Class 15: LEV Pathology & Scanning Flashcards
5 venous diseases?
- acute venous thrombosis
- chronic venous thrombosis
- valvular insufficiency
- varicose veins
- venous hypertension
what is virchow’s triad?
risk factors for venous disease:
1. venous stasis
2. hypercoagulability of blood
3. changes/injury to venous walls
myeloproliferative disorders can cause venous stasis. T/F?
false – it can cause hypercoagulability of blood
what are myeloproliferative disorders?
abnormal growth of red blood cells in the bone marrow
4 S&S of acute DVT?
- swelling
- pain with acute onset
- redness/erythema
- warmth
5 S&S of chronic DVT
- swelling
- heaviness
- brawny discoloration
- ulceration
- varicosities
where does brawny discoloration occur and what can it indicate?
occurs at the gaiter zone and it can indicate ulcer formation
what is varicositis?
inflamed venous wall after developing varicose veins
where can thrombosis form in the deep veins?
they can occur anywhere, but the most common location are at the valve cusps
thrombosis can cause ___ restrictions and lead to ___ ___
flow restrictions –> venous HTN
what is the most serious consequence of DVT?
pulmonary embolism
5 sequela of DVT
- collateral formation
- valvular damage
- venous HTN
- skin changes
- varicose veins
what is valvular damage?
vein wall laxity due to stiffened/leaky valves
valvular damage can lead to: (3)
- skin changes
- varicose veins
- venous HTN
varicose veins can be separated into two types. what are they?
- primary
- secondary
what are primary varicose veins?
these are hereditary, not DVT related, and affects the GSV & LSV
what are secondary varicose veins?
incompetent valves of the deep & communicating venous systems
real pathology
what causes secondary varicose veins?
- repeated episodes of DVT
- pregnancy
- obesity
which type of varicose veins can collaterals form?
secondary
4 types of skin changes due to DVT?
- edema
- redness, brawny discoloration
- phlegmasia alba dolens
- phlegmasia cerulea dolens
another name for phlegmasia alba dolens?
milk leg/white leg
what is phlegmasia alba dolens?
extensive acute iliofemoral DVT –> arterial spasms –> severe swelling
what is phlegmasia cerulea dolens?
DVT –> decreased venous outflow –> deceased arterial flow –> tissue hypoxia –> cyanosis –> gangrene
where are venous ulcers located?
near the medial malleolus
where are arterial ulcers located?
outer bony prominences, toes, tibial area
pain level of venous ulcers?
mild
pain level of arterial ulcers?
severe
appearance of venous ulcers?
- irregular and shallow
- venous ooze
- brawny discoloration
- varicosities
appearance of arterial ulcers?
- regular & deep
- little bleeding
- skin is shiny & hairless
- thickened toenails
patient position for LEV duplex scanning
- reversed trendelenberg (torso elevated 10-20 degrees)
- hips rotated externally
a diagnostic criteria for DVT includes ____ to compress vein
inability to compress vein
a diagnostic criteria for DVT includes ____ thrombus
visualization of a thrombus
a diagnostic criteria for DVT is the vein looks ____
distended
a diagnostic criteria for DVT includes ____ Doppler signals
abnormal
a diagnostic criteria for DVT includes ___ or ____ augmentation
reduced/absent augmentation
a diagnostic criteria for DVT includes ___ or ___ color
reduced/absent CD
U/S appearance of acute DVT (5)
- may be sonolucent
- spongy
- loosely attached/tail of the dog
- expansion of lumen
- no collaterals
U/S appearance of chronic DVT (5)
- echogenic thrombus
- well attached
- smaller vessel size
- irregular vein walls
- collaterals have formed
3 treatment options for DVT
- medical treatment
- anticoagulant treatment
- surgical treatment
surgical treatment for DVT is for patients who can’t use ____ treatment
anticoagulant
what type of device is inserted in the IVC to break up clots?
venal caval interruption devices/green field filters
3 other imaging modalities for LEV
- isotope venography
- contrast venography/phlebography
- lung perfusion scan
abnormal waveform for lower extremity venous?
steady continuous flow without breaks during respiration
