Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Vascular > Venous LE > Flashcards

Venous LE Flashcards

1
Q

Veins: thin walled collapsible tubes, expand. 3 layers. Media layer is thinner than artery media.

Valves in intima
Media
Adventitia. Contains vasa vasorum.

A

Transport blood to heart, regulate body temp, and cardiac output. Storage reservoir for blood

Deep
Superficial
Perforating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

SVC

A

Confluence of innominate veins. Drain head and upper extremities.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

IVC

A

Confluence of iliac veins. Drain lower body.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Deep veins

A

Accompanied by an artery
Surrounded by muscle
Bring blood back to heart

Thrombus have higher risk for PE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Deep femoral vein used to be

A

Profunda

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Femoral vein becomes popliteal vein after passing ______

A

Adductor’s canal aka hunters canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

First deep vein to come off pop V

A

2 Anterior tibial vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Gastruc nemeus vein

A

Also comes off pop vein. Stay in gastruc nemus muscle. 2 veins 1 artery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Tibioperoneal trunk

A

Bifurcates into PTV and Peroneal Veins. Paired.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Solleal sinus veins

A

Enter into either ptv or Peroneal veins. Storage veins. Clots form when calf muscle not active.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Venous sinuses

A

Gastrocnemius vein (drains into pop vein) and soleal vein (drains into PTV and Pero V)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Superficial veins

A

No artery. Regulate body temp. Hot, enlarge to move blood close to skin to let heat escape body.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

GSV (large saphenous)

A

Empties into CFV below inguinal ligament.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Small saphenous vein

A

Used to be called Lesser saphenous vein. Empties into Pop V around same level as gastruc nemius.

Some people it empties into femoral vein.

Between Fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Longest vein in the body

A

GSV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Vein often used in coronary artery bypass graft.

A

GSV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Gaicomini vein

A

Variant of lesser/short saphenous

Not present in everyone.

Connects LSV to GSV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Perforators

A

Connect veins deep to superficial

If not working, blood pools and ulcers occur.

80-140 perforators in lower extremities.

*posterior accessory GSV (aka posterior arch vein): superficial connection of 3 ankle perforating veins. Posterior tibial perforators, upper mid and lower.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Communicating veins

A

Connect veins in same system. Deep to deep. Superficial to superficial.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Perforator of femoral canal (Hunter’s) and (Dodd’s perforator)

A

Perforator of Femoral Canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Paratibial perforator (Boyd’s)

A

Perforator at knee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Tibial perforator upper (Cockett III) middle (Cockett II) and lower (Cockett I).

A

Perforator in calf

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Venous valves

A

Bicuspid. Allow blood to flow in one direction.

24
Q

Stats

A

> 2.5 million cases of venous thromboembolic disease in US

25% of untreated DVT will sustain a nonfatal pulmonary embolism.

Untreated PE assoc with 30% mortality rate.

25
Q

Venous hemodynamics

A 
Low pressure 
Pressure/volume
Cardiac influence 
Respiration 
Posture (hydrostatic pressure)
Calf pump
26
Q

Venous pressure / volume relationship

A

Resistance: flat shape of vein offers more flow resistance than circular shape

Shape of vein is determined by transmural pressure ( pressure difference from inter mural in vein and interstitial pressure outside of vein )

Small pressure changes required to expand or distend vein from normal dumbbell shape to a circular one.

Extra pulmonary venous circulation carry about 2/3 of the blood in the body. Veins carry more blood than arteries, without the increase in pressure.

Reverse transdelenburg fills up calf veins.

27
Q

Cardiac influence

A

Venous pressure and flow are affected by cardiac activity

This effect is most pronounced in thoracic vessels due to atrial contraction and relaxation. Jugular and subclavian can be very pulsatile. Due to proximity of heart.

Usually not apparent or reduced in lower extremities.

28
Q

Pulsatile flow in LE indicates

A

Congestive heart failure. Or right heart failure.

Due to high pressure in the right side of heart. Occurs bilaterally.

29
Q

Respiration variation.

A

Venous flow highly dependent on respiration.

Inspiration: Diaphragm moves downward and increases infra abdominal pressure.
IVC is compressed and venous outflow is temporarily reduced or stopped.

Exhalation: blood flow resumes.

Respiratory phasicity is opposite in arms.

30
Q

Valsalva

A

Inhale and bear down.

Blood flow should stop in LE

Opposite for UE

31
Q

Hydrostatic pressure

A

Weight of Column of blood extending from heart to level where pressure is being measured.

Fórmula HP= pgh

Inc transmural venous pressure distally
Venous distension: due to transmural pressure

Venous pooling :due to hydrostatic pressure, blood unable to go back up leg

Dec in capillary perfusion
Dec in venous return
Dec in cardiac output.

If stand in one place for too long without moving you can pass out. Hypotension

32
Q

Hydrostatic pressure =

A

gravity of blood * acceleration due to gravity * distance from heart.

HP = pgh

Heart reference 0 mmHg

Standing = 100 mmHg. Higher the further you go. At feet. Due to venous pooling.

HP decreases if knee is raised above level of heart.

22mmHg per every inch tall a person is.

Lying 10mmHg

Walking 25mmHg

33
Q

Calf veno-motor pump

A

Muscles in calf contain deep veins. Aug calf and not thigh.

Veins: PTV, pero, atv, gastric nemus, soleol sinus, GSV, LSV and perforator.

Valves. Need to pump blood out against Hydrostatic pressure.

Muscles

During muscle contraction, blood is propelled upward. Proximal valve opens while distal valve is closed. Perforator valves close during muscle contraction. To prevent flow in superficial system. (Perforators connect superficial to deep veins)

Valve closes, muscle relaxes.

Calf pump returns blood to heart, reduces hydrostatic pressure and venous pooling. And is depending on competent valves and muscle contraction.

34
Q

Virchow’s Triad

A

Risk factors for vein thrombosis

3 categories:
•endothelial damage (vessel trauma): IV drugs, catheter, extrinsic trauma, long trips

  • venous stasis: bed rest, paralysis, HTN, pregnancy, IVC compression, SVC syndrome, obesity
  • hypercoagulability: pregnancy, hormone, cancer, inherited states. Leiden favor 5

Airplanes.

35
Q

DVT

A

Common
80% of PE come from dvt
F>M

LE DVG commonly originate in calf veins at valve leaflets. Soleal sinus MC site.

36
Q

Well score

A

Points to determine risk for DVt
0= low probability
1-2=intermediate
> or = 3 = high probability

D dimer: measures five in degration products that accumulate in blood when thrombus form.

Neg: DVT is unlikely
Pos: false positive or further testing to check for DVT

37
Q

Criteria for vein thrombosis

A

Absence of vein compressibility (most important)

Visualization of thrombus

Vein distention

Abnormal Doppler signals

Reduced/absent augmentation

Reduced/absent color filling.

38
Q

Positive homan’s sign

A

Person flex foot and gets calf pain.

39
Q

Venous vs arterial symptoms

A

Venous: acute, swelling, persistent pain in calf or thigh, local tenderness, palpable cord with superficial thrombus, chest pain or short of breath with PE, warm to touch, redness.

Arterial: progressive, claudication, rubor dependent, limb/foot coolness, limb pallor, gangrene.

40
Q

Acute vs chronic DVT

A

Acute: hypoechoic, poorly attached (can cause PE), spongy texture, dilated vein (complete obstruction)

Chronic: echogenic, well attached, rigid texture, contracted vein (complete obstruction), collaterals, thickened vein wall.

20% of chronic DVT. Recanulization occurs and can see flow again.

41
Q

Phlegmasia Alba Dolens “Milk Leg”

A

Limb threatening
Arterial spasms occur secondary to extensive acute iliofemoral vein thrombosis. Arterial spasm causes insufficient arterial blood flow.
Limb is swollen, pale, and painful White leg because of arterial insufficiency.

42
Q

Phlegmasia Cerulia Dolens

A

Limb threatening
Acute iliofemoral vein thrombosis with severely reduced venous outflow which causes a marked reduction in arterial inflow.
Tissue hypoxia
Venous gangrene
Limb is swollen, darker, bluish / cyanosis, and painful. Due to insufficient oxygen.

43
Q

May Thurber syndrome

A

Left common iliac vein is compressed by the right common iliac artery.

Continuous flow in femoral vein would indicate a proximal obstruction. Will be hard to compress.

Normally the LCIV passed under the RCIA to empty into IVC.

44
Q

Venous flow patterns

A

Phasic: flow should stop when inhaling and resume with exhale.

Augmentation: should produce inc flow pattern with maneuver

Prox compression: venous flow should stop. Should mimic valsalva maneuver.

45
Q

Loss of respiratory phasicity indicates (continuous flow)

Inability to augment

A

Proximal obstruction

46
Q

Continuous flow in femoral vein could indicate

A

Proximal dvt in the iliac

47
Q

Pulsatile venous flow represents

A

Congestive heart failure or right heart failure.

Represents fluid overload:
Over hydration and chronic venous insufficiency can also be causes.

(Pulsatile flow is normal in subclavian due to proximity to heart)

48
Q

Superficial thrombophlebitis

A

Erythema/inflammation
Local tenderness
Palpable cord or mass

Usually more painful than DVT

49
Q

Varicosites

A

Varicose veins swirl. And GSV does not.

50
Q

Venous insufficiency/ venous reflux

A
  1. Primary: congenital absence or defect of valves
  2. Secondary: valves damaged by venous thrombosis and or chronic outflow obstruction. Postphlebotic syndrome

Symptoms: recurrent swelling/edema, leg pain, varicose veins, heaviness, stasis dermatitis (brawny edema) at ankle, ulceration (gaiter zone)

51
Q

Venous vs arterial ulcers

A

Venous: near medial and lateral malleolus (gaiter zone). Mild pain, shallow irregular shape, oozy, stasis dermatitis and brawny discoloration.

Arterial: lower leg or feet, severe pain, deep, regular shape, small size, trophic changes: hair loss, shiny skin, thickened toenails.

52
Q

Valsalva

A

Have patient take a breath in and bear down. Should stop venous flow if valves are working. Coughing should elicit same response.

Can also stop venous flow with proximal compression.

Reversal slow seen in venous insufficiency.

53
Q

Bakers cyst aka Synovial cyst

A

Synovial lining and fluid bulge into the pop space

Found in medial aspect of pop fossa

May dissect into medial calf muscles

54
Q

Soft tissue edema

A

Limb swelling associated with elevated venous pressure (hydrostatic pressure)
•CHF
•venous compression
•fluid overload.

Typically bilateral
Changes in venous flow pattern: pulsatile or bidirectional.

55
Q

Lymphedema

“Ant farm” appearance

A

Blockage in lymphatic system that prevents lymph fluid from draining well

Caused by malignancy, trauma, injury,

Mimics dvt. 
Excess lymph fluid
Leg swelling 
Pain
Unilateral or bilateral.
56
Q

Cellulitis

A

Infection/inflammation of tissue in calf

Redness, shiny, warm to touch, not related to DVT.

Vascular (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions