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Cardiovascular System > Venous and Lymphatic Disease > Flashcards

Venous and Lymphatic Disease Flashcards

1
Q

Varicose vein

A

A dilated and tortuous vein

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2
Q

Varicose veins are often which kind of vein

A

Superficial

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3
Q

Varicose veins are most commonly found in

A

The lower limbs

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4
Q

Varicose veins are usually found in the

A

Saphenous veins

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5
Q

Factors that assist flow of blood in the veins back to the heart

A

Valves
Calf muscle pump
Perforating veins to drain blood into the deep system

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6
Q

Blood is drained into the deep veins because

A

They are within muscular compartments and can withstand higher pressure

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7
Q

Causes of valvular failure

A

Surgical or traumatic disruption of valve
DVT - obstruction
Hormonal changes during pregnancy cause weakness
Large pelvic tumour

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8
Q

Effects of one valve failing

A

Venous pressure increase
Dilation of the distal veins
Further valvular incompetence

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9
Q

Risk factors of varicose veins

A 
Age
Female
Pregnancies
DVT
Standing for long periods
Family history
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10
Q

Symptoms of varicose veins

A

Burning
Itching
Heaviness
Tightness

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11
Q

Examination findings of varicose veins

A 
Swelling
Discolouration
Phlebitis - inflammation 
Bleeding
Disfiguration
Eczema
Ulceration
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12
Q

Special test for diagnosing varicose veins

A

Tap test
Trendelenburg/tourniquet test
Doppler

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13
Q

Tap test

A

Place one hand over the saphenofemoral junction and other over the long saphenous vein above the knee
Tap the saphanofemoral junction - a transmitted impulse at the knee indicates incompetence of the valves between the two hands

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14
Q

Trendelendburg/tourniquet test

A

Drain superficial veins by raising the leg
Apply pressure over the saphenofemoral junction and keep it on as patient stands
On release if the veins refill then the saphenofemoral junction valve is incompetent
Tourniquet is same but with tourniquet instead of hands

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15
Q

Doppler

A

Hold doppler probe over the saphenofemoral junction
Squeeze calf muscles
Hear a ‘whoosh’ as the blood flows upwards into the deep system if competent superficial veins.
Hear two waves if incompetent.

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16
Q

Investigations for varicose veins

A

Special tests

Ultrasound

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17
Q

Varicose veins C0

A

No visible or palpable signs of venous disease

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18
Q

Varicose veins C1

A

Teleangiectasies or reticular veins

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19
Q

Varicose veins C2

A

Varicose veins

20
Q

Varicose veins C3

A

Oedema

21
Q

Varicose veins C4a

A

Pigmentation or eczema

22
Q

Varicose veins C4b

A

Lipodermatosclerosis or atrophie blanche

23
Q

Varicose veins C5

A

Healed venous ulcer

24
Q

Varicose veins C6

A

Active venous ulcer

25
Q

What classification of varicose veins qualifies you for treatment

A

C3 or above

26
Q

Treatment should be given to patients complaining of varicose veins that are

A 
Bleeding
Symptomatic
Recurrent symptomatic
Lower limb skin changes of chronic venous insufficiency 
Superficial venous thrombosis
Venous leg ulcer
27
Q

First line management of varicose veins

A

Endovenous treatment

28
Q

Second line management of varicose veins

A

Ultrasound guided foam sclerotherapy

29
Q

Third line management of varicose veins

A

Open surgery

30
Q

If intervention of varicose veins in unsuitable, offer

A

Compression hosiery

31
Q

Intervention of varicose veins shouldn’t be offers if

A

Deep venous system is obstructed eg DVT or pregnancy

32
Q

Endovenous treatment

A

Injury to vein wall via heat or laser resulting in fibrosis and occlusion of the vein and so ablation

33
Q

Complications of endogenous treatment

A

Skin burns
Paraesthesiae
Phlebitis
DVT

34
Q

Foams sclerotherapy

A

Chemical foam injected into affected vein, damaged the venous walls causing fibrosis, occlusion and ablation

35
Q

Complications of foams sclerotherapy

A

Foam migration - causes potential complications of stroke, TIA or MI
Thrombophlebitis
Skin pigmentation

36
Q

Open surgery

A

Removal of saphenous vein

37
Q

Complications of open surgery

A

Anaesthetic risk
Wound infection
Damage to nearby nerves
Bleeding

38
Q

Venous insufficiency causes

A

Failure of calf muscle pump
Superficial venous reflux
Deep venous reflux
Venous obstruction

39
Q

Pathophysiology of venous insufficiency

A

Insufficiency - venous hypertension - endothelial leak - oedema - increase perfusion distance - impaired healing - inflammation - fibrinogen, tissue damage - impaired tissue perfusion

40
Q

Examination findings on chronic venous insufficiency

A 
Oedema
Telangiectasia
Eczema
Haemosiderin pigmentation - orange
Hypopigmentation - white
Lipodermatosclerosis
Ulceration
41
Q

Features of venous ulcers

A 
In gaiter area
Granulomatous (red) base
Shallow
Irregular margins
Exudative, oedematous
Painless
Pulses present
42
Q

Features of arterial ulcers

A

Defined borders
Smaller and deeper
Painful
Food on anterior skin, under heel, around malleolus

43
Q

Features of neuropathic ulcers

A

Can’t feel them

Found at metatarsal head, under heel, around malleolus

44
Q

Investigation of chronic venous insufficiency

A

Ankle-brachial pressure index (ABPI) - excludes arterial disease

45
Q

Treatment of chronic venous insufficiency

A

Wound care - antibiotics
Elevation
Compression bandaging
Shockwave therapy

46
Q

Secondary causes of lymphoedema

A

Malignancy
Surgery
Radiotherapy
Infection

47
Q

Treatment of lymphoedema

A

Elevation
Drainage
Compression bandaging

Cardiovascular System (27 decks)

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