Chapter 26 TESTING CONSIDERATIONS FOR NONINVASIVE VENOUS TESTING Flashcards
What are some examples of pertinent clinical history?
- past studies
- past procedure
Physical examinations findings
1.swelling
2. redness
3. warmth
What are laboratory findings?
blood work
What is the degree of tension in vein walls?
Venomotor tone
A sonographer is responsible for knowing?
- laboratory protocols/standards
- study capabilities
- Study limitations
- correct patient positioning
- Correct technique
- correct interpretation
What does an IAC must have?
- uniform diagnostic criteria
- interpret all data obtained
What are common findings for a DVT?
- swelling
- Pain
- Redness
- Erythema
- Warmth
What does the Wells Score determine?
The likelihood of an acute DVT
What are some other conditions that mimic DVT’s?
- muscle strain
- direct injury to the leg
- muscle tear
4.Bakers cyst - Cellulitis
- Lymphangitis
- Heart Failure
- Extrinsic compression
- Compilations of the chronic venous insufficiency
- Adventitial cystic disease
What are the symptoms of Chronic Venous Thrombosis?
- swelling
- Erythema
- Heaviness/aching
- Discoloration of ulcerations
- varicosities
What is Virchow’s Triad
Trauma to the vessel
What are the three conditions of Virchow’s Triad
1.Stasis
2. Vessel Wall injury
3. hypercoagulability
What does intrinsic trauma entail?
- intravenous drugs
- catheter
- Central venous catheter
Extrinsic trauma is a result of what?
an accident
Venous stasis can be a result of what?
- Bed rest
- myocardial infarction
- congestive heart failure
- hypotension
- chronic obstructive pulmonary disease
- obesity
- pregnancy
- Previous DVT
- Extrinsic compression
Hypercoagulability is a result of what?
- Pregnancy
- Cancer
- Oral contraceptives
- hormone replacement therapy
- inherited states
Where does thrombosis like to form?
Valve cusps/ soleal sinuses
What is Paget-Schroetter syndrome?
Thrombosis of SCV/Axillary Vein due to intense repetitive activity.
May-Thurner syndrome is now known as what?
Left Common iliac vein compression
What does May Thurner syndrome entail?
Left common iliac vein (LCIV) compression by the Right common iliac vein (RCIV).
What is Left renal vein compression?
aka nutcracker syndrome
compressed between the aorta and SMA.
What is the great clinical danger of DVT?
Pulmonary Emoblism
What are some ways valvular incompetence occurs?
Damaged valves by DVT or venous HTN.
Chronic Venous insufficiency involves what?
1.both deep and superficial systems
2. Incompetent venous valves
CVI is secondary to what?
DVT
What type of environment decreases vasoconstriction?
warmer temperatures
This condition, which leads to thrombosis, is caused by intense repetitive activity of the muscles in the thoracic outlet region.
Paget-Schroetter Syndrome
This condition, which may lead to thrombosis, involves a gene mutation increasing risk for clot formation.
Factor V Leiden
What is the only condition that is secondary to another condition?
post thrombotic syndrome
Your next patient comes to you with a painful, swollen left leg. The swelling is extensive and involves the entire extremity. She’s a very healthy 19 year old who plays varsity soccer, and has been for the past 5 years. She has no history of clotting disorders in her family. What do you think you should look for with this patient?
check her iliac vessels
You’re performing a renal duplex on a patient when obtain this image. You examine all vessels with color and spectral Doppler only to discover that there is no flow observed in the LRV. What do you think is happening here?
Nut cracker syndrome. LRV is compressed by the SMA and aorta.
What essentially are we seeing with edema here in the tissue?
interstitial fluid in tissue
What is Klippel-Trenaunay Syndrome?
hypoplastic or absent deep veins. Congenital Venous Disease.
Portal hypertension will have what?
obstructed flow through the portal vein.
Flow is hepatofugal
Explain Superior Vena Cava Syndrome
Obstructed SVC,
Head, neck, and arm congestion
What is the most common cause of IVC Tumor?
Renal cell carcinoma
A venous aneurysm will have a focal dyameter of what?
> 50%
What is the main site of swelling discoloration and ulcer formation?
The gaiter zone
Erythema (red edema) is what?
inflammatory process and/ or cellulitis
Brawny (brownish edema) represents what?
chronic venous insuficiency
Lipodermatosclerosis is what?
Skin thickening/ hardening
Due to longstanding venous hypertension
Explain Phlegmasia Alba Dolens.
Whiteness/Pallor
limb is very swollen, pale and painful.
Has Pandiastolic flow
Arterial compromise
EXTENSIVE ACUTE PROXIMAL THROMBOSIS.
Phlegmasia Ceruela Dolens
Blueish coloration
Caused by an acute proximal vein thrombosis.
Limb is very swollen, dark colored and painful
Venouse ulcerations is due to what?
lack of oxygenated blood
Ulcerations are commonly found where?
near the medial malleolus aka Gaiter zone
Pitting edema is what?
an accumulation of fluid and subcutaneous tissue
is displaced with manual pressure
Non-Pitting edema is what?
Tissue is fully engorged with fluid and can’t be displaced with manual pressure.
