Venous & Lymphatic Disease Flashcards
RECAP- in terms of anatomy, what is the difference between an artery and a vein?
Artery is thicker and has a smaller lumen compared to the total vessel size.
Vein is thinner and have a larger lumen compared to total vessel size.
Which vein is used with the calve pump to push venous blood back to the heart?
Popliteal vein
Where does the dorsal aspect of the foot drain into?
Great saphenous vein
What are perforating veins?
Veins which transports blood from the superficial venous system to the deep venous system
What is the sole of the foot drained by?
Short saphenous vein
Which veins make up the deep venous system?
Tibial vein, the popliteal vein and the femoral vein.
What are the two main problems that occur in the venous system?
Chronic venous insufficiency and varicose veins.
What are venous veins caused by?
Damage of the valves of the venous system
What are some of the causes for varicose veins?
Recent DVT
Pregnancy
Trauma
Tumours
How can pregnancy cause varicose veins?
Due to hormone changes and the uterus sitting on the deep iliac veins, creating pressure
What are some of the risk factors forvaricose veins?
Increasing age
Female>male
Previous DVT or trauma
Prolonged standing
What is chronic venous insufficiency?
Prolonged damage to the venous system
Combination of superficial and deep disease
Describe the pathophysiology for venous insufficiency.
Venous hypertension-> damages veins and causes endothelial leak -> oedema -> increased perfusion distance -> Impaired healing -> inflammation -> tissue damage
What are the symptoms for systematic venous disease?
Pain, infection, ulcers, swelling, bleeding, itchiness, burning
When doing a venous examination of the legs, what are some things to look out for?
Oedema, any discolouration, any signs of venous eczema.
If you palpate the veins, what are you feeling for?
See if it is thrombosed
If it’s hard/tender
If its compressible i.e. you can move blood out of it
What does a full vascular examination involve?
-Femoral, popliteal, dorsalis pedis and posterior tibial pulses.
-Ankle brachial pressure index to measure the pressure gradient between the arm and the ankle
Which investigation is the best for venous disease?
Venous duplex ultrasound scanning
Which classification guide is used to help in vasuclar disease?
CEAP
C-clinical causes
E- aetiology
A- anatomical distribution
P- pathophysiology
Which part of the CEAP is most important for us rn?
Clinical (C0-C6)
What does calf pump failure cause?
Oedema
How is deep venous insufficiency usually treated/managed?
Compression- as long as there is no arterial compromise
When may surgery be carried out in venous disease?
For superficial varicose veins
What is the surgery for superficial varicose veins?
Endovenous treatment
Or, less commonly but still an option, foam sclerotherapy
