Chapter 24- Venous Pathology S/S Flashcards
What are 3 of the risk factors for developing venous thrombosis?
1-Trauma to the vessel
2- Venous stasis ( decreased venous return)
3-Hypercoagulability
What is Paget Schroettter Syndrome? Caused by?
an upper extremity thrombosis of the axillary/subclavian veins
Caused by stress or effort
Patient’s who have Thoracic Outlet Syndrome are more at risk for developing what syndrome
Paget Schroetter Syndrome
If you think about the extra rib or subclavian injury that occurs with TOS and PSS having to do with the axillary/subclavian veins it makes sense why the two are connected.
What is two examples of “trauma” induced DVT?
1- Paget Schroetter Syndrome
2-PICC lines
IF you know your anatomy well, explain why a PICC line inserted into the cephalic vein can cause a DVT
Cephalic-subclavian - innominate-SVC. Thombosis usualaly occurs at the proximal end of the PICC line
What is Virchow’s Triad and what does it related to?
The risk factors for venous thrombosis
1-Trauma-
2- Venous stasis
3-Hypercoagulability
What are some examples of why venous stasis (decreased venous return to heart) can happen
Long flights, compression of vein, immobility, pregnancy, COPD or history of DVT
A person who works out way too much can be at risk for which trauma induced- venous thrombosis?
Think of all the collaterals that form / veins popping out :)
Paget Schroetter Syndrome
EFFORT THROMBOSIS
A patient who takes estrogen is at risk for hypercoagulability and DVT.
True or False
True
When an acute thrombosis occurs, what other disorders/disease processes can happen after that?
Pulmonary Embolus, valvular incompetence, post-phlebitic syndrome, or acute outflow obstruction
What is post-phlebitic syndrome?
A DVT sequelae that occurs when the deep vein are occurs, the valves and walls are scarred, resulting in poor venous return
Venous hypertension is common to see after an acute DVT
Post-phlebitic syndrome
Ultrasound is the best imaging to diagnose a Pulmonary Emboli.. True or False
FALSE, CT is
When does pulmonary embolism occur?
when a part of the thrombosis dislodges and finds its way into the pulmonary circulation.
What is the most life-threatening sequelae of acute DVT?
Pulmonary Emboli
When a patient devlopes the Superrior Vena Cava syndrome, what should we expect to see clinically?
This is an obstruction in the SVC, The SVC drains the upper half of the body. You will see edema, collaterilization, patient will cough or have difficulty breathing and SOB.
Chronic venous insufficiency is often seen more commonly in the superficial veins..true or false?
This is basically incompotent valves
True
What are the main differences between primary chronic venous insufficiency versus secondary?
Primary, the varicose veins form due to incompetent valves in the superficial vein with a normal deep system
Secondary, varicose veins form due to deep system obstruction OR incompotent valves,
Portal hypertension is often caused by patients with what liver
2 diseases?
hepatitis and cirrhosis
What is the syndrome in which patient does have a completely formed deep veins, resulting in multiple superificial varicosities.
Klippel-Trenaunay
The most common cause of a IVC tumor is…..
very important
Renal Cell Carcinoma-this is because the tumor invades renal vein extending into the IVC.
Varicose veins are often seen in patients with
Chronic venous insufficiency.
What are the most common findings of a patient with an acute venous thrombosis?
Swelling, pain, redness, and warmth
What is phlegmasia alba dolens, what’s another word for it?
Milk leg :(
when the arterial inflow is compromised, the whole leg is white.
Phlegmasia alba dolens is a MEDICAL emergency and possible leg losss
True / False
True
When you see a patient with “wine stain” redness in different parts of their arm, what disorder should we immediately think of?
Klippel-Trenaunay
What is Phlegmasia cerula dolens
blueish discoloration due to limited venous outflow, at risk for gangrene.
What are the signs of a chronic venous obstruction?
swelling, tiredness, discoloration, skin changes, and varicosities.
If we see a patient that has a “blue leg” what should we bethinking?
Phlegmasia cerula dolens….limited venous outflow
If we see a patient that has a leg that is noticeably white, what should we think?
Phlegmasia alba dolens
There is a classification system for venous disease. What is class 1-6?
Class 1- Spider veins Class 2- Varicose Veins Class 3- Edema Class 4- Skin changes such as brawny skin discolor Class 5- Healed ulceration Class 6 - Active ulceration
How would we know the differences between venous ulcerations and arterial ulcerations location wise?
Venous ulcers are in the lower leg whereas arterial is in the feet and toes.
How would we know the differences between venous ulcerations and arterial ulcerations appearance wise?
Venous ulcers -Shallow and irregular
Arterial ulcerations are deeper and more regular in shape
If we see a shallow and irregular ulcer in the mid calf, is this an arterial or venous ulcer?
Venous
If we see an ulcer in the toe that is deep and regular in size, is this arterial or venous?
arterial
Are brawny skin discoloration changes usually seen in VENOUS disease or ARTERIAL disease?
VENOUS
