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89 Cards in this Set
- Front
- Back
- 3rd side (hint)
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The bodies blood is contained in a _____ system? |
closed |
not open, but ___ |
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2/3 - 3/4 of body's blood in the venous system, what is this aka? |
Capacitance system |
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Veins have how many walls and which are thinner? |
3 Tunica adventitia and media |
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Veins have ____, they are bicuspid, semilunar shaped, formed by folds of epithelium, located at valve sinus. |
valves |
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Valves in veins (increase/decrease) toward periphery? |
increase |
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Veins have ______: dilated pockets that let blood accumulate in the calf |
sinusoids |
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T/F some patients may have a duplicated system? |
True |
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The venous system is a high or low pressure system? |
low pressure |
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Blood flows from ___ pressure areas: (pressure gradient needed for blood to flow): A. Low to High B. High to Low |
B |
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what is the normal pressure of the venous system? |
6 mmHg |
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Venous flow is ______, varies with respiration. |
phasic |
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Veins are pulsatile: T/F? |
False, except ones near heart |
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Venous pulsatility is due to? |
1. elevated right heart pressure impeding blood return 2. liver or kidney failure |
there are 2 |
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Steady flow results from the presence of what in the venous system? |
DVT, detected distal to site |
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What are the 2 types of pressure that exist in the venous system? |
1. Transmural 2. Hydrostatic |
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What pressure is the difference in pressure b/t the inside of the V and the surrounding tissue/muscle? |
Transmural |
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What pressure causes the shape and size to change of the vein? |
Transmural |
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With increased transmural pressure, the V will _____. What shape? |
Dilate, Circular |
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With pressure outside that is higher( low transmural pressure) Vs _____ and make a shape of a ___. |
collapse, dumbell |
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What pressure is the major determinant of overall pressure w/in veins? |
Hydrostatic |
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What pressure is exerted by a fluid in a closed system?(related to a weight of a column of blood) |
Hydrostatic |
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When a patient is supine, the hydrostatic pressure will be max or no pressure in the legs? |
None, because same level as right atrium/heart |
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When a patient is standing, the hydrostatic pressure in their leg will be max or not present? |
max, esp in ankles because furthest from the heart |
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What exist to break the weight of the column of blood when hydrostatic pressure is increased to help to decrease hydrostatic pressure? |
Venous Valves |
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What keeps blood from flowing retrograde into extremities? |
Venous Valves |
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Retrograde is known as ____ or ___ |
reflux or insufficiency |
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When venous valves are not working, the venous pressure is (increased/decreased), and this results in ______. |
increased, Post Phlebtic Syndrome |
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What is known as the peripheral heart? |
the calf musle pump |
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What helps to contract propel blood back to heart to keeps flood from pooling and forming DVT, increases cardiac output, and used when hydrostatic pressure is increased? |
The calf muscle pump (peripheral heart) |
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What is the AKA for Venous Sinusoids? |
calf sinuses |
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What are the areas which collect venous blood from the Gastrocnemius and Soleal calf muscles? |
Calf sinusoids |
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What are used to store blood until the muscle pump squeezes? |
sinusoids |
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Sinusoids drain into what two veins? |
PTVs and Peroneals |
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With deep inspiration/Valsalva maneuver, the blood stops or flows? |
stops |
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During expiration/ Valsalva Maneuver release, the blood stops or flows in the Lower extremity? |
flows |
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Thrombus, will (increase/decrease) venous resistance and pressure? |
increase |
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Long term venous HTN results in what? |
Post Phlebetic Syndrome |
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Post Phlebetic Syndrome causes what ? |
edema, oozing ulcers, hyperpigmented skin |
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What occur with complete and/or chronic obstruction of a vein overtime? |
Collateral pathways |
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What is the number one reason to perform lower extremity venous testing? |
venous thrombosis |
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What is an acute inflammation of a vein associated with thrombus formation? |
Thrombophlebitis |
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What is a VTE stand for |
Venous thromboembolism |
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What is the obstruction of one of the main branches of the pulmonary As? |
Pulmonary Embolism |
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Pulmonary Embolisms are commonly due from? |
embolus in the deep system |
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Which pulmonary artery is affected more often? |
Right, b/c it is longer in its course to the lungs |
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What is found straddling the LPA and RPA? |
saddle embolus |
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During venous thrombus formation, what points toward the heart? |
the tail |
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T/F: Thrombus may "freeze" leaflets open? |
True |
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When valves no longer prevent backflow of blood due to damage, this causes ____, which is termed? |
reflux, venous insuffiency |
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Venous insufficiency results in _____ hydrostatic pressure to affected area? |
increased |
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After valve damage, what results? |
Post Phlebetic Syndrome |
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What is the result of: venous stasis d/t: occlusive DVT, damaged valves from prev DVT, persistent venous HTN, and decreased calf muscle function? ALL these ___ Hydrostatic & transmural pressure. |
Post Phlebetic Syndrome, increased |
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What is associated with decreased cardiac output? |
Post Phlebetic Syndrome |
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Post Phlebetic Syndrome occurs in ___-__% of patients who sustain prox vein thrombosis |
50-70 |
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Chronic Venous Stasis manifest in: |
-swelling and edema distal to affected area -stasis dermatitis (gaitor zone,ooze) -ulcer formation (gaitor zone, ooze) |
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What is not as dangerous as a DVT? |
SVT |
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What is the appearance of a Superficial thrombophebitis |
palpable, warm, red cord |
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What are superficial V dilatations? |
Varicose veins |
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What are enlarged broken capillaries called? AKA? |
Telangiectasia and Spider Veins |
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What is the major risk factors of a thrombus formation called? |
Virchow's Triad |
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What are the 3 major risk factors in Virchow's Triad? Example of each. |
1. Endothelial Damage: trauma, needle stick 2. Stasis(low flow areas): surgery 3. Increased (hyper) Coagulability: smoking,BCP |
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What are the 2 rare forms of a DVT? Color? |
1. Phlegmasia Alba Dolens, Milky White 2. Phlegmasia Cerulea Dolens, blue tint |
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What are some clinical S&S of DVT? |
-pitting edema & swelling - warm - varicosities - pain w/dependence - redness in gaitor zone - ulceration in gaitor zone |
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What is dorsal flexion of the foot that causes severe pain in the calf muscle with DVT? |
Positive Homan's Sign |
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What is found behind the knee and what is it composed of? |
Baker's Cyst, Synovial Fluid |
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DVT may mimic what 2 other conditions? |
lymphedema and Celluitis |
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What is edema due to accumulation of interstitual fluid and secondary to obstruction of or trauma to the lymph vessels/nodes |
Lymphedema |
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What is a diffuse, acute infection of the skin and subcutaneous tissue? |
Cellulitis |
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How is Cellulitis and Lymphedema differentiated from a DVT? |
- onset occurs gradually - elevation does not alleviate swelling - not a specific gaitor zone appearance - no pitting edema assoc. |
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What is the AKA for Venography Testing? (type of Angiography) |
Contrast Phlebography |
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What is the Gold Standard for DVT diagnosis? |
Venography Testing |
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Venography Testing is non-invasive or invasive? |
invasive |
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1. ______ can detect very small thrombi in both deep and superficial venous systems, identify double venous system easily |
Ascending Venography |
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2. Used to detect reflux |
Descending Venography |
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What is testing is where tagged isotopes are injected into deep venous system and hand-held gamma camera used to scan LE? |
Nuclear Medicine Testing |
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Nuclear Medicine Testing: 1. Technetium-99: only ___knee DVT is located 2. Fibrinogen-125: only ___ DVT ___ knee detected 3. VQ scan: dectects PE w/in the lungs(Old Method) |
1. above 2. acute, below |
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In Radiographic Imaging, what is used for more accurate detection of a PE? |
CTPA (Cat Scan Pulmonary Angiography) |
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What uses a blind pedoff probe, is the outdated exam method? |
CW Doppler Exam |
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What are the 6 normal venous characteristics? |
1. Patency 2. Phasic 3. Spontaneity 4. Augumentation 5. Competence 6. Non Pulsatile |
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What are the interpretations of Normal Venous Signal in CW Doppler Exam? |
- phasic - spontaneous - non-pulsatile - flow auguments w/distal compression - flow auguments w/release of VAL/prox compression - flow stops w/valsalva or prox compression or release of distal compression |
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What are the interpretations of Abnormal Venous Signal in CW Doppler Exam? |
- loss of spontaneity - loss of phasic changes - lack of augumentation w/distal compression - retrograde flow w/prox compression/valsalva - occlusion |
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What has identified venous duplex as the primary non-invasive diagnostic method to evaluate peripheral vascular disease? |
ICAVL (Intersocietal Commission for the Accreditation of Vascular Labs) |
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Deep system runs ____ with corresponding artery? |
parallel |
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T/F: the superficial system has a corresponding artery |
False |
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What are the most common to the least common sites affected by thrombus? |
-deep calf - hunter's canal - saphenofemoral juntion - pop - iliac |
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How do we assess reflux? |
Valsalva and prox compression, release of distal compression |
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T/F: Reflux can also occur in perforators and superfical V's |
True |
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What is performed on nonweight bearing leg while the patient is standing? |
True Reflux Study |
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Interpreting Valve Competency: 1. Flow that lasts > _ sec with prox compression or valsalva - Flow Reversal lasting > _ sec after release of prox compression or valsalva 2. Flow reversal lasting _ sec after release of distal compression |
1. 3, 1 2. 1 |
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