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22 Cards in this Set
- Front
- Back
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Venous Pathophysiology |
Deep venous thrombosis (DVT) superficial venous thrombosis (SVT) varicose veins post-phlebitic syndrome Pulmonary Embolism (PE) |
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Untreated manifestation of DVT |
Pulmonary Embolism (PE) collateral formation (active remodeling of non-functional or smaller secondary veins) damaged venous valves tissue damage complete occlusion |
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Clinical Manifestation of DVT |
Leg swelling dilated superficial veins calf and thigh tenderness stasis dermatitis venous ulceration can be complicated by PE |
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Clinical Diagnosis of DVT |
often difficult Dvt can be entirely asymptomatic the primary indications of DVT can have multiple other causes cellulitis lymphangitis bakers cyst underlying arterial disease |
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Deep venous thrombosis |
involves the formation and propagation of thrombus within the lumen of the deep veins. increased venous resistance increases venous pressure. the usual decrease in venous pressure with exercise is absent in acute DVT. |
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Venous thrombosis |
occurs when blood elements become solidifies and held in place by a fibrin (protein involved in clotting) net. Differs from arterial thrombosis. venous - RBC and fibrin (coagulation thrombi) Arterial - Platelet aggregates and fibrin |
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Resolution of thrombus |
Thrombus may recanalize allowing flow to be reestablished. Permanent damage may result. Residual webs and bands may remain. Partial obstruction/damage to venous valves ofter results. |
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Virchow's Triad |
has 3 primary risk factors for venous disease Stasis Endothelial injury Hypercoagulability
consider patient history |
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Stasis |
Non moving blood tends to clot -immobility -polycythemia (high circulating RBC count) |
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Endothelial and |
damage to the vein wall can form a nidus for the formation of clot. blood will try to repair rough surfaces -dysfunction- smoking and hypertension -damage- surgery, catheter and trauma |
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Hypercoagulability |
various conditions, inherited or acquired, and increase the tendency for blood to clot. -Hereditary- factor V leiden, prothrombin G2021OA, protein C and S deficiency. -Acquired-cancer, chemotherapy, OCT/HRT, pregnancy, obesity and hit |
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Deep venous thrombosis |
in deep veins forms anywhere that blood flow slows down valve pockets/cusps soleal sinus left common illac vein (anatomically) |
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Typical DVT progression |
starts as small nidus (formed) clot some spontaneously lyse (death of cells) others propagate (both directions) occupies small area initially as clot grows vein enlarges veins can dilate to 7 times normal size |
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Occlusive DVT |
initially dilates vein contracts and pulls vessel walls with it over time vein shrinks with age collaterals (active remodeling of smaller secondary veins) form. |
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Non occlusive DVT |
only attaches to part of the vein wall Thrombus will contract and get smaller recanalization less valvular damage |
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venous pressure in DVT |
due to high venous pressure, collateral (smaller secondary) veins become engorged swelling from edema can lead to ulceration and stasis changes. |
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Pulmonary Embolism (PE) |
part of the thrombus breaks off travels through right heart to the PA lodges in lung (shortness of breath-dyspenea and chest or back pain can cause death |
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Superficial Venous Thrombosis (SVT) |
superficial veins of the lower extremity rarely progresses into deep vein rarely results in PE clinical presentation tenderness over affected area palpable cord warmth local inflammation
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Varicose veins |
elongated, dilated, tortuous superficial veins that are usually incompetent deep veins are surrounded and supported by muscle |
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varicose veins (primary) |
congenital, inherent weakness of walls May become prominent following pregnancy no abnormality of deep veins |
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varicose veins (secondary) |
DVT absence of deep venous valves congenital absence or atresia of deep veins |
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Post phlebitis syndrome (AKA post thrombotic syndrome) |
following a DVT, the collaterals that bypassed the venous obstruction are damaged due to the inflammatory process. valves no longer work properly results in chronic edema, stasis changes and ulceration. |
