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Vascular Sonography > Intro to Lower Extremity Vessels > Flashcards

Intro to Lower Extremity Vessels Flashcards

1
Q

What type of vein has a companion artery?

A

Deep veins

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2
Q

What type of vessel connects the deep and superficial venous system?

A

Perforating vein

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3
Q

What are examples of lower extremity superficial veins?

A

1.GSV
2. SSV

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4
Q

When does the external iliac become the common femoral artery?

A

At the inguinal ligament or groin crease

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5
Q

What does the common femoral artery divide into?

A
  1. Profunda femoris artery (deep femoral artery)
  2. Superficial femoral artery or femoral artery
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6
Q

When does the femoral artery turn into the popliteal artery?

A

At the knee crease and behind the knee

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7
Q

What does the popliteal artery bifurcate into?

A
  1. Tibio-peroneal trunk
  2. Anterior tibial
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8
Q

What does the tibio-peroneal trunk branch into?

A
  1. Posterior tibial artery
  2. Peroneal arteries
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9
Q

What does the anterior tibial artery become?

A

Dorsalis pedis artery

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10
Q

What does the posterior tibial artery become?

A

Medial and lateral plantar artery

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11
Q

Many of the collaterals that bypass the superficial femoral or popliteal artery occlusions arise from what artery?

A

Profunda femoris AKA deep femoral artery

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12
Q

What is the longest vein in the body?

A

Great saphenous vein (GSV)

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13
Q

What two veins drain into the common femoral vein?

A
  1. Femoral vein
  2. Deep femoral V.
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14
Q

What are the main superficial veins in the lower extremity system?

A
  1. Great saphenous vein (unites at CFV)
  2. Small saphenous vein (unites at popliteal V.)
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15
Q

Where does the GSV terminate?

A

GSV terminates into the common femoral vein at the sapheno-femoral junction

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16
Q

Does the SSV course anteriorly or posteriorly to the calf?

A

Posteriorly

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17
Q

Where does the SSV terminate?

A

SSV terminates into the popliteal vein at the sapheno-popliteal junction

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18
Q

What veins drain into the tibio-peroneal trunk?

A
  1. Posterior tibial V.
  2. Peroneal V.
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19
Q

What veins are included in the deep venous system?

A
  1. Femoral V and DFV
  2. Popliteal V
  3. Anterior tibial V
  4. Posterior tibial V
  5. Peroneal V
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20
Q

What vein does the peroneal vein join with?

A

Posterior tibial at the tibio-peroneal trunk

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21
Q

What does the anterior tibial vein drain into?

A

Popliteal vein

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22
Q

What does the common femoral vein drain into?

A

External iliac V.

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23
Q

The calf muscle pump aids in the return of blood from the legs against what type or force?

A

Force of gravity or hydrostatic pressure

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24
Q

How much pressure does the calf muscle generate upon contraction?

A

200 mmHg

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25
Q

Function of perforating veins?

A

Perforating veins in the superficial system can drain blood into the deep system but not the other way around

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26
Q

When is blood from the perforating veins of the superficial system drained into the deep system?

A

During relaxation

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27
Q

When are valves closed in perforating veins?

A

During contraction so blood cannot travel from the deep system to the superficial system

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28
Q

What determines primary varicose veins?

A

Incompetent valves with the ABSENCE of a DVT

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29
Q

What are primary varicose veins usually caused by and in what veins?

A

Incompetent valves in the common femoral V and GSV

30
Q

What determines secondary varicose veins?

A

When varicose veins occur due to a chronic DVT where valves become destroyed over time

31
Q

Valves in what system are incompetent with primary varicose veins?

A

Valves in the superficial venous system

32
Q

Valves in what system are incompetent with secondary varicose veins?

A

Superficial
Perforating
Deep

33
Q

Venous stasis ulcers occur due to what?

A

Persistent increased venous pressure

34
Q

Varicose veins in pregnancy cause increased pressure + compliant veins = ?

A) venous distension + decreased blood return to the heart

B) venous distension + increased blood return to the heart

C) venous non-compliance + decreased blood return to the heart

D) venous non-compliance + increased blood return to the heart

A

A) venous distension + decreased blood return to the heart

35
Q

What is the main purpose of deep veins?

A

To return blood to the heart

36
Q

Why are thrombi likely to become dislodged in deep veins?

A

Since deep veins travel within the muscle, it is more likely the thrombus will become dislodged due to the movement of muscle with activity

37
Q

Is a thrombus found in a deep vein or superficial vein usually largest?

A

Deep vein

38
Q

Is a thrombus from a deep vein or superficial vein more life threatening to cause a pulmonary embolism?

A

Deep vein as it is responsible for returning blood directly to the heart and more potential for it to travel to the pulmonary artery

39
Q

What is the main purpose of superficial veins?

A

To regulate body temperature as blood travels close to the body surface

40
Q

When body temperature needs to be conserved, what happens to the superficial veins?

A

Contract to shunt blood away from the skin

41
Q

What is the role of a perforator vein?

A

To move blood from the superficial to the deep system where blood is returned to the heart

42
Q

What does VTE stand for?

A

Venous thrombo-embolism

43
Q

What is known as the primary mechanism for the formation of venous thrombosis?

A

Virchow’s triad

44
Q

What does Virchow’s triad consist of?

A
  1. Venous stasis
  2. Hypercoagulability
  3. Damaged vessel walls
45
Q

DVT’s very commonly begin where?

A

Soleal sinus veins in the calf due to slower flow in that area

46
Q

What are signs and symptoms of VTE

A
  1. Venous obstruction
  2. Inflammation
  3. Thrombus embolization
47
Q

What symptoms are consistent with pulmonary embolism?

A

Tachycardiac

Tachypnea

Chest pain

48
Q

What levels in the blood will be high in the presence of a clot?

A

D-dimer: a breakdown product of fibrin

49
Q

What is D-dimer?

A

A breakdown product of fibrin that is present with a DVT

50
Q

What position should the bed be for a lower extremity vein exam?

A

Reverse Trendelenburg

51
Q

Which leg vein may be a bifid system?

A

Femoral vein

52
Q

What veins are near the tibia?

A

Posterior Tibial Veins

53
Q

What veins travel adjacent to the fibula?

A

Peroneal veins

54
Q

One of the major storage areas for blood in the calf is a network of veins called?

A

Soleal sinus veins

55
Q

What should spectral doppler look like in a normal vein?

A

Phasic with respiration

56
Q

When a thrombus forms in a vein, what happens to the resistance and pressure?

A

They both increase

57
Q

What should be suspected if continuous flow is seen and does not change with respiration?

A

A proximal thrombus

58
Q

What disorder occurs with the compression of the left common iliac vein by the right common iliac artery, leading to restricted blood flow?

A

May-Thurner syndrome

59
Q

What disorder is associated with marked swelling of the lower extremity, pain, pitting edema, and blanching, but no ischemia is present?

A

Phlegmasia alba dolens

60
Q

What disorder is also known as milk leg or white leg?

A

Phlegmasia alba dolens

61
Q

In what LEV disorder does massive swelling and cyanosis occur?

A

Phlegmasia cerulean dolens

62
Q

What is the most common incidental finding in a LEV exam?

A

Hematoma

63
Q

Popliteal fossa cysts are also known as?

A

Baker’s cysts

64
Q

What does NOAC stand for?

A

New oral anti-coagulants

65
Q

Patient presents with UNILATERAL pulsatile flow, what would this indicate?

A

AVF

66
Q

Patient presents with BILATERAL pulsatile flow, what would this indicate?

A

Venous congestion

67
Q

Patient presents with retrograde flow, what would this indicate?

A

Reflux - incompetent valves

68
Q

T or F? Phlegmasia cerulean dolens is associated with pregnancy?

A

FALSE: Phlegmasia alba dolens is associated with pregnancy

69
Q

What kind of waveform will appear with a proximal thrombus?

A

Non-phasic, Continuous flow

70
Q

When does blood flow from the superficial system through the perforator veins and into the deep system in the calf?

a. During contraction
b. During relaxation
c. At rest

A

During relaxation

71
Q

In secondary DVT, what veins act as collaterals?

A

Superficial veins

72
Q

T or F? Pregnancy causes varicose veins?

A

FALSE: the increase in venous pressure and venous distension brings about predisposing factors

Vascular Sonography (17 decks)

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