Venous Diease

Question 1

How does respiration affect the lower extremities?

Answer 1

inhale=flow is reduced
exhale=flow occurs

Question 2

How does respiration affect the upper extremities?

Answer 2

inhale=flow occurs
exhale=flow is reduced

Question 3

How do muscle impact venous flow?

Answer 3

the contraction of arm/leg muscles squeezes veins and propels blood towards the heart

Question 4

What are muscles aka?

Answer 4

venous heart

Question 5

What is superficial thrombophlebitis?

Answer 5

a blood clot in a superficial vein
(GSV, LSV, cephalic, basilic)
often caused by trauma

Question 6

What is cellulitis?

Answer 6

inflammation of cellular or connective tissue

often caused by bacterial infection

Question 7

What is edema?

Answer 7

when body tissue contains excess fluids

Question 8

What are the 2 types of edema?

Answer 8

1. Pitting
2. Non pitting

Question 9

What is pitting edema?

Answer 9

when fluid is displaced when pressure is applied

Question 10

What is non pitting edema?

Answer 10

when tissue is so swollen the fluid does not move with pressure (much worse)

Question 11

What is a deep venous thrombosis (DVT)?

Answer 11

blood clot within deep veins
causes increased venous pressure
stretches walls
damages valves

Question 12

Where do DVTs most commonly occur?

Answer 12

calf or where IVs were placed in UE

Question 13

What is Virchows Triad (causes of DVT)?

Answer 13

1. Trauma to vessel
2. Venous stasis (bedrest, obesity, etc)
3. Hypercoagulability (hormone therapy, chemo)

Question 14

What are the signs and symptoms of acute DVT?

Answer 14

• swelling
• pain
• erythema (redness)
• warmth

Question 15

What does acute DVT look like?

Answer 15

-hypo echoic appearance
-spongy
-dilated vessel
-thrombus poorly attached
-abnormal doppler
-vein not compressible

Question 16

What does chronic DVT look like?

Answer 16

-echogenic
-thrombus adhered to wall
-collaterals (alt path) may be present
-recanalization (reopening) may be present

Question 17

What are the signs and symptoms of chronic venous disease?

Answer 17

-swelling
-pain
-erythema
-discoloration
-brawny (brown)
-ulcerations

Question 18

What are the characteristics of a venous ulcer?

Answer 18

-near medial malleolus
-mild pain
-shallow, irregular shape
-oozing
-brawny, varicosities

Question 19

What are the characteristics of an arterial ulcer?

Answer 19

-near bony areas
-severe pain
-deep, round shape
-little bleeding
-shiny skin, loss of hair, thickened toenails

Question 20

What does venous reflux disease consist of?

Answer 20

1. valves become damaged/diseased
2. reflux/backflow occurs
3. pooling of blood causes pressure
4. surface veins dilate (varicose veins)

Question 21

What are the 2 types of varicose veins?

Answer 21

Primary and secondary

Question 22

What are primary varicose veins caused by?

Answer 22

-hereditary
-congenital absence of valves

Question 23

What are secondary varicose veins caused by?

Answer 23

caused by previous vein condition (DVT, obesity, pregnancy)

Question 24

What are the treatments for leaky valves?

Answer 24

elevation, compression stockings, surgery

Question 25

What do filters do?

Answer 25

protects pt from PE by trapping traveling emboli

Question 26

What are the LE venous duplex veins being scanned?

Answer 26

-distal iliac
-popliteal
-peroneals
-lesser saphenous
-common femoral
-posterior tibials
-great saphenous
-gastrocnemius

Question 27

What is the most important thing in a venous duplex exam?

Answer 27

compressibility

Question 28

What is spontaneous and phasic flow?

Answer 28

when flow occurs on its own or with respirations without manual augmentation

Question 29

What is augmentation?

Answer 29

increase in flow caused by manual compression, abrupt ‘gush’

Question 30

What is the protocol for UE venous duplex?

Answer 30

-internal jugular
-subclavian (prox and dist)
-axillary
-brachial (2)
-radial (2)
-ulnar (2)
-basilic (above and below elbow)
-cephalic (above and below elbow)

Question 31

What UE veins are very pulsatile?

Answer 31

jugular and subclavian

Question 32

What is a contrast venography?

Answer 32

-aka venogram
-‘gold standard’ of venous testing
-contrast injected in foot then serial x-rays (fluoroscopy) are taken
-filling defect indicated thrombus