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Chirurgie > Vene > Flashcards

Vene Flashcards

1
Q

Reflexul brainbridge

A

Contractia reflexa a peretelui venos

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2
Q

Tipuri de varice

A
  1. Primitive/idiopatice/hidrostatice
  2. Secundare dobandite
  3. Secundare congenitale
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3
Q

Prevalenta varice:

A

Dupa 50 ani
Hispanice
Femei 28%
Barbati 15%

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4
Q

Factori favorizanti locali varice

A

Localizarea extrafasciala
Aparat valvular slab
Compresiuni externe (jantiere)

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5
Q

Factori favorizanti generali varice

A

Statiunea bipeda
Ereditatea
Tip constitutional (longilini cu hipotensiune arteriala, hipotonie venoasa)
Tulb endocrine
Obezitatea
Sarcina (hormoni, supraincarcare, presiune)

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6
Q

Factori declansatori varice

A

Ortostatism prelungit
Sport cu efort intens
Abandonare brisca sport
Mediu cald si umed
Carente alimentare
Toxici/infectiosi cu alterarea perete venos

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7
Q

Cauze varice secundare:

A

Congenitale:
Sd Klippel-trenauney (agenezie trunchiuri profunde)
Sd Parks-webber (fistule arterio-venoase congenitale)
Aplazia congenitala

Dobandite:
TVP
Tumori, Adenopatie, invazie, scleroza radica
Fistule arterio venoase traumatice
Ligaturi voite sau accidentale
Sd Trouseau(trombofleb migr)
Maladie Burger
Boala Mondor(tromboflebita toraco epigastrica post neoplasm mamar

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8
Q

Teorii ale fiziopatologiei varicelor

A

Hidrostatica(140 cm apa)
Parietala (def colagen si elastina)
Endocrina
Infectioasa

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9
Q

Debut boala vemoasa cronica

A

Insidios sau brusc (primare, secundare)

Simptome: parestezii, tensiune in molet, jena dureroasa gambe dupa ortostatism prelungit

Semne: edem discret, cianoza perimaleolara

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10
Q

Perioada stare boala venoasa cronica

A

Simptome:
durere gambiera in ortostatism ameliorata poz procliva
Claudicatoe venoasa mers
Impotenta functionala(grav)

Semne:
Varice care dispar in clinostatism sau permanente(secundare)
Dermatita pigmentara, cianoza, edem constant, pilozitate, celulita, lipidermatoscleroza, aspect marmorat.
Vene in evantai(avansat)
Ulcere indolore

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11
Q

Stadializare si clasificare varice

A

CEAP(clinic, etiologic, anatomic, patologic)
VSS: scorul severitatii venoase
VCSS: scor clinic de severitate
VDS: scor dizabilitate venoasa
Vss= vcss+vds

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12
Q

Imagistica varice

A

Ecografia doppler duplex
Fotopletismografie
Pletismografie aerica
CT subst contrast
Venografie RMN
Flebografie retrograda
Flebomanometrie
Eco intravenos

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13
Q

Diagnostic diferential varice primitive

A

Varice sec tvp, sd posttr.
Hernie femurala
Adenopatie inghinala
Anevrism femurala
Hernie tibial anterior
Fistula arteriovenoasa
Alte cauze edem
Chist baker rupt
Ulcer artrial
Varice congenitale

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14
Q

Sd klippel-trenaunay

A

Varice unilaterale, fata externa coapsa, nu se golesc, circulatie colaterala
Nevi pe membre
Hipertrofie membru

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15
Q

Sd parkes-weber

A

Evolutie in pusee, in adolescenta, varice pe o retea superficiala
Suflu si tril

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16
Q

Complicatii varice

A

Ruptura
Tromboflebita varicoasa
Dermatita pigmentara
Hipotensiune ortostatica
Ulcer varicos( putin sau deloc dureros, mediotibial, cu margini dure, neregulate, scleroase, fund cu muguri carnosi, secretie mudara, fibrina

17
Q

Terapie interventionala varice

A

Injectii sclerozante
(asimptomatice, valva ostiala continenta, insuf safena mica, nesistematizate, subcutanate)

Terapie laser transcutanata
(Venectazii, varice mici)

Scleroterapia cu spuma
(Venectazii)

Ablatie endovenoasa laser/radiofrecv.

Stentare

18
Q

Cura chirirgicala varice

A

Contraindicatii: varice secundare simpt, cardiopati, neoplasme, sarcina, tare decompensate, aco

Babcock: stripping
Narath: etajate
Terier: incizie continua
Moderne: revalvulari, endochirurgie, chiva, chirurgie subfasciala endoscopica
Ablatia subcutanata a perdorantelor

19
Q

Ingrijire postoperatorie varice

A

Mobilizare precoce, hmmg
Bandaj compresiv
Compresie externa 3-4 s
Evitare ortostatism prleungit 3 kuni

20
Q

Cauze favorizante varicocel stg(idiopatic):

A

-varsare in v renala unghi 90°
-lungime mai mare v spermatica stg
-lipsa valvelor
-comprimare de catre colon stg
-ortostatism prelungit
-longilini

21
Q

Microscopie varicocel:

A

Cresc serotli, cresc leydig

22
Q

Stadializare varicocel

A
  1. Dilatatia nu coboara sub polul sup testicul decat la valsalva
  2. Dilatatia coboar sub polul superior in orto, reflex cremasterian diminuat
  3. Dilatatie mare, refelx disparut, testicul atrofic
23
Q

Tratament medical varicocel

A

In faze incipiente:
Supensor
Exercitii kegel
Venotonice
Ains
Diminuare ortostatism
Evit constip, efort
Psihoterapie

24
Q

Tratament interv si chir varicocel

A

Embolizare venoasa percutanata

Varicocelectomie
Rezectie hemiscrot
Suspensie interna testicul
Plastii musculoaponevrotice
Ligatura inalta vene spermatica

Tehnici microchirurgicale- -standard actual
Laparoscopic

Chirurgie (16 decks)

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