Duplex Imaging of Upper Extremity Venous System Flashcards
What denotes an acute vs chronic thrombus?
Acute thrombi are usually <14 days old
Do superficial or deep veins have an accompanying artery?
Deep veins have an accompanying artery
Three major differences between upper and lower extremity veins?
- Most thrombi in the lower extremity are cause by stasis, which is not true of the upper extremity
- Superficial veins are affected more in the upper extremity than the lower
- Veins in lower extremity follow more reliable courses
T or F? A thrombus in a superficial vein in the upper extremity is of greater significance than in the lower extremity?
TRUE
In what veins are thrombi more aggressively treated?
Subclavian and axillary
What is Virchow’s triad in determining pathogenesis of upper extremity thrombosis?
- Venous stasis
- Hypercoagulability
- Damage to venous walls
What is the term for a primary UEV thrombosis where patients have no history of venous puncture?
Paget-Schroetter syndrome or effort thrombosis
Primary thrombosis occurs due to the repeated compression of what vein?
Subclavian vein as it passes through thoracic inlet
In what population is primary UEV most seen? (Paget-Schroetter syndrome)
Young, athletic, muscular males
What are the most common reasons for secondary UEV thrombosis?
- Central venous catheters
- Malignancy
Why is thrombosis in the UEV more common with secondary causes?
More injury to the venous walls due to catheters and needles.
What veins are usually used to insert catheters for drug administration and feeding?
IJV and subclavian
In what vein are pacemaker wires usually inserted?
Subclavian
What does PICC stand for?
peripherally inserted central catheter
What symptoms may present with a SVC thrombi?
- Facial swelling
- Dilated chest wall with venous collaterals
Symptoms in patients with a suspected pulmonary embolism?
- Tachycardia
- Chest pain
- Tachypnea
What vein terminates into the subclavian?
Cephalic vein
What vein is being assessed using the “sniff test”?
Subclavian
What two veins connect with the median antecubital vein?
Cephalic and Basilic
What vein should be compressed and documented if there is a suspected superficial thrombophlebitis?
Median cubital vein
What vein should be compressed and documented if there is a suspected superficial thrombophlebitis?
Median cubital vein
In what vein is a common site for thrombus due to it being common for venipuncture? (site for IV)
Median cubital vein
The axillary vein begins at the junction of what veins?
Cephalic and subclavian
The brachial veins are formed by the junction of what veins?
Two radial and two ulnar
What does the basilic vein terminate into?
Axillary
The medial cubital vein connects what two veins?
Cephalic and basilic
In what veins should you observe pulsatile flow? (3)
Subclavian
IJV
Brachiocephalic V.
When both subclavian veins demonstrate non-pulsatile flow, what should be suspected?
Pathology in SVC
SF of a catheter?
Echogenic, straight and parallel echoes
In what population is Paget-Schroetter syndrome most commonly seen?
Young, athletic, muscular males
What is Paget-Schroetter syndrome also called? (hint: 2 names)
- Effort thrombosis
- Thoracic outlet syndrome (TOS)
What is the thoracic outlet?
The space between the collarbone and first rib
Is primary or secondary UEV thrombosis more common?
Secondary - due to central venous catheters
