brachial + basilic veins
Where is the EJV?
Posterior from IJV
Does the EJV have an accompanying artery?
No
Where does the EJV terminate into?
The subclavian vein
Do most protocols include imaging the EJV?
No, only if thrombosis is present in the extracranial neck veins
The brachiocephalic vein forms the ___?
SVC
Can we compress the brachiocephalic vein?
No
Which vein terminates into the subclavian vein?
The cephalic vein
The subclavian vein becomes the ___ vein?
Axillary
Because we can not compress the subclavian vein due to the clavicle, what other maneuver can be performed?
The sniff test - this quick inspiration should cause the vein to collapse
What are the 2 main superficial UEVs?
Cephalic + basilic (use high frequency)
We use a mid-frequency linear probe for which UEVs?
IJV, brachiocephalic, subclavian, axillary + brachial veins
What is the median cubital vein?
A vein that connects the cephalic + basilic veins at the antecubital fossa
Why is the MCV a common site for thrombus?
B/c it is used for venipuncture
The axillary vein begins at the junction of the ___ + ___ veins?
Cephalic + subclavian
The basilic vein terminates into the ___ vein along the medial part of upper arm?
Axillary
Which vein is m/c a bifid system (meaning duplicated)?
The brachial vein
The brachial veins are formed at what level?
Level of antecubital fossa (by junction of 2 radial + ulnar veins)
Which veins are very small + not often a site for venous thrombosis?
Radial veins (they are technically deep veins, but are not in the routine exam)
Are the ulnar veins normally examined?
No
Why is the basilic vein a common site for thrombosis?
B/c commonly used for PICC lines
Will an acute or chronic DVT appear contracted?
Chronic
Will an acute or chronic DVT appear dilated?
Acute
Which UEVs have normal pulsatile flow due to the close proximity to the heart?
The IJV, brachiocephalic + subclavian veins
If both subclavian veins have non-pulsatile continuous flow, what disease should be suspected?
SVC disease
How would the PW appear in partially thrombosed veins?
Continuous with augmentation with distal compression
SF of a catheter?
Bright, straight, parallel echoes
What is the m/c treatment for a DVT?
Anticoagulation
