(V)- Chronic Venous Insufficiency Flashcards

1
Q

How does chronic venous insufficiency occur?

A

Blood does not efficiently drain from the legs back to the heart

Usually due to damage to the valves inside the veins

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2
Q

What causes valve damage inside the veins?

A

Age
Immobility
Obesity
Prolonged standing or after DVT

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3
Q

What is chronic venous insufficiency commonly associated with?

A

Varicose veins

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4
Q

What happens in venous hypertension?

A

Valves ensure blood flow in one direction as leg muscles contract and squeeze the veins

Damaged valves, leg muscles become less effective in draining blood to the heart

Blood pools causing venous hypertension

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5
Q

What is the gaiter area?

A

Area between top of the foot and bottom of the calf muscle

Chronic pooling of blood usually leads to skin changes here

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6
Q

What is haemosiderin staining caused by?

A

Chronic pooling of blood, increased pressure causes haemoglobin to be pushed out from veins

Haemoglobin then breaks down into haemosiderin and pools causing a red/brown discolouration

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7
Q

What causes venous eczema?

A

Chronic inflammatory response in the skin

Dry
Itchy
Flaky
Scaly
Red
Cracked skin

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8
Q

What is lipodermatosclerosis?

A

Hardening and tightening of the skin and tissue beneath the skin

Chronic inflammation causes subcutaneous tissue to become fibrotic

Inflammation of subcutaneous fat is called panniculitis

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9
Q

What is narrowing of the lower legs called?

A

Inverted champagne bottle appearance

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10
Q

What is atrophie blanche?

A

Patches of smooth, porcelain-white scar tissue on the skin surrounded by hyperpigmentation

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11
Q

What skin changes does chronic venous insufficiency lead to?

A

Haemosiderin staining
Venous eczema
Lipodermatosclerosis
Atrophie blanche
Cellulitis
Poor healing after injury
Skin ulcers
Pain

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12
Q

How is chronic venous insufficiency managed?

A

Keeping skin healthy
Improving venous drainage to the legs
Managing complications

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13
Q

How is skin kept healthy in chronic venous insufficiency?

A
  • Monitoring skin health and avoiding damage
  • Regular emollient use e.g. diprobase and oilatum
  • Topical steroids to treat flares of venous eczema
  • Very potent topical steroids to treat flares of lipodermatosclerosis
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14
Q

How is venous drainage improved in chronic venous insufficiency?

A
  • Weight loss if obese
  • Keeping active
  • Keeping legs elevated when resting
  • Compression stockings
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15
Q

How are complications of chronic venous insufficiency managed?

A
  • Antibiotics for infection
  • Analgesia for pain
  • Wounder care for ulceration
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