Week 3 - Venous and Lymphatic Disease Flashcards
What is the anatomy of the lower limb veins?
great saphenous medially, small saphenous posteriorly, drains into popliteal, both drain into femoral veins. then external iliac, common iliac and inferior vena cava
What 2 main venous issues can occur?
chronic venous insufficiency and varicose veins
What is varicose veins?
another word is superficial venous insufficiency. caused by damage of venous valves.
What are risk factors for varicose veins?
recent DVT, pregnancy (compression onto veins or hormones), tumours (compression) or trauma (direct trauma to vein)
What is chronic venous insufficiency?
damage that has been ongoing for long period of time. combo of superficial and deep disease.
What is the pathophysiological process of chronic venous insufficiency?
venous insufficiency, hypertension, damage veins, endothelial leak, inflammation, oedema, increased diffusion distance between vein and tissue, increased healing time, impaired healing and inflammation again. cycle
How do you take a history of venous disease?
- distended veins which go away when laying down?
- may have symptoms like pain, infection, tightness, ulcers, burning
How do you examine the venous system?
- look, listen, feel.
- watch them stand so in worst state and you can see distension. look at great and small saphenous. look for oedema, discoloration
- feel for thrombosis - hard and tender. easily compressable blood (milking)
- use doppler to listen
What is the trendelenburg test?
test to see which valves in the leg are incompetent
What investigations are there for chronic venous disease?
complete full vascular examination - listen to all pulse pressure points on legs.
venous duplex ultrasound scanning shows size of vessel, flow and backflow.
What is the classification system for venous disease?
CEAP - clinical manifestation, etiology, anatomical distribution and pathophysiology.
What are the types of management given for venous disease?
conservative and surgical managements.
What conservative managements are there for venous insufficiency?
compression bandages and elevation. reduces oedema and pathophysiology cycle.
What is endovenous treatment for superficial varicose veins?
laser/radio frequency ablation. intensely heats inside of vein causing it to stick to itself. use compression to prevent vein re-opening
What alternative surgical intervention is there to endovenous treatment?
foam sclerotherapy. foam inserted into vein, causing irritation and vein closes down on itself. use compression after
