Venous evaluation Flashcards
the paired deep veins of the arm and forearm follow the arteries are called what?
venae comitantes( cooresponding veins)
the radial and ulnar veins unite to for what?
brachial veins
the paired brachial veins become the ________ usually near the armpit
axillary vein
another landmark fot he brachials becoming the axillary is where the brachial and _ veins join
basilic
the axiallary vein becomes the ____ vein when it is joined by the cephalic vein, usually near the lateral border of the first rib
subclavian vein
the subclavian vein joins the internal jugular to form the ?
brachiocephalic or innominate
the veins are collapsible tubes that expand in response to increased ? aka as?
transmural pressure aka distension pressure
_______ valves are structural elaborations of the intimal layer that keeo the blood flowing in only one direction.
bicuspid valves
What is intraluminal pressure?
pressure exerted on the venous walls from within the vein
what is interstitial pressure? aka ?
interstitial pressure called transmural pressure
___________ _________ is equivalent to the weight of a column of blood extending from the heart to the level where the pressure is being measured
hydrostatic pressure
what is the formula for hydrostatic pressure?
HP=pgh hysrostatic pressure= specific gravity of blood (p) acceleration due to gravity (g) and distance from the hear (h)
what is the hydrostatic pressure when a patient is supine?
ommHg
what is the hydrostatic pressure measure at the ankles when the patient is standing?
100 mmHg
the development of venous thrombosis is based on 3 groups of risk factors know as?
virchow’s triad
what are the three groups of virchows triad?
trauma, venous stasis, hypercoagulability
___________ is predominantly composed of red blood cells trapped with in a fibrin web, frequently originate at the cusps of the venous valves or in the doleal sinus
intraluminal thrombi
_________ syndrome aka as ______ usually involves thrombosis of the subclavian or axillary vein secondary to intense repetitive activity
Paget- schroetter syndrome, aka stress or effort thrombosis
what is May thurner syndrome?
left common iliac vein compression by by the right common iliac artery as the artery crosses over it
What is compression of the left renal vein called?
nutcracker syndrome, squished between the AO and the SMA
the combination of chronic swelling, brawny discoloration and ulceration formation in the distal calf to ankle area is referred to as?
post thrombotic or post phlebitic syndrome
the distal calf to ankle area is aka?
gaiter zone
with portal hypertension, the elevated pressure results in a reverse pressure gradient that is called what kind of flow?
hepatofugal flow
what is Dyspnea?
difficulty breathing
superior vena cava syndrome is what? what is the most common symptom?
obstruction of the SVC, dyspnea
_______________ is the most common solid renal mass in the adult that can result in thrombosis of the renal vein.
renal cell carcinoma
_______ is a localized dilatation not associated with the normal dilatation at a valve site.
venous aneurysm, the focal diameter increases >50%
_________ are dialted tortuous superficial veins that may be hereditary. e.g result of a congenital absence of one or more valves
primary varicose veins
____________ are caused by obstructive conditions of the deep venous system.
secondary varicose veins
what is erythema?
redness
what is brawny?
brownish
what is lipodermatosclerosis?
thickening and hardening of the skin
what is a limb threatening condition that results from arterial spasms that occur secondary to extensive acute iliofemoral vein thrombosis?
phlegmasia alba dolens
when performing venous photoplethysmography you are testing what?
venous refill time aka venous reactive time VRT
if VRT is >20 the study is considered what?
normal
a VRT of < 20 seconds w/o the tourniquet that normalizes to >20 seconds with the tourniquet above the knee is consistent with ?
reflux in the great saphenous vein
a VRT <20sec with out the tourniquet that normalizes to >20secs only when the tourniquet is applied below the knee is consistent with what?
reflux in the small saphenous vein
a VRT< 20 with and without tourniquet application is consistent with what?
reflux in the deep system
with volume plethysmography arterial changes are related to what? and venous changes reflect what?
cardiac activity, venous emptying and venous filling
venous filling index (VFI) documents what?
the rate of venous refilling
normal VFI is what? what is severe ?
<=2.0 >10.o
__________ measures the calf muscle pump function after one toe up exercise
ejection fraction
an ejection fraction that is ________% is considered normal
> 60%,
the __________ is calculated as the percentage of venous volume remaining after 10 toe up movements. what is considered normal?
the residual volume fraction (RVF), <35%
pulsatile venous flow of the lower extremities is most commonly from what? 2 things
congestive heart failure or tricuspid regurgitation
T/F Peripheral arterial disease(PAD) has no affect on venous filling ?
false, PAD results in decreased venous filling leading to decreased venous flow
coaptation refers to what?
compressibility
what is Rouleau?
used to describe the appearance of red bloodcells arranged like rolls of coins … represents sluggish flow
Venous refluz lasting longer that >.5 or >1 is considered what?
abnormal
What is budd-chiari syndrome
results from hepatic vein occlusion
T/F when a patient has a D-dimer test, a negative result is conclusive for absence of thrombotic process?
false
What is the purpose of venous ablation?
it closes the diseased vein thus keeping the blood in the deep vein where the calf muscle contraction causes normal unidirectional flow towards the heart
What does radio frequency ablation do? (RFA)
achieves thermal ablation within the vein via a catheter equipped with radio frequency
what is endovenous laser ablation?
small laser that releases energy into the vein creating damage and sealing the vein through contraction
What is microphlebectomy?
a phlebotomy can be done when a vein is to large for sclerotherapy or to close to the skin for an endogenous procedure
_____ is the injection of a sclerosing solution, an irritant into the vessel resulting in its closure. What is it used for?
sclerotherapy, small varicosities aka spider veins (telangiectasias)
surface laser treatment is good for?
leg spider veins and reticular veins on cheeks , under eyes and on legs
medicated wraps or dressings used to treat infection also provide compression they are called what?
unna boots
what is used to treat portal hypertension?
TIPS ( transjugular intrahepatic portosystemic shunt)
Where is the TIPS placed?
shunt between portal and hepatic veins to decompress the portal vein
normal recovery time for a photoplethysmography venous reflux study should be what?
greater than 20 seconds
