Week 9 - Lesson 2 (Part 2) Flashcards
Chronic thrombus
Complete dissolution of clot over time may occur naturally
What are characteristics of older clots? (2)
- Firmer
2. More echogenic
What happens to chronic clots over time?
They become better attached
- this is why acute is more dangerous
What will develop with chronic thrombus?
Large collaterals
- indicates chronic problem
What do echoic clots do?
Blends into the walls
- hard to determine
What are 4 characteristics of chronic clots?
- Scarring appearance
- Not moving
- Well adhered thickened walls
- Gets brighter over time
Recanalized vessel
The process of restoring flow to or reuniting an interrupted channel of a bodily tube
What does a bilateral lower extremity swelling more likely to indicate what kind of origin?
Cardiovascular
- secondary to heart failure
What is Homan’s sign?
Sign of DVT
- but it is an unreliable diagnostic criterion
What is another unreliable DVT sign?
Palpable cord
Why is a palpable chord an unreliable DVT sign?
Because its more for superficial venous thrombosis
- rather than deep
Collateral flow
When a clot forms, blood return to the heart is blocked and smaller, alternate veins can return blood back to the heart
What are potential complications of DVT? (7)
- Pulmonary embolism
- Incompetent valves
- Post thrombotic syndrome
- Recurrent DVT
- Varicose veins
- Chronic venous insufficiency
- Ulcers
What % of untreated DVT’s will sustain a non-fatal pulmonary embolism?
25%
What is the mortality rate of untreated cases of DVT?
30%
Pulmonary embolism
Emboli break off of thrombus in the leg vein and travels to the lungs
Where does pressure increase for a pulmonary embolism?
The right ventricle
- pumping out to the lungs
What are symptoms of a pulmonary embolism? (2)
- Difficulty breathing
2. Chest pain on inspiration and palpitations
How does a pulmonary embolism show clinically? (4)
- Low blood oxygen saturation
- Cyanosis
- poor circulation - Rapid breathing
- Increased heart rate
What do severe cases of a pulmonary embolism cause? (3)
- Collapse
- Abnormally low blood pressure
- Sudden death
What is a pulmonary embolism diagnosed by? (3)
- D-Dimer
- CT
- Pulmonary angiography
What is the treatment for a pulmonary embolism? (2)
- Anticoagulent-heparin
2. Warfarin
What is the surgical intervention for pulmonary embolisms?
Pulmonary thrombectomy
What is recurrent DVT largely due to?
Damage to the walls and valves
- hereditary factors are unavoidable
What are acquired factors that are inevitable with recurrent DVT? (3)
- Cancer
- Surgery
- Age
What is a sign of recurrent DVT?
Pigmentation
What % of vein wall and valves are permanently damaged in post thrombotic syndrome?
60%
What occurs with post thrombotic syndrome? (3)
- Valve leaflets are immobile
- fixed to vein wall - Venous reflux ensues
- Venous stasis worse in standing position
What does chronic venous obstruction and reflux manifests as? (3)
- Chronic leg swelling
- Ankle pigmentation
- Ultimately ulcers form
Where are venous ulcers located?
More medial
- reflux
Where are arterial ulcers located?
More lateral
