Venous Disorders

Question 1

What is Morrissey Cough impulse?

Answer 1

• The limb is elevated to empty the vein, and then patient is asked to cough.
• If an expansile impulse in felt in the long saphenous vein, means saphenofemoral valve is incompetent

Question 2

Brodie- Trendelenburg test is positive in?

Answer 2

• incompetency of the sapheno-femoral jn.

- incompetency of the perforators or communicating veins

Question 3

What is Brodie- trendelenburg test?

Answer 3

It is performed in 2ways:

• In both the methods, patient is first placed in recumbent position and his legs are raised to empty the veins.
• The sapheno-femoral junction(SFJ) is now compressed with the thumb of clinician and patient is asked to stand up quickly

1st method: The pressure on SFJ released—> The varices fill very quickly by a column of blood from above—>Indicates INCOMPETENCE OF SFJ

2nd method: The pressure on SFJ is not released—> The varices fill gradually—> INDICATED INCOMPETENCE OF PERFORATOR VEINS

Question 4

What is three tourniquet test?

Answer 4

3 tourniquets are ties, 1st at thigh below SFJ, 2nd below knee and 3rd just above knee
- now patient is asked to standup and appearance of varicosity is looked for, within 30 sec in each segment.
The leg is also observed for retrograde filling of distal segment, after removal of tourniquets one by one by below upwards, the exact levels of perforators can thus be assessed