VLD EVL Flashcards
What are the risk factors for acute and chronic venous disease?
A(VO)2N (PH)3
Age, Inceased VTE History varicose veins Obesity Oral Contraceptive use Nephrotic syndrome Pregnancy Postpartum state, recent Postoperative state Hormone replacement therapy hypercoagulable states Hospitalization and Immobilization
True about Chronic venous insufficiency
a. it does not cause skin and subcutaneous tissue changes in the affected limb.
b. most CVI involves venous obstruction
c. severe CVI often reflects venous reflux
d. NOTA
D
A - CVI may lead to characteristic changes in the skin and subcutaneous tissues
B - Most CVI involves venous reflux
C - severe CVI often reflects a combination of reflux, and venous obstruction
True about CVI
a. a typical leg will be edematous, worse upon waking up
b. Leg may be indurated and pigmented with eczema and dermatitis
c. Nutritional exchange is not affected
d. Microvascular congestion
B.
typical leg affected by CVI
will be edematous, with edema increasing over the course of the day. The leg may also be indurated and pigmented with eczema and dermatitis. These changes are associated with excessive proteinaceous capillary exudate and deposition of a pericapillary
fibrin cuff that may limit nutritional exchange. In addition, an increase in white blood cell trapping within the skin microcirculation in CVI patients may lead to microvascular congestion
and thrombosis.
Fat necrosis is also known as
lipodermatosclerosis
Fibrosis can develop from 3 predisposing conditions (3)
FIN
Fat necrosis (lipodermatosclerosis)
Inflammation, chronic
Nutrition, Imparied
This causes characteristic pigmentation of the skin in patients with chronic venous disease
Hemosiderin deposition
Hemosiderin deposition due to the extravasation of red cells
and subsequent lysis in the skin contributes to the characteristic
pigmentation of chronic venous disease.
This is the result of longstanding venous hypertension and associated with alterations in microcirculatory and cutaneous lymphatic anatomy and function.
Ulcerations
Where is the most common location for venous ulceration in CVI?
3cm proximal to the medial malleolus
The region 3cm proximal to the medial malleolus is a.k.a
gaiter region
This is a clinical test to determing comptency of valves and in which of the three venous systems (superficial, deep, peroforator) the valves are abnormal
Trendelenburg’s test
True about the Trendelenburg’s Test
a. Patient is supine, leg is elevated to 30 deg to empty the veins
b. The GSV is occluded with the examiner’s hand
c. GSV valves are incompetent if gradual filling is noted following release of compression
d. positive result indicates sudden filling of veins with standing when GSV is released
e. negative result is characterized by no filling of the veins
B.
a. Leg is elevated 45 deg
c. GSV - valves are incompetent if RAPID filling is noted following release of compression
d. positive result indicates sudden filling of veins with standing while GSV is OCCLUDED
e. GRADUAL filling
T/F Trendelenburg’s test is an objective test
F; subjective
Possible Signs of Superficial venous abnormalities (6)
WET TV and DVD Warmth Erythema Tenderness Tortuosity Varicosity Distended subdermal venules Venous saccule Distended intradermal venules
Coronal phlebectatica
a. Tortuosity
b. Varicosity
c. Venous Saccule
d. Distended subdermal venules
e. Distended intradermal venules
D
Spider angiomata
a. Tortuosity
b. Varicosity
c. Venous Saccule
d. Distended subdermal venules
e. Distended intradermal venules
E
