Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Vascular > Chapter 17: Duplex Ultrasound Imaging of the Lower Extremity Venous System > Flashcards

Chapter 17: Duplex Ultrasound Imaging of the Lower Extremity Venous System Flashcards

1
Q

Newly formed clotted blood within a vein, generally less than 14 days old

A

acute thrombus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

residual material present within a vein for a period of several weeks or months; also called chronic change, scarring

A

chronic post-thrombotic changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

a vein that is the companion vessel to an artery and travels deep to the muscular fascia and lies within the deep muscular compartments of the leg

A

deep vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

a small vein that connects the deep and superficial venous systems

A

perforating vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

a vein that is superficial to the muscular fascia and the muscular compartments of the leg; travels within superficial fascial compartments; has no corresponding companion artery

A

superficial vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

an inward projection of the intimal layer of a vein wall producing two semilunar leaflets, which present the retrograde movement of blood flow

A

valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Well’s criteria high probabality of DVT

A

more than 3 points

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Well’s criteria intermediate probability of DVT

A

1-2 points

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Well’s criteria low probability of DVT

A

0 points

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

thrombus poorly attached to vein wall; may be free floating

A

acute thrombus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Spectral and color Doppler signals complete thrombus

A

none

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

thrombus fully attached to vein wall

A

chronic post-thrombotic changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

veins will partially compress but not able to completely coapt walls

A

partial nonocclusive thrombus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Venous ultrasound used to assess three main things:

A

presence of absence of thrombus
appearance of thrombus
competence of contained valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

3 main categories of veins that can be imaged:

A

deep veins
superficial veins
perforating veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

main conduit for blood returning to the heart

A

deep veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

travel close to skin, superficial to muscle

A

superficial veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the purpose of superficial veins?

A

get blood near skin to help regulate body temperature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

small veins that connect deep veins with superficial veins

A

perforating veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

move blood from superficial veins to deep veins where blood can be pumped back to heart by muscular contractions

A

perforating veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Leading cause of preventable death

A

venous thromboembolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

most common mechanisms for the formation of venous thrombosis

A

Virchow Triad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Virchow Triad

A

venous stasis
vessel wall injury
hypercoaguability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

allows for increased exposure of clotting factor occurs in immobility

A

venous stasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

affect body’s normal thrombolytic system
cather related
trauma

A

vessel wall injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

associated with: cancer, birth control pills, hormone replacement therapy

A

hypercoaguability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

very commonly begin in soleal sinus veins in calf or around small valve cusps in calfs because areas of slower flow may cause areas of stagnation

A

deep venous thrombus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Signs and symptoms are caused by:

A

venous obstruction
vascular and perivascular inflammation
embolization of thrombi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

breakdown product of fibrin, which will be elevated in presence of DVT

A

D-dimer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What position works best for sonographic examination?

A

reversed Trendelenburg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the reversed Trendelenburg position?

A

patient lie flat on back, knees slightly bent, hips slightely externally rotated, head 20 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Transducer that best images femoral, popliteal, most of calf, subclavian, and larger arms

A

linear array 5- 10 MHZ transducer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Transducer that best images superficial veins and most of arm veins; used in detailed reflux mapping and mapping

A

10-18 MHz linear array transducer with small footprint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

transducer that best images IVC and iliac veins as well as deeper lying veins in bigger patients

A

curved linear array 2-5 MHz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

A sonographer should compress a vein every __-__ cm throughout leg.

A

2-3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Where is the EIV located?

A

at the level of the inguinal ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Where is the CFV/GSV located?

A

medial direction in groin crease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

large and longest superficial vein in the body

A

greater saphenous vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

The GSV terminates into the CFV at the _______ junction

A

saphenofemoral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

The CFV is formed by the junction of the ___ and ____.

A

FV
DFV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

The FV is more ____ than the DFV.

A

superficial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

main venous outflow of the calf

A

Femoral vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

mainly drains thigh

A

DFV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

located distal to the adductor canal

A

popliteal vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

main drainage for blood leaving the calf

A

popliteal vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

terminates into popliteal vein in mid to upper regions of popliteal fossa

A

anterior tibial vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Why are thrombi rare in the anterior tibial veins?

A

do not communicate with primary source of thrombi in leg- soleal sinus veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

primary source of thombi in leg

A

soleal sinus veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

drain gastrocnemius muscles

A

gastrocnemius veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

superficial vein; terminates into popliteal vein at about same level as gastrocneumius veins

A

small saphenous viens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

terminus of the SSV into popliteal vein

A

saphenopopliteal junction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

when SSV bypasses popliteal vein and continues up to posterior thigh of GSV in thigh

A

cranial extension of SSV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

merge together to form fibioperoneal trunk

A

common posterial tibial and common peroneal vein

54
Q

Paired PTVS unite to form:

A

common posterior tibial trunk

55
Q

paired peroneals unite to form:

A

common peroneal trunk

56
Q

paired and positioned alongside posterior tibial artery

A

posterior tibial veins

57
Q

lie adjacent to fibula; parallel to the PTVs through most of the calf

A

Peroneal veins

58
Q

major storage areas for blood in calf

A

soleal sinus veins

59
Q

common site for thrombi to form

A

soleal sinus veins

60
Q

Normal venous walls

A

thin and smooth

61
Q

slight dilatations in vein wall

A

valve sinuses

62
Q

thin white structures within sinus freely moving in bloodstream

A

valve leaflets

63
Q

Spectral Doppler should show _____ signals within all normal major vessels

A

spontaneous

64
Q

The waveform of a normal vein should be ____ with respiration.

A

phasic

65
Q

Signals should _____ with proximal compression or Valsalva maneuver

A

cease

66
Q

composed of a mixture of fibrin and red blood cells with platelets and acute inflammatory cells; heterogeneous echoes

A

acute thrombus

67
Q

may demonstrate a tip or tail that appears to be free-floating

A

acute thrombus

68
Q

strands of material within vein lumen; scarring; wall-thickening

A

chronic post-thrombotic changes

69
Q

volume of thrombus shrinking

A

thrombus contraction or relaxation

70
Q

surface characteristics of chronic post-thrombotic changes

A

irregular

71
Q

thin strands with a weblike appearance in vein lumen

A

synechaie

72
Q

important descriptors for thrombus

A

size of vein
surface characteristics
compressability and deformability
free-floating or firmly attached

73
Q

flow that lacks respiratory phasicity and does not cease with proximal compression or Valsalva

A

continuous

74
Q

flow in lower extremity veins both antegrade and retrograde

A

venous reflux/ venous insufficiency

75
Q

Which category of veins are the main conduit for blood, are surrounded by muscle, and have an accompanying artery?

A

deep veins

76
Q

What is the main function of the superficial venous system under normal conditions?

A

to help regulate body temperature

77
Q

In which way do valves in perforating veins ensure that blood moves, under normal conditions?

A

from the superficial to the deep system

78
Q

From epidemiologic studies, what percentage of patients develop postthrombotic symptoms?

A

30%

79
Q

Which limb of Virchow’s triad is demonstrated by a venous thrombus that starts at a valve cusp?

A

stasis

80
Q

A patient presents to the vascular lab for lower extremity venous evaluation. The patient has known Factor V Leiden genetic factor. Under what risk factor of Virchow’s triad does this patient fall?

A

hypercoaguability

81
Q

Many patients with venous thrombosis are asymptomatic; however, when symptoms occur, what are some of the most common?

A

extremity pain, tenderness, and swelling

82
Q

What would a high probability for DVT correspond to on Well’s score?

A

> 3 points

83
Q

When can a false-negative D-dimer be seen in the presence of a DVT?

A

assay cannot detect low levels of fibrins

84
Q

For routine operation of a vascular lab, the use of a high-frequency linear transducer ( 10-18 MHz) is recommended for the evaluation of which of the following?
a. superficial vein reflux
b. perforators
c. distal femoral vein
d. iliac veins

A

a

85
Q

Why will using a reverse Trendelenburg position to examine the lower extremity venous system make the exam more difficult?

A

veins without thrombus will be harder to compress

86
Q

What is the primary method used to determine the presence of thrombus in the extremity veins?

A

transducer compression of the veins

87
Q

Which of the following is NOT a normal qualitative Doppler feature evaluated in the lower extremity venous system?
a. continuity of signal
b. spontaneity of signal
c. phasicity of signal
d. augmentation of signals

A

a

88
Q

Which of the following large deep veins are commonly bifid?
a. the profunda and popliteal veins
b. the femoral and popliteal veins
c. the external iliac and femoral veins
d. the common femoral and popliteal veins

A

d

89
Q

Which vessels are NOT routinely evaluated in a lower extremity venous duplex examination?
A. Femoral vein
B. Great saphenous vein
C. Anterior tibial veins
D. Small saphenous vein

A

C

90
Q

Which veins are one of the major blood located in the calf?
A. The tibial veins
B. The small saphenous vein
C. The soleal sinus vein
D. The popliteal vein

A

C

91
Q

What do intraluminal echoes that are rigid, well attached to the vein wall, and have an irregular surface suggest?

A

Chronic postthrombotic changes

92
Q

In what case will indirect assessment of the iliac veins and IVC using Doppler at the common femoral veins suggest evidence of obstruction?
A. The Doppler spectrum exhibits phasicity
B. The Doppler spectrum exhibits pulsatility
C. The Doppler spectrum exhibits continuity
D. The Doppler spectrum ceases with Valsalva

A

C

93
Q

During a lower extremity venous duplex examination, a thin, white structure is noticed moving freely in the lumen of the vein. What does this most likely represent?

A

Valve leaflet

94
Q
A
95
Q

Which veins are one of the major blood reservoirs located in the calf?
A. The tibial veins
B. The small saphenous vein
C. The soleal sinus vein
D. The popliteal vein

A

C

96
Q

What do intraluminal echoes that are rigid, well attached to the vein wall, and have an irregular surface suggest?

A

Chronic postthrombotic changes

97
Q

In what case will indirect assessment of the iliac veins and IVC using Doppler at the common femoral veins suggest evidence of obstruction?

A

The Doppler spectrum exhibits continuity

98
Q

During a lower extremity venous duplex examination, a thin, white structure is noticed moving freely in the lumen of the vein. What does this most likely represent?

A

Valve leaflet

99
Q

Which of the following is a normal response to venous flow with a valsalva maneuver?
A. Augmented flow
B. Phasicity of flow
C. Continuous flow
D. Cessation of flow

A

D

100
Q

A patient presents to the vascular lab with sudden onset of left lower extremity pain and swelling. Upon duplex examination, poorly attached Echogenic material is noted within a dilated femoral vein, and the femoral vein does not compress with applied transducer pressure? What do these findings suggest?

A

Acute deep venous thrombosis

101
Q

When a patient presents with right heart failure, what impact is often observed in the spectral Doppler waveform in the lower extremities?

A

Increased pulsatility

102
Q

A patient presents to the emergency department with a massively swollen right lower extremity which is extremely painful and bluish in color. What do these findings suggest?

A

Phlegmasia cerulea dolens

103
Q

Which treatment option is typically reserved for emergent situations in larger veins of the iliofemoral region?
A. Heparin
B. Coumadin
C. Elastic stockings
D. Thrombolysis

A

D

104
Q

What is the primary treatment of acute lower extremity deep venous thrombosis?

A

Anticoagulation

105
Q

Duplex ultrasound for the evaluation of the deep and superficial venous system has largely replaced _______ for the detection of DVT.

A

Radio graphic contrast venography

106
Q

Duplex ultrasound has the capability to diagnose, localize, and determine the relative age of _____.

A

Thrombus

107
Q

The primary mechanism for the formation of venous thrombosis which includes venous stasis, vessel wall injury, and a hypercoaguable state is known as _____.

A

Virchow triad

108
Q

The fact that DVT is often undiagnosed or undiagnosed is likely because DVT is frequently _____.

A

Asymptomatic

109
Q

The development of venous thrombosis is determined by a balance between clotting factors and _______.

A

Coagulation inhibitors fibrinolytic system

110
Q

Tachypnea, tachycardia, and chest pain are often signs of _______.

A

Pulmonary embolism

111
Q

A palpable cord along the medial aspect of the lower extremity would be a clinical sign for ______.

A

Superficial venous thrombosis

112
Q

A patient with localized tenderness with limb swelling and a recent history of major surgery would score _____ points based on Wells criteria.

A

> 3

113
Q

The clinical diagnosis of DVT has _____ sensitivity and specificity

A

Poor

114
Q

Appropriate positioning of the patient for a lower extremity venous evaluation includes having the patient lie on their back with their knee slightly bent and hip ______ rotated.

A

Externally

115
Q

The evaluation of the IVC and iliac veins in most adult patients would require the use of a ______ transducer.

A

Curvilinear

116
Q

The position described as the tilting of the exam table during a venous examination so that the legs are approximately 20 degrees lower than the upper body is called ______.

A

Reverse trendelenburg

117
Q

Transducer compression of the extremity veins should NOT be performed in a _______ plane as it is easy to roll off the veins from this approach.

A

Longitudinal

118
Q

The junction of the great saphenous vein within the common femoral vein usually occurs ______ to the bifurcation of the superficial and deep femoral arteries.

A

Proximal

119
Q

The main venous outflow for the calf is the _____.

A

Femoral vein

120
Q

The extension of the small saphenous vein above the popliteal fossa is referred to as the _____ extension of the small saphenous vein.

A

Cranial

121
Q

It is not unusual for the ________ vein to share a common trunk with the gastrocnemius vein.

A

Small saphenous

122
Q

The posterior tibial and peroneal veins typically communicate with the _______ veins.

A

Soleal sinus

123
Q

The only way to adequately image the content of the venous lumen to exclude DVT when performing compression is to view the vessel in ______

A

Transverse

124
Q

The process of a thrombus continuing to shrink and fill less of the vein can be known as ______.

A

Recanalization

125
Q

When using Doppler, if there is a thrombosis between the level of the transducer and the site of distal compression, the result will be _________ with the compression.

A

No augmentation

126
Q

Unilateral pulsatile venous flow can be associated with _______.

A

Arteriovenous fistulae

127
Q

Compression of the left common iliac by the right common iliac artery can result in _______ syndrome.

A

May Thurner

128
Q

A no vascular, anechoic, well-defined, oval mass found incidentally during a lower extremity venous duplex evaluation most likely represents a(n)

A

Cyst

129
Q

Computed tomography venography and magnetic resonance venography are often used to evaluate the status of the _____ veins.

A

Iliac

130
Q
A

Vascular (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions