Deep Vein Imaging Flashcards
Trifurcation in the calf
Anterior tibial
Posterior tibial
Peroneal
Where do thrombus’ occur more often in the calf
Peroneal and posterior tibial veins (versus anterior tibial)
Whats more lateral posterior tibial or peroneal
Posterior tibial (will be more anterior on US)
Main drainage conduit for the blood flow from the calf
Popiteal vein
Popliteal vein normal variant (25%)
Duplicated
Because of high juncture of posterior tibial and peroneal trunks
Most DVT extending into popliteal vein originate in the
Soleal sinus vein
The soleal sinus vein dumps into (2) whereas the gastroc dumps into (1)
Posterior tibials or peroneals
Popliteal
What is the most superior branch of the trifurcation
Anterior tibial trunk
Order of branching from popliteal superior to inferior
Pop V - anterior tibial trunk (most superior) - tibioperoneal trunk - common tibial trunk & common peroneal trunk - paired tibial & paired peroneal
T/F the anterior tibials are not easy to see on US
True
Why do the ______ almost never develop DVT. When are these usually imaged
Anteriot tibials do not communicate with soleal sinus. Injury to lateral calf
Paired veins near the tibia
Posterior tibial veins
Paired veins near the fibula
Do these appear larger or smaller
Peroneal veins, larger than posterior tibials
What passes through MM and achielles tendon
Posterior tibial veins
What location poses a higher risk of embolizaiton
Thrombosis above the trifurcation
T/F most calf veins resolve spontaneously
True
T/F d-Dimer is not reliable for calf DVT. What is the sensitivity?
True
65%
You can rule out a pulmonary embolism if what two veins are patent
Popliteal vein
Femoral vein
How sensitive is doppler to diagnosing calf DVT
70%
T/F gastrocs pose a lesser risk of embolisaiton
True
Calf vein imaging limitations (3)
Obese
Severe edema
Acoustic windows
D/D (3)
Bakers cyst
Superficial venous thrombosis of varices
Calf muscle tears
What is a common variant of deep calf veins
Single deep calf vein instead of a pair (usually larger than if paired)
The popliteal vein often gets confused with the ___ vein
Gastrocnemius vein
What do you do if it’s difficult to locate both trunks when scanning
Follow the posterior tibials (medial aspect) first then go bacm to the trunk and follow the peroneals
OR
_____ is necessary to fill the lumen with colour due to lack of spontaneity in the calf
Augmentation
