Venous Pathology/Signs and Symptoms

Question 1

describe Virchow’s triad

Answer 1

trauma
stasis
hypercoagulability

Question 1

describe the two types of trauma that can cause venous thrombosis

Answer 1

blunt trauma or potentially surgical trauma

ex. paget schroetter syndrome, PICC LINE

Question 2

describe causes of venous stasis

Answer 2

immobility, obesity, pregnancy, COPD, extrinsic compression of the vein, long flight (coach class syndrome), previous DVT

Question 3

describe causes of hypercoagulabiity

Answer 3

certain protein deficiencies, pregnancy, malignancy, hormones (estrogen intake)

Question 4

Phlegmasia cerulea dolens

Answer 4

bluish discoloration due to severely limited venous outflow, a precursor to gangrene

Question 5

phlegmasia alba dolens

Answer 5

white discoloration, “milk leg” compromised arterial inflow

Question 6

what are some chronic effects of venous thrombosis

Answer 6

post phlebitic syndrome and valvular incompetence

Question 7

describe post phlebitic syndrome

Answer 7

scarred vein walls and damaged valves result in poor venous return

chronic venous hypertension may result in skin degradation/ulceration

often persistent/chronic edema, pain/discomfort

Question 8

describe valvular incompetence

Answer 8

damaged valves no longer maintain unidirectional flow

calf muscle pump becomes ineffective with poor valve function

results in poor venous return

may occur when thrombosis is in the deep or superficial systems

Question 9

describe primary chronic venous insufficiency

Answer 9

dilated veins due to valve failure
dilated veins due to wall failure
both lead to valvular incompetence

Question 10

describe secondary chronic venous insufficency

Answer 10

dilated veins caused by obstruction (destroys valves and wall)

leads to incompetence

DVT: increased pressure is transmitted to the superficial system

Question 11

signs and symptoms of chronic venous obstruction / insufficiency

Answer 11

swellings
heaviness, achiness, tiredness
discoloration
skin changes/degradation
varicosities

Question 12

describe venous ulceration

Answer 12

lower leg, often near the medial malleolus

shallow, irregular shape

stasis changes such as skin discoloration, degradation, lipodermatosclerosis

Question 13

describe arterial ulceration

Answer 13

feet, toes, bony prominence

deeper, more regular shape

trophic changes such as dry, scaly skin, loss of hair, thickened toenails

Question 14

types of congenital venous disease

Answer 14

avalvular (valveless) veins

arteriovenous malformation - results in elevated venous pressures

syndromes - ex. klippel-trenaunay: may include multiple superficial varicosities and incomplete or malformed deep system

Question 15

describe superior vena cava syndrome

Answer 15

obstruction (neoplasm, central line catheter, dialysis catheter)

edema and engorgement of vessels may be evident (collateral development)

flow in the upper extremity remains the same during respiration

patient may have a cough and or difficulty breathing, shortness of breathe