Vascular Ulcers & Varicose veins Flashcards
MC of Venous ulcers
Incompetent venous valves that prevent efficient venous return from LE
What SXS in pts would indicate possible venous ulcer?
Signs of venous insufficiency
- Varicose veins
- Venous stasis dermatitis
- Heaviness & pain in legs that gets better with elevation
- Edema
- Usually painless
Venous Stasis Dermatitis
Deposition of hemosiderin –> Hyperpigmentation
MC location of venous ulcers
Medial aspect of ankle & calf
- Can be anywhere between ankle & knee tho
Best initial assessment of venous insufficiency w/ venous stasis ulcers
Doppler duplex scan/ Duplex ultrasound
Tx of venous ulcers
- Elevation
- Compression stockings
- Unna’s boot - compression dressing w/ zinc oxide for healing
MCC of Arterial ulcers
Occlusive arterial disease
RFs/ Indications for Arterial Ulcers
- Smoking
- HTN
- Hypercholesterolemia -
- Diabetes
When is symps of arterial ulcers worse?
Night- Dec perfusion
- Leg pain
Best initial assessment of Arterial Ulcers
Ankle Brachial Index (ABI)
MC location of Arterial ulcers
Dorsum of toes, feet & ankle
Sites of increased pressure
Appearance of Arterial ulcers
“Punched-out”
Wound base of Arterial ulcers
Necrotic tissue
Appearance of Venous ulcers
Shallow w/ irregular margins
Wound base of Venous ulcers
Granulation tissue
MC form of venous disease in the LE
Varicose veins
Varicose veins
Distention of the tortuous superficial veins d/t incompetent valves in the deep, superficial or perforator systems.
MC site of incompetent valves (varicose vein)
- Saphenous veins & its tributaries
- Esophagus
- Anorectum
- Scrotum
RFs for developing varicose veins
- Inc. age
- Female
- OCP use
- Pregnancy
- DVT
Dx of Varicose veins
Based on clinical & physical findings
- Visible long, dilated & tortuous superficial veins along thigh & leg
- Evidence of venous stasis - ulceration, hyperpigmentation, and induration
- Heavy sensation in leg
What test is pts. w/ varicose veins positive for?
Brodie- Trendelenburg test/ Valvular competence test
Brodie- Trendelenburg test/ Valvular competence test
Pt. supine –> raise leg and compress saphenous vein @ thigh —> Pt. stand –> veins fill quickly from top down –> INCOMPETENT VALVES
Best initial management of varicose veins
Conservative measures
- Leg elevation
- Compression stocking
Other management for varicose veins
- Injection Sclerotherapy
- Laser ablation
Superficial thrombophlebitis
Inflammation or thrombosis of superficial veins that causes pain
CFs of Superficial Thrombophlebitis
- Palpable cord
- Pain
- Mild fever
Associations of Superficial Thrombophlebitis
- Varicose vein in LE
- Site of IV infusion in UE
Tx of Uncomplicated Superficial Thromboplebitis
- Warm compression
- Aspirin
What should never be used for Tx of S. Thrombophlebitis?
ANTICOAGULATION
Why is anticoagulation never used for Tx of S. Thrombophlebitis?
BC it is not a RF for PE or DVT
