Vascular exam - varicose veins Flashcards
What would you inspect on the legs in a varicose vain examination?
- Observe gait
- Inspection - standing and lying down
- Venous dilatation and tortuosity
What features of venous insifficiency would you look for on the legs in a varicose vein examination?
- Venous eczema
- Haemosiderin deposits
- Lipodermatosclerosis - champagne bottle
- Venous ulcers
- Atrophe blanche
What characteristics would you want ot look for in venous varicose veins on inspection?
- Distribution
- Colour
- Prominence
What would you want to do when palpating as part of a varicose vein exm?
- Varicosities - palpate all the way along
- SFJ - feel for saphena varix, and ask to cough
- Elevate limb - venous emptying
- Trendelenberg test
- Calf tenderness
- Percuss and auscultate
Describe the trendelenberg test?
- Lift leg high and empty veins
- While leg elevated - apply tournique/thumb over SFJ
- Ask patient to stand
- Look for filling of veins
What would rapid filling of varicosities on trendelenberg test indicate?
Suggest incompetent perforater vein lies below the level of the tourniquet. If there is no filling, the incompetent perforator is above this level.
What else would you do when examining varicose veins once you have inspected, palpated, auscultated and percussed legs/varicose veins?
Examine for
- Pitting oedema
- Peripheral pulses
How would you complete a varicose vein examination?
Full abdominal and pelvic exam - look for masses causing venous obstruction
If you suspected varicose veins, what imaging would you suggest?
Duplex USS
