Varicose Veins Flashcards
what are varicose veins
they are superficial, permanently dilated veins
where do varicose veins occur
lower limbs
why do varicose veins occur
incompetence of the valves between the deep and superficial venous systems, resulting in retrograde flow and pooling of blood in the superficial venous system
aetiology (primary causes) of varicose veins
weakness in the vein wall; increased dilation and valvular incompetence
secondary causes of varicose veins
pregnancy, ovarian cysts, ascites, valve damage (DVT e.g.) or high flow
risk factors for varicose veins
age, female, family Hx, caucasian and obesity
presenting symptoms of varicose veins
cosmetic appearance, aching in legs, swelling, itching, bleeding, infection, ulceration
when will the aches be worst
at the end of the day; after standing for long periods of time
how will be the patient be (position) for physical examination for varicose veins
standing
what will suggest an arteriovenous fistula
palpable thrill or bruit on auscultation
what is the trendelenburg test
Allows localisation of the sites of valvular incompetence
Leg is elevated and the veins are emptied
A hand is placed over the saphenofemoral junction
The leg is put back down and filling of the veins is observed before and after the hand is released from the saphenofemoral junction
A Doppler ultrasound can be used to show saphenofemoral incompetence
what investigations will be done for someone with varicose veins
duplex ultrasound to exclude the presence of a DVT
3 categories of management of varicose veins
conservative, medical and surgical
conservative management of varicose veins
exercise to strengthen muscles, elevation of legs at rest and support stockings
medical management of varicose veins
laser sclerotherapy and microinjection sclerotherapy
