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MIDS 237 > Ch 8 Venous Valvular Testing > Flashcards

Ch 8 Venous Valvular Testing Flashcards

1
Q

What is the anterior GSV?

A

Superficial vein at the anterior thigh

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2
Q

What does CEAP stand for?

A

Clinical, etiologic, anatomic, pathophysiologic (classification of venous disease)

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3
Q

What is chronic venous insufficiency?

A

Long lasting venous valvular or obstructive disorder

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4
Q

What is elastic compression?

A

The effects of stockings used to compress the leg, with intent to compress the veins

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5
Q

What is lipedema?

A

Swelling of fat tissue

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6
Q

What is plethysmography?

A

-Graphic presentation of pulses
-It measures changes in volume in different parts of the body

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7
Q

What is reflux?

A

Reverse flow, m/c in veins with incompetent valves

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8
Q

What is a reticular vein?

A

Superficial vein less than 3mm

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9
Q

What is a spider vein?

A

-Small clusters of veins near the skin surface that are red, blue or purple + measure b/w 0.5-1mm
-Aka telangiectasias

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10
Q

What is a tributary vein?

A

Vein that terminates/empties into another larger vein

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11
Q

Measurement for a varicose vein?

A

> 3mm

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12
Q

What is the vein of giacomini (VOG)?

A

Extension of SSV to GSV within a saphenous fascia

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13
Q

What is CVVI?

A

-Chronic venous valvular insufficiency
-Occurs in deep or superficial veins with incompetent valves + reflux

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14
Q

Do most pt’s with CVVI have venous obstruction?

A

No!

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15
Q

Which vein is the primary concern in CVVI?

A

GSV

(easily seen at the groin/SFJ as the medial mickey mouse ear OR in the thigh bordered by the deep + superficial fascia creating the egyptian eye look)

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16
Q

GSV hypoplasia/agenesis is common where?

A

Below the knee

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17
Q

Differentiate b/w true GSV duplication + superficial/accessory veins?

A

True: 2 veins staying within saphenous part

Superficial/Accessory: coursing in + out the saphenous part

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18
Q

The prox GSV has 2 major valves, what are they?

A

-Terminal valve (0.4cm from SFJ)
-Preterminal valve (3.1cm from SFJ)

19
Q

The SFJ tributaries join the GSV b/w what valves?

A

The terminal + preterminal valves

20
Q

What is AAFSV?

A

Anterior accessory GSV (is anteromedial in thigh + empties into SFJ)

21
Q

What is PAGSV?

A

Posterior accessory GSV (lies deep to GSV in thigh)

22
Q

The m/c SSV termination is where?

A

At the Pop V via the SPJ

(note there are 3 other SSV variations)

23
Q

What is the function of persistent sciatic veins?

A

-Functions as collateral pathways for the FV
-The sciatic vein is deeper in the thigh + adjacent to the sciatic nerve

24
Q

What is venous valvular insufficiency testing?

A

Venous reverse flow (reflux) detection

25
Q

Explain the anatomy behind valves?

A

-Unidirectional
-More valves with distance away from the heart
-Open with contraction, close with relaxation

26
Q

Incompetent valves cause abnormal retrograde flow/reflux, what does this cause?

A

An increased volume of blood in the lower leg

27
Q

List the 3 types of disorders that affect LE venous bicuspid valves?

A

Valve agenesis: is congenital (reflux occurs at any time)

Valve damage: caused by DVT or degeneration due to age (reflux occurs at any time)

Valve leakage: due to venous dilatation, the vein is too big for the valve to close properly (reflux occurs intermittently)

28
Q

What 2 things are varicose veins associated with?

A

Valve reflux + venous obstruction

29
Q

List the clinical CEAP classification?

A

C0: no signs/symptoms
C1: spider or reticular veins (<3mm)
C2: varicose veins (>3mm)
C3: edema
C4: skin changes
C5: healed skin ulcers
C6: open skin ulcers

(view chart in slides for full CEAP)

30
Q

What is VCSS?

A

-Venous clinical severity score
-Used to assess those with venous disease that is complementary to the CEAP classification

(score varies b/w 0-30)

31
Q

U/s exam for CVVI has what 2 key diagnostic goals?

A

-To exclude deep venous obstruction or acute thrombosis
-To evaluate the function of valves, or reflux detection

32
Q

What is the pt prep for valvular testing?

A

-Get pt to remove clothes from waist down
-Deep veins are imaged first in reverse trendelenburg
-Superficial veins are imaged while pt stands

33
Q

Is detecting acute DVT rare?

A

Yes!

34
Q

Normal antegrade flow should be ___ the baseline?

A

Below

35
Q

Abnormal retrograde flow should be ___ the baseline?

A

Above

36
Q

What does the valsalva maneuver test?

A

Reflux in the CFV + prox GSV, at the SFJ

(does not test more distal veins)

37
Q

What does the parana maneuver test?

A

Valves above + below knee (calf muscle must pump)

38
Q

What do foot flexion + toe curls do?

A

Causes calf muscle contractions

39
Q

What do hand compressions do?

A

The tech can squeeze the distal leg being tested for a variety of conditions

40
Q

Chronic venous valvular insufficiency (CVVI) may present with an increase in what?

A

Collateral vein diameters, but the veins are still completely compressible

41
Q

How will the valves + affected veins appear with CVVI on 2D?

A

Valves: Thickened leaflets
Veins: tortuous, varicose or aneurysmal

42
Q

How will CVVI appear on spectral doppler + CD?

A

SD: Reverse/reflux flow seen following prox or distal compression

CD: Retrograde turbulent flow within valve sinuses

43
Q

How fast does the saphenous, deep femoropopliteal + perforating vein valves close?

A

Saphenous: <0.5 sec
Deep FP: <1 sec
Perforating: <0.35 sec

(longer duration’s = abnormal reflux)

44
Q

Treatment options for superficial CVVI?

A

Traditional: Ligation with or w/o stripping + phlebectomies

Present: Sclerotherapy (chemical ablation), thermal ablation + cyanoacrylate glue occlusion

(ablation has replaced stripping + ligation)

MIDS 237 (23 decks)

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