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11 Cards in this Set
- Front
- Back
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Venous drainage of limbs |
Upper limbs -superficial veins Lower limbs- mostly deep veins ie. Tibial,peroneal,popliteal,femoral and 10%by superficial veins ie. Saphenous vein w its tributaries |
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Types of veins |
Deep veins Superficial veins Perforator veins |
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Anatomy of the types of veins |
Superficial veins lie superficial to deep fascia Deep veins are surrounded by muscles Perforator veins pass thru deep fascia The superficial and deep veins are intercommunicated by Perforator veins |
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Types of Venous thrombosis |
1 thrombophlebitis- affects Superficial veins (common in people w varicose veins, iv lines)& does not produce embolism 2 phlebothrombosis- affscts deep veins (common in bedridden patients, surgery, trauma,& pregnancy predisposed by virchows triad) Virchows triad consists of 3 factors which predispose a person to venous thrombosis which are 1. Hypercoagulability 2. Stasis 3.endothelial injury/damage Can produce an emboli |
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Treatment of dvt |
1. Analgesia,fluid electrolyte balance, rest & elevation of foot 15°-30° for 24-48hrs later ambulate w elastic stokings 2.anticoagulants ie. IV heparin 70 I.U/kg 8hrly 5-10days, oral anticoagulants warfarin 9mg loading dose 3. Thrombolytics ie. Streptokinase, urokinase .. Given when thrombus is extensive & viabilityof limb is threatened |
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Axillary vein thrombosis |
Caused by excessive exercise involving abduction of shoulder, clinical features, invenstigations & management are like dvt |
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What are venous ulcers |
Are ulcers caused by venous hypertension |
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Pathogenesis of venous ulcer |
1. Venous hypertension (causes trapping of WBC in capillaries) 2.capillary leakage of fibrin |
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Clinical features of venous ulcer |
1. Located in lower 1/3 of the leg around ankle(gaiters area) due to ankle imperforator incompetence usually on medial side rarely on lateral side 2. Associated w varicose veins |
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Differentials of venous ulcer |
1)trophic ulcer -occur on pressure bearing areas & are painless. Has punched out edges 2. Ishaemic ulcers- peripheral pulses are absent, ulcersoccur on dorsum of foot & are painful 3. Chronic osteomyelitis of tibia w sinus 4. Tropical ulcers- associated w malnutrition 5. Traumatic ulcer 6. Rheumatoid arthritis 7. Diabetic ulcer 8. Squamous cell carcinoma 9. Malignant melanoma 10. Yaws 11. Gummatous ulcer( occurs in tertiary stage of syphilis & occur on subcutaneous bones ie. Tibia, sternum, skull. Has punched out edges. 12. Basal cell carcinoma (rodent ulcer). Appears on face |
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Treatment of venous ulcer |
Investigation- venograph Tx- 1. Conservative method- sleeping w foot elevated, walking while keeping the heel down 1st & to contract calf muscles to lift the heal, elastic bandaging or stocking 2. Pharmacotherapy- aspirin..more effective are compressive bandages 3. Surgery- for primary varicose veins surgery is trendelenburg's w or w/o stripping and sclerotherapy - for ankle perforator incompetence surgery is sub-fascial ligation of ankle perforators - for chronic ulcers surgery is excision & skin grafting |
