Peripheral Venous Disease Flashcards
what are Varicose veins?
long, tortuous and dilated veins of the superficial venous system.
Blood from the superficial veins of the leg passes into the deep veins via ______ veins and at the _____-femoral and ______-popliteal junctions.
Blood from the superficial veins of the leg passes into the deep veins via perforator veins and at the sapheno-femoral and sapheno-popliteal junctions.
what do valves do?
prevent blood from passing from deep to superficial veins.
what happens if the valves become incompetent?
there is venous hypertension an dilatation of the superficial veins occurs.
what are the risk factors for varicose veins? 5
prolonged standing, obesity, pregnancy, family history and the pill.
what are secondary varicose veins?
those developing as collateral pathways, typically after stenosis or occlusion of the deep veins, a common sequel of extensive deep venous thrombosis (DVT)
what are the primary causes of varicose veins?
- unknown
- congenital valve absence
what are the secondary causes of varicose veins?
- obstruction
- valve destruction: DVT
- arteriovenous malformation (increased pressure )
- constipation
- overactive muscle pumps (eg cyclists)
what are some obstructive causes of varicose veins?
DVT, fetus, ovarian tumour
why do you get varicose veins following a DVT?
DVT is a condition that can increase the deep veins pressure - eg from occlusion or deep valve incompetence
what are the symptoms of VV?
Pain, cramping, tingling, heaviness and restless legs
what are the signs of VV?
- dilated and tortuous superficial veins
- Oedema, eczema, ulcers, haemosiderin, haemorrhage, phlebitis
- atrophie blanche
what is atrophie blanche?
white scarring at the site of a previous, healed ulcer
VV are more prominent standing up, true/false/
true
where can VV occur?
in groin or behind the knee
what should be inspected for when examining VV?
- ulcers with deposition of haemosiderin
what should be palpated for when examining VV?
veins for tenderness and hardness
pulses to rule out arterial disease
what would a hard vein indicate?
thrombosis
what would a soft vein indicate?
phlebitis
what do doppler sound probes do?
listen for flow in incompetent valves
under what circumstances should patient’s be referred to specialists?
if patients have : bleeding, pain, ulceration, superficial thrombophlebitis or a ‘severe impact on QoL’.
what should management of vv comprise of?
treat the underlying cause
education
intervention
what should patients be educated on?
- they should avoid prolonged standing and elevate leg wherever possible
- support stockings
- lose weight
- regular walks
what are support stockings used for?
to prevent ulcers / symptoms
