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33 Cards in this Set
- Front
- Back
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What are the most common clinical symptoms of DVT? |
- swelling - pain - redness - warmth |
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What are the three factors known as Virchow's triad? |
- trauma to the vessel - *venous stasis (blood not moving)* - (see list from lecture) - hypercoagulability (just clots off automatically) |
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What is the main clinical danger from DVT? |
pulmonary embolism |
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What is hemosiderin? |
from the breakdown of stagnant RBC which causes a brawny discoloration of the skin |
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What is phlegmasia alba dolens? |
results from arterial spasms that occur secondary to extensive acute iliofemoral vein thrombosis |
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What skin color may be seen in phlegmasia alba dolens? |
whiteness (pallor) |
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What is phlegmasia cerulea dolens? |
severely reduced venous outflow causes a marked reduction in arterial inflow of an acute iliofemoral vein thrombosis |
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What skin color may be seen in phlegmasia cerulea dolens? |
bluish (cyanosis) |
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What are venous ulcers? |
- near the medial malleolus - irregular shape - shallow - mild pain
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What are arterial ulcers? |
- near the lateral malleolus and toes - well defined margins - deep - severe pain |
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What is pitting edema? |
an accumulation of fluid in the subcutaneous tissue that when pressure is exerted on the skin a depression is formed
- may be secondary to fluid retention, electrolyte imbalance, renal dysfunction or congestive heart failure |
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What is non pitting edema? |
the tissue is so swollen that fluid cannot be displaced with manual pressure |
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With duplex and color flow imaging of the lower extremities, how should the patient be positioned? |
to help with the venous filling, have the patient in a reversed trendelenburg position |
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What is the best view to see the vein? |
must clearly be seen in transverse view to ensure complete compressibility (never compress in sagittal) |
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Which veins may be difficult to compress? |
- the CFV high in the groin - the SFV distal as it dives to the popliteal fossa
may need a different angle or slightly more pressure to compress |
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What is the interpretation for acute thrombosis? |
- veins are not completely compressible and you may see low level echoes within the lumen - visible thrombus may be seen low to medium level echoes - *vessel is dilated* - *color flow will show no filling or partial filling* |
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What is the interpretation for chronic thrombosis? |
- old clot can be highly echogenic - the vessel is NOT dilated and retracts over time - the walls may be scared but the vein can shrink down over time - visible collaterals |
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When will you see false positives for impedance plethysmography (IPG)? |
results may be caused by extrinsic compression: - improper patient position - pain or anxiety may cause muscle contraction and venous compression - pregnancy |
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What are incompetent valves? |
- they allow blood to travel both antegrade and retrograde, increasing pressure and creating venous hypertension which can participate edema and primary variscosities - fluid, RBC and fibrinogen may leak into the surrounding tissue secondary to the increased pressure - hemosiderin |
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What is redness (rubor) caused by? |
an inflammatory process and/or celluitis |
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What is brownish (brawny) discoloration caused by? |
represents chronic venous insufficiency |
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What are primary varicose veins? |
- dilated tortuous veins that may be hereditary - caused by valvular incompetence - the increased venous pressure that causes primary varicose veins is unrelated to obstruction of the deep system |
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What are secondary varicose veins? |
- dilated veins caused by obstructive conditions of the deep venous system such as: previous DVT, pregnancy, obesity - causes blood to be backed up into the superficial veins and leads to valvular incompetence |
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What is a Baker's cyst? |
cystic structure or mass located in the popliteal fossa |
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***DUNN'S CAP*** What is lymph edema? |
lymph edema is impaired transportation of lymph |
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What is the valsalva? |
- taking a breath (increase abdominal pressure) - bearing down (increase thoracic pressure) |
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What are the capabilities of contrast venography? |
considered the gold standard but is used less because of advances in ultrasound |
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What are the limitation of contrast venography? |
- highly technical in technique and interpretation - relatively expensive - may be uncomfortable for the patient - adverse effects, such as allergic reactions |
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How does contrast venography work? |
- a radiopaque contrast material is injected into the foot veins - serial x-rays are taken as the contrast material passes through the veins - any deviation from normal is evidence of obstruction; filling defect |
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What is a VQ (ventilation quotient) scan? |
a screening test for detection of perfusion defects of the lungs, most commonly caused by pulmonary embolism (DVT) |
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How does breathing effect the extremities? |
- inspiration (breath in) reduces or stops the outflow of blood from the lower extremities - expiration (breath out) reduces or stops the outflow of blood from the upper extremities |
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Which signals should be phasic? |
- the IVC and hepatic venous signals should be phasic with respiration and bi-directional - portal vein is phasic but more continuous - hepatic signals should be triphasic |
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What are the controlling risk factors for DVT? |
- limit long periods of inactivity or bed rest - promote venous drainage: wear support hose, elevate leg - prevent injury or infection |
