Venous Non Imaging Testing Flashcards
Finding the presence/absence of venous insufficiency and determine if superficial vs deep insufficiency describes the capabilities of what
Venous PPG
Where is the PPG placed for venous PPG
above the medial malleolus
> 20 sec is
a) normal VRT
b) abnormal VRT
a) normal VRT
< 20 sec is
a) normal VRT
b) abnormal VRT
b) abnormal VRT
If the initial reading comes back normal what do this mean
There is no venous insufficiency
If the initial reading comes back abnormal what is the next step
Repeat with a tourniquet
-purpose of the tourniquet is to cut off influence of the superficial system
If the reading normalizes with the tourniquet applied what does this mean
There is superficial insufficiency
If the reading never normalizes when the tourniquet is applied what does this mean
There is deep insufficiency
If the tourniquet is placed above the knee and the reading comes back normal what does this mean
GSV insufficiency
If the tourniquet is placed below the knee and the reading comes back normal what does this mean
SSV insufficiency
What study can quantify venous reflux and measure venous function
Venous air plethysmography
An ejection fraction of what % is considered normal for a venous air plethysmography study
> 60%
What study can detect the presence/absence of venous insufficiency and detect the presence of an DVT
CW doppler
What study cant not choose vessel or sampling depth and has no imaging only waveform contour reading
CW doppler
A test that seems negative but there is really disease describes
a) false negative
b) false positive
a) false negative
Partial non-occlusive DVT, venous collaterals, and bifid systems are examples of
a) false negative study
b) false negative study
a) false negative study
A test that has an abnormal reading but really is normal describes
a) false positive study
b) false negative study
a) false positive
Extrinsic compression, severe PAD, CODP, and incorrect doppler or tech error are examples of
a) false negative study
b) false positive study
b) false positive
For a CW doppler study what position is the patient placed in
Revered trendelenburg. (limb lower than the heart)
- Increased hydrostatic pressure encourages venous filling and allows for easier evaluation of the lower extremity veins
__________ naturally occurring and occurs in most larger deep veins
spontaneity
Name 3 veins non spontaneous flow should be seen in
1) tibials
2) superficial veins
3) radial/ulnar
_________ flows with respiration
Phasicity
Phasicity is normally seen in what veins
Peripheral
If there is non-phasic or continuous flow where is the obstruction at
a) proximal
b) distal
a) proximal
______ flow is normal for veins close to the heart
pulsatile
Name 3 veins that have pulsatile flow
1) IVC
2) subclavian
3) IJV
CHF, tricuspid regurgitation, and fluid overload are seen in what type of veins
peripheral
Augmentation with distal compression or proximal release is considered
a) normal flow
b) abnormal flow
a) normal
During proximal compression or valsalva what should happen to the flow
should halt or stop
If there is augmentation during proximal compression or valsalva what does this mean
there is valvular incompetence
In CW doppler reflux testing, what is a normal result
a) cessation of flow during proximal compression, augmentation on release
b) cessation of flow during distal compression, augmentation on release
c) augmentation of flow during proximal compression, cessation on release
d) augmentation of flow during distal compression, cessation on release
a) cessation of flow during proximal compression, augmentation on release
Posterior tibial and peroneal veins are found to be non-spontaneous but augment with distal compression. How is this interpreted?
a) distal obstruction
b) normal finding
c) proximal obstruction
d) partial obstruction
b) normal finding
Which of the following techniques is best for demonstrating spontaneous venous flow
a) hyperflexion and extension of the foot
b) proximal compression
c) patient breathing quietly
d) distal compression
c) patient breathing quietly
-Spontaneous means naturally occurring. There should be no need to induce the flow, it should be there as the patient is breathing normally
What technique is best utilized to test for valvular incompetence during duplex testing?
a) flexion and extension of the foot
b) patient breathing quietly
c) distal compression
d) proximal compression
d) proximal compression
A venous PPG is performed on a patient with complaints of swelling and brawny discoloration. Her initial VRT is 10 sec and 12 sec after tourniquet is placed above the knee. How are these findings interpreted?
a) within normal limits
b) GSV insufficiency
c) deep venous insufficiency
d) SSV insufficiency
c) deep venous insufficiency
-A VRT that never normalizes with the tourniquet= deep venous insufficiency.
normal = >20
abnormal= <20
What clinical finding would be a contraindication to venous air plethysmography
a) pain and swelling
b)brawny discoloration
c) ischemic ulcers
d) lipodermatosclerosis
a) pain and swelling
What is the most likely findings in a patient with post thrombotic syndrome
a) initial VRT < 20 and > 20 with tourniquet
b) initial VRT >20 and < 20 with tourniquet
c) VRT > 20 with and without tourniquet
d) VRT < 20 with and without tourniquet
d) VRT < 20 with and without tourniquet
-Post-thrombotic syndrome is chronic deep venous insufficiency due to previous DVT
Normal VRT > 20
superficial venous insufficiency VRT <20 that normalizes with the tourniquet
Deep venous insufficiency VRT < 20 that never normalizes
