Venous System Disorders Flashcards
Detail the saphenous venous system.
Superficial saphenous veins drain blood into deep veins via perforating branches (common femoral vein)
Define varicose veins.
Veins that are abnormally distended + tortuous
What is the most common site of varicose veins?
Superficial saphenous veins
Aside from the superficial saphenous veins, what other locations are common sites of varicose veins?
Distal esophagus (portal hypertension) Anorectal region (internal hemorrhoids) Left scrotal sack (varicocele)
What is the most common clinical manifestation of chronic venous insufficiency?
Varicose veins
Detail the pathogenesis of superficial varicosities in the lower extremities.
Valve incompetence in perforating branches- retrograde blood flow from high P deep venous system into superficial veins (may be secondary to DVT)
What treatment is available for varicose veins?
Compression stockings
Aside from compression stockings, what are other treatment options for varicose veins?
Sclerotherapy, ligation
What are 2 broad classes of causes of venous thromboses?
Stasis of blood flow
Hypercoagulability
What is the most common site of venous thrombosis?
Lower extremity- veins in calf, popliteal vein, femoral vein
What are the acute signs of DVT in the calf?
Swelling of the affected leg (relative to other leg)
Pain with dorsiflextion of foot (Homan sign) and compression of calf
Pitting edema distal to the thrombosis (increased hydrostatic pressure)
What dermatitis is associated with DVT?
Stasis dermatitis- hemorrhagic or orange discoloration of the skin and ulcers (medial malleolus)
What causes stasis dermatitis?
Rupture of perforating vessels due to pressure backup
What is the treatment of stasis dermatitis?
Corticosteroids, antibiotics of infection present
How do you diagnose a DVT?
US, serum D-dimer
How do you treat a DVT?
LMWH, compression stockings
Long term therapy is warfarin
Define thrombophlebitis.
Inflammation of the wall of a vein with associated thrombosis
What are the clinical findings for a patient with superficial thrombophlebitis?
Pain and tenderness along the course of a superficial vein, erythema, edema
Define superior vena cava syndrome.
Obstruction of blood flow through the superior vena cava
What is the most common cause of superior vena cava syndrome?
Primary lung cancer- small cell carcinoma
What is the cell of origin for small cell carcinoma?
Kulchitsky cell (Enterochromaffin cell)
What are clinical signs of superior vena cava syndrome?
“Puffiness”
Blue/purple face, arms, and shoulders
Retinal hemorrhage
Stroke
A patient presents and says their arm “falls asleep” when they sleep, they also say that they have numbness in their arm. You note diminished pulses and order a CXR which shows an extra rib. What is your diagnosis?
Thoracic outlet syndrome
cervical rib
