Peripheral Venous Flashcards
The following vein is a component of the superficial venous system A. Common femoral vein B. Posterior tibial vein C. Popliteal vein D. Great saphenous vein
D. The great saphenous vein is part of the superficial system in the lower extremities. The common femoral, posterior tibial, and popliteal veins are all part of the deep system of the lower extremities.
In relation to arteries and veins which statement is true?
A. Only veins have internal valves
B. Arteries have a much higher internal pressure
C. Arteries and veins both have a tunica intima, media, and adventitia
D. All of the above
D. Only veins have internal valves, arteries do not. The internal pressure of the arterial system is much higher than that of the venous system. Both arteries and veins have three distinct layers known as the tunica intima, media, and adventitia.
The common femoral vein becomes the external iliac vein above the level of what structure? A. Adductor canal B. Inguinal ligament C. Profunda hiatus D. Popliteal fossa
B. Above the inguinal ligament is the anatomical landmark where the common femoral vein becomes the external iliac vein.
A normal venous spectral waveform of the lower extremities is A. Phasic B. Continuous C. Pulsatile D. Bidirectional
A. A normal spectral waveform for the lower extremity veins should be phasic with changes in respiration and in one direction. Pulsatile waveform suggest increased pressure in the venous system while continuous waveforms suggest the presence of a more proximal obstruction.
The deep vein that runs along the lateral portion of the lower leg between the tibia and fibula and joins the tibioperoneal trunk is the A. Posterior tibial vein B. Anterior tibial vein C. Peroneal vein D. Gastrocnemius vein
B. The deep vein that runs along the lateral aspect of the lower leg between the tibia and fibula is the anterior tibial vein. The posterior tibial vein runs along the medial aspect of the lower leg.
The paired posterior tibial veins in the lower leg join in the upper portion of the calf to form the A. Tibioperoneal trunk B. Common peroneal trunk C. Common tibial trunk D. Soleal sinuses
C. The common tibial trunk is formed in the upper calf by the paired posterior tibial veins. The common peroneal trunk is formed by the paired peroneal veins. These two common trunks eventually join to form the tibioperoneal trunk higher in the calf.
The innermost layer of the vein wall is known as the tunica A. Media B. Adventitia C. Intima D. Superficial
C. The innermost layer of the vein wall is the tunica intima. The middle layer is the tunica media and the outermost layer is the tunica adventitia.
Which of the following best describes a normal waveform of the brachiocephalic veins? A. Phasic B. Pulsatile C. Continuous D. Oscillating
B. The normal spectral waveform for the brachiocephalic vein is pulsatile because of its close proximity to the heart. Upper extremity veins that are further from the heart such as the axillary vein will be more phasic.
The vein that runs along the lateral aspect of the upper extremity and joins the axillary vein just before becoming the subclavian vein is known as the A. Cephalic vein B. Brachial vein C. Basilic vein D. Innominate vein
A. The cephalic vein runs along the lateral aspect of the arm until terminating in the axillary vein just before it becomes the subclavian. The basilic vein runs along the medial aspect of the arm and terminates at the axillary vein. The brachial vein is located in the upper arm and eventually becomes the axillary vein at the level of the axilla.
All of the following veins contain internal valves EXCEPT the A. Internal jugular vein B. Brachial vein C. Brachiocephalic vein D. Cephalic vein
C. There are no internal valves located in the brachiocephalic veins. The internal jugular, brachial, and cephalic veins all contain internal valves.
Which perforators connect to the posterior accessory great saphenous vein and typically play a significant role in regard to venous stasis ulcers? A. Paratibial perforator B. Perforator of femoral canal C. Superficial epigastric vein D. Posterior tibial perforator
D. Posterior tibial perforators connect to the posterior accessory great saphenous vein near the gaiter zone just above the medial malleolus. They commonly play a significant role in venous stasis ulcerations.
During expiration, as abdominal pressure decreases and thoracic pressure increases
A. There is no significant change in venous blood flow return
B. Venous blood flow return in the lower extremities increases while decreasing in the upper extremities
C. Venous blood flow return in the lower extremities decreases while increasing in the upper extremities
D. Flow is suspended in both the upper and lower extremities
B. Flow always goes from an area of higher pressure to an area of lower pressure. The pressure in the abdomen decreases as a person exhales. This causes venous flow to increase in the lower extremities. At the same time the pressure in the chest increases causing venous flow in the upper extremities to decrease. The opposite is true when a person inhales.
Most deep venous thrombi become established in the A. Groin B. Thigh C. Calf D. Foot
C. The majority of DVTs become established in the calf veins, specifically in the soleal sinusoids. However, DVT can develop in any deep vein.
The condition involving an outflow obstruction of the venous system that presents with extreme swelling, cyanosis, and reduced arterial inflow is known as A. Dependent rubor B. Phlegmasia alba dolens C. Phlegmasia cerulea dolens D. Venous insufficiency
C. Phlegmasia cerulea dolens is an outflow obstruction with extreme swelling accompanied by cyanosis and reduced arterial inflow. Phlegmasia alba dolens is an outflow obstruction with extreme swelling without cyanosis and reduced arterial inflow.
Which location of DVT is more likely to travel to the lung as a pulmonary embolus? A. Peroneal vein DVT B. Common femoral vein DVT C. Posterior tibial vein DVT D. Gastrocnemius vein DVT
B. The common femoral vein DVT is more likely to travel to the lung as a pulmonary embolism because it is located above the knee. DVT located above the knee is more likely to become a PE.
The three predisposing conditions known as “Virchow’s Triad” are
A. Trauma, hypertension, and hypercoagulability
B. Trauma, sclerosis, and hypercoagulability
C. Thrombosis, stasis, and hypertension
D. Trauma, stasis, and hypercoagulability
D. The three conditions that make up Virchow’s Triad are trauma, stasis, and hypercoagulability.
All of the following are classic symptoms of deep vein thrombosis EXCEPT A. Pain B. Edema C. Paralysis D. Redness
C. Paralysis is a symptom more related to arterial disease or stroke like symptoms. Pain, edema, and redness are all symptoms related to DVT.
When the calf-muscle pump and venous valves become inadequate at returning blood back to the heart it leads to the pooling of blood in the lower extremities. A condition known as A. Deep vein thrombosis B. Phlegmasia alba dolens C. Phlegmasia cerulea dolens D. Venous insufficiency
D. Venous insufficiency is the condition in which blood return back to the heart is inadequate. It leads to the pooling of blood in the distal veins which leads to increased pressure in the venous system.
An ascending venogram is used to evaluate for A. Thrombosis B. Venous insufficiency C. Baker's cyst D. Varicose veins
A. Ascending venograms are used to evaluate for an obstruction caused by thrombosis. Descending venograms are used to evaluate for incompetent valves.
After initial treatment of deep vein thrombosis patients are often treated with oral anticoagulation in an effort to
A. Serve as a thrombolytic
B. Prevent chronic scarring of the vein lumen
C. Prevent reoccurrence
D. Prevent post thrombotic syndrome
C. Oral anticoagulation is initiated after the initial treatment with heparin for a DVT in an effort to prevent reoccurrence. The duration of treatment will vary depending on the patient’s condition and circumstances. It cannot prevent scarring or post thrombotic syndrome nor can it serve as a thrombolytic.
All of the following are sonographic findings associated with chronic post thrombotic scarring EXCEPT A. Partially compressible B. Hyperechoic C. Recanalization lumen D. Dilated vein
D. Dilated vein is not a finding associated with chronic post thrombotic scarring. The findings that are associated with chronic changes are increase in echogenicity, attached to vein wall, larger collateral veins, contracted vein, and recanalization of vein.
While scanning a patient’s upper extremity veins you obtain a phasic spectral Doppler waveform within the right subclavian vein and a pulsatile spectral Doppler waveform within the left subclavian vein. What does this suggest?
A. An obstruction proximal to the left subclavian vein
B. An obstruction proximal to the right subclavian vein
C. An obstruction distal to the left subclavian vein
D. An obstruction distal to the right subclavian vein
B. Normally subclavian veins have pulsatile flow with some respiratory patterns. Lack of pulsatility in a subclavian vein indicates a proximal obstruction on the side with the phasic waveform.
