FN: Varicose Veins Flashcards
1
Q
Definition
A
Tortuous, dilated veins of the superficial venous system
2
Q
Pathophysiology
A
One-way flow from superior to deep maintained by valves
Valve failure - raised pressure in sup veins - variscosity
3
Q
3 main sites where valve incompetence occurs
A
SFJ: 3cm below and 3cm lateral to pubic tubercle SPJ: popliteal fossa Perforatos: draining GSV -3 medial cal perforators (Cocketts) 1 medial thigh perforator (Hunters)
4
Q
Causes
A
Primary
Secondary
5
Q
Primary causes
A
Idiopathic: (congenitally weak valves)
- prolonged standing
- Pregnancy
- Obesity
- OCP
- FH
Congenital valve absence (v. rare)
6
Q
Secondary causes
A
Valve destruction - reflux: DVT, thrombophlebitis Obstruction: DVT, foetus, pelvic mass Constipation AVM Overactive pumps (e.g. cyclists) Klippels-Trenaunay -
7
Q
Klippels-Trenaunay -
A
- PWS, varicose veins, limb hypertorphy
8
Q
Symptoms
A
Cosmetic defect Pain, cramping, haeviness Tingling Bleedin: may be severe Swelling
9
Q
Signs
A
skin changes: 1. Venous stars 2. Haemosiderin deposition 3. Venous eczema 4. Lipodermatosclerosis (paniculitis) Atrophie blanche
Ulcers: medial malleolus/gaiter area
Oedema
Thromnophlebitis
10
Q
Investigations
A
Duplex ultrasonography
- Anatomy
- Presence of incompetence
- Caused by obstruction or reflux
11
Q
Investigations for surgery
A
FBC U+E Clotting G+S CXR ECG
12
Q
Referral criteria
A
Bleeding Pain ulceration Superficial thrombophlebitis Severe impct on QOL
13
Q
CEAP classification
A
Chronic venous disease can be classified according to
- Clinical signs (1-6 + sympto or asympto)
- Etiology
- Anatomy
- PAthophysiology
14
Q
Conservative Mx
A
- Treat any contributing factors
- Education
- Class II graduated Compression stockings
- Skin care
15
Q
Contributing factors
A
Lose weight
Relieve constipation
