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Lower Venous Extremities > Chapter 6 > Flashcards

Chapter 6 Flashcards

1
Q

How many cases of Pulmonary Embolus occurs annually?

A

600,000

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2
Q

How many deaths are a result of PE?

A

200.000

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3
Q

How many new cases of DVT (Deep Vein Thrombosis) occurs annually?

A

1-10million

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4
Q

What is a blood clot?

A

Applies to a clot anywhere, even in a test tube

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5
Q

What is a thrombosis?

A

The formation of a blood clot in an artery or vein

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6
Q

What is a thrombus?

A

The actual clot within a vessel

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7
Q

What is a thromboembolism?

A

A thrombus that breaks free and travels

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8
Q

What occurs with Phlebitis?

A

Inflammation of a vein wall

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9
Q

What is thrombophlebitis?

A

Thrombus associated with phlebitis

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10
Q

What is a thrombus that travels to the heart, through the heart and to the lungs?

A

Pulmonary Embolism (PE)

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11
Q

What is a thrombosis in a superficial vein?

A

Superficial Thrombophlebitis

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12
Q

Who postulated that there were three related factors that caused venous thrombosis?

A

Dr. Virchow

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13
Q

What are the three parts of Virchow’s triangle?

A

Stasis, Hypercoaguability, Vein Wall Injury

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14
Q

What are risk factors for DVT?

A 
Post Operative State
Previous DVT
Cancer
Thrombophilia
Trauma
Pregnancy
High Dose Estrogen Rx
"Economy Class Syndrome"
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15
Q

What are the symptoms of DVT?

A

Persistent leg pain with acute onset
Persistent leg swelling
Calf pain/tenderness
( If pts have above symptoms 50% of DVT)

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16
Q

In the clinical diagnosis of DVT, what is associated with low sensitivity and low specificity?

A

Low Sensitivity- Many Patients are asymptomatic

Low Specificity- Non-thrombotic disorders can cause the same clinical symptoms as DVT.

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17
Q

What signs and symptoms are associated with Phlegmasia Cerulea Dolens?

A

Massive thigh and calf swelling
Limb Cyanosis
Ilio-Femoral outflow obstruction

18
Q

What are the symptoms associated with Superficial Thrombophlebitis?

A

Erythemia/inflammation
local tenderness
palpable cord or mass
usually more painful than DVT

19
Q

Is Superficial Thrombophlebitis life threatening?

A

Usually not life threatening, unless the thrombus extends/propagates into the deep system

20
Q

What is looked for in a venous physical exam?

A 
Swelling
Limb discoloration
Stasis dermatitis, ulceration
Varicose Veins
Palpable "cords" (STP)
21
Q

What are the venous duplex techniques?

A
  1. ) compressibility/coaptation of the vein
  2. ) Visualization of Thrombus
  3. ) Spectral Doppler
  4. ) Color Doppler
22
Q

What position is the lower venous exam began in?

A

With pt in a Semi-Fowler’s or Reverse Trandelenburg postion

23
Q

About how many degrees is the head of the bed elevated in a Reverse Trandelenburg position?

A

25-45 degrees

24
Q

How many degrees is the torso elevated?

A

10-20 degrees

25
Q

How is the patient’s leg rotated?

A

Leg rotated externally

26
Q

What vein is located just proximal to inguinal ligament at the groin crease?

A

Distal external iliac vein

27
Q

Where does the sapheno-femoral junction occur?

A

At the location of the CFA bifurcation

28
Q

In lower venous scanning when is the image best in accordance to probe position?

A

The best image is when the ultrasound beam is perpendicular to the vessel.

29
Q

If a thrombus is found in the GSV what should one determine?

A

If the thrombus extends into the CFV at the sapheno-femoral junction

30
Q

How often should compressions be done to determine coaptation?

A

Compress every 2-4 cm along the length of the common femoral, femoral, popliteal, and calf veins

31
Q

At the level of the adductor canal, the femoral vein may be difficult to compress due to what factors?

A

Due to the depth of the vessel and proximity to the adjacent femur

32
Q

What may prevent coaptation of the popliteal vein?

A

If the transducer is placed directly over the biceps femoris tendon laterally or the semitendinosus tendon medially in the popliteal fossa

33
Q

If the distal popliteal vein is not clearly visualized what can be used to assist in visualization?

A

Imaged with color doppler in longitudinal plane

34
Q

What is spontaneity?

A

Flow that is present without augmentation maneuvers

35
Q

What is respiratory phasicity?

A

Flow should increase and decrease with respiration

36
Q

Augmented flow can easily occur in the presence of DVT via what?

A

The collateral channels

37
Q

What is augmentation particularly useful for?

A

Calf vein flow evaluation and for reflux assessment

38
Q

Spectral and Color Doppler Techniques
(Longitudinal Evaluation)
Look For

A

Spontaneous flow?
phasic with respiration?
augments with distal limb compression?
reflux?

39
Q

Typically is the flow direction above or below the baseline?

A

Below baseline

40
Q

Is continuous venous flow in the CFV a normal finding?

A

No-Abnormal Finding

41
Q

Is venous reflux a normal finding?

A

Abnormal Finding

Lower Venous Extremities (1 decks)

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