Chronic Venous Insufficiency Flashcards

1
Q

Chronic Venous Insufficiency

A

a condition that occurs when the vein wall and/or valves in the leg veins do not work effectively, which impairs the ability for blood to return to the heart from the legs, resulting in venous-stasis

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2
Q

Venous network in LE 3 parts

A
  • Superficial, (lesser and greater saphenous)
  • Deep, (anterior and posterior tibial, peroneal, popliteal, deep femoral, superficial femoral, and iliac veins)
  • Perforating or communicating veins
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3
Q

CVI may result from?

A

Vein wall degeneration, post-thrombotic valvular damage, chronic venous obstruction, or dysfunction of the muscular pumps.

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4
Q

Edema

A

a clinically apparent increase in the interstitial fluid volume

  • Develops when Starling forces are altered so that there is increased flow of fluid from the vascular system into the interstitium.
  • Due to Increase in capillary pressure usually results from an elevation of venous pressure caused by obstruction to venous and/or lymphatic drainage.
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5
Q

Generalized Edema

A

Due to

•Heart failure, Hypo-albumenia, nephrotic syndrome, Cirrhosis, sepsis

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6
Q

Localized Edema

A

Due to

•Musculoskeletal Injury, DVT

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7
Q

Pitting edema

A

1+ Barely detectable impression when finger is pressed into skin
2+ Slight indentation. 15 secs to rebound
3+ Deeper indentation. 30 secs to rebound
4+ >30 secs to rebound

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8
Q

PT Implications for CVI

A
  • Exercise increases muscle pump for venous return and kidney function to clear fluid
  • Short walks with occupations involving prolonged sitting, weight shift in standing
  • Elastic pressure stockings - effective up to knee-don’t need to go above the knee
  • Compression pump - below DBP, 90 sec on: 30 sec off (Generally)
  • Unna boot - Semirigid dressing, layered application from 1st metatarsal to below tibial tubercle. - Cast dries 1h, wear 7 days. Muscle contracts and presses against rigid Unna boot to force fluid proximally
  • Edema massage helps prevent pitting edema, which increases likelihood of wounds - contraindications include uncompensated CHF, untreated infection or cellulitis, active cancer (check with MD), renal failure, and severe pulmonary problems
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