7] Venosu Ulcers

Question 1

3 reasons why wounds do not heal

Answer 1

Inadequate vascular support
Excessive pressure
Inadequate nutritional support to grow new tissue

Question 2

locatedin subcutaneous tissues

Answer 2

Superficial veins

Question 3

accompany

the arteries and are deep to fascia and muscles

Answer 3

Deep veins

Question 4

penetrate fascia to

connect the superficialand deep veins

Answer 4

Perforating veins

Question 5

Proper venosu return

Answer 5

calf muscle forcing bloodupward; as muscle
relaxes, valve opens and
blood flows

Question 6

Venous insufficiency

Answer 6

valvesbecome damaged and

blood leaks backwards

Question 7

Thrombi scar the intima andcause valvular incompetence

Answer 7

Venous Insufficiency

Question 8

Failure of valves results in

Answer 8

Venous HTN

Question 9

Venous HTN causes ? Of superficial veins and fluid is forced ?

Answer 9

Distention (swollen or enlarged); into interstitial space

Question 10

3 other theories of venous insufficiency

Answer 10

Pericapillary fibrin cuffs
Leukocyte trapping
Micoangiopathy

Question 11

—fibrinogen leaks from capillaries And creates a barrier between the capillary and the tissue it supplies

Answer 11

Pericapillary fibrin cuffs—

Question 12

WBC adhere to the capillary

endothelium because of sluggish blood flow 2o venous hypertension; this leads to inflammation

Answer 12

Leukocyte trapping

Question 13

venous congestion leads to damagedcapillaries surrounding the wound (dilation, elongation,
tortuosity, stasis, thrombus)

Answer 13

Microangiopathy—

Question 14

leads to extravasation offluid and cells

Answer 14

Venosu HTN

Question 15

Causes of venous insufficiency

Answer 15

Outflow obstruction
 Valve insufficiency
 Loss of muscle pump

Question 16

How many stages of Venous Insufficiency

Answer 16

3

Question 17

venous system overloaded, edema

results

Answer 17

Stage 1

Question 18

Venous system overloaded

Answer 18

Stage 0

Question 19

How do you treat stage 1

Answer 19

Compression, elevation, exercise

Question 20

Lymphatic
system becomes damage from overuse for an
extended period of time, lymphedema results (alsopigmentation,
varicosities, pain)

Answer 20

Stage II

Question 21

How do you treat stage II

Answer 21

CDT

Question 22

severe skin changes due to tissue

hypoxia and necrosis

Answer 22

Stage III

Question 23

How do you treat stage III

Answer 23

CDT and wound care

Question 24

Risk factors for venous ulcers (9)

Answer 24

1] Thrombosis of deep venous system
 Postphlebitic syndrome
 CHF
 Incompetent valves
 Obesity
 Pregnancy
 Superficial vein regurgitation
 Muscle weakness
 Varicose veins

Question 25

It’s usuall where

Answer 25

LE not involving feet

Question 26

Wound margins

Answer 26

Irregular

Question 27

Pain

Answer 27

Painless to moderate

Question 28

Drainage

Answer 28

Moderate ot heavy

Question 29

Edema

Answer 29

Firm

Question 30

Other characteristics of venosu ulcers

Answer 30

Moist Irregular ridges Firm, fibrotic, infuriated surrounding skin Yellow, fibrous film cover

Question 31

Observation of venous ulcer

Answer 31

Hemosiderin staining | Shiny, taut, sclerotic skin

Question 32

Pitting edema scale ranges from

Answer 32

1 + to 4+

Question 33

pit is noticeable deep and may last more than a minute

Answer 33

3+

Question 34

somewhat deeper pit, disappears in 10-15 | seconds

Answer 34

2+

Question 35

pit is very deep, lasts 2-5 minutes, extremity is grossly distorted

Answer 35

4+

Question 36

slight pitting, no visible distortion, | disappears rapidly

Answer 36

1+

Question 37

Normal circulation – leg volume increases gradually through arterial inflow (venous fill time test)

Answer 37

10-15 sec

Question 38

volume increases rapidly | through arterial inflow and venous backflow. Peripheral veins become obvious

Answer 38

Venous insufficiency

Question 39

Goals of Treatment

Answer 39

 Decrease venous pressure  Decrease edema and prevent reoccurrence  Optimize wound healing environment  Prevent recurrence due to chronic nature of disease

Question 40

If not healing > 0.1 cm a week, probably

Answer 40

Not going to be healed at 6 weeks

Question 41

If a suspected venous ulcer does not improve after 6 weeks, recommendation is for a

Answer 41

biopsy to rule out malignancy, vasculitis, pyoderma | gangrenosum, or infection

Question 42

Wound interventions

Answer 42

Dressings Debridement Topicals/antibiotics

Question 43

Do you do whirlpool for edema management?

Answer 43

NO!!!

Question 44

Contraindications for compression

Answer 44

ABI less than 0.7 Thrombus Infection Acute CHF

Question 45

Arterial ulcer location

Answer 45

Toes, dorsal foot

Question 46

Venous ulcer location

Answer 46

Pretibial or prox to medial malleolus

Question 47

Appearance for arterial vs venous ulcer

Answer 47

A: pale V: beefy red

Question 48

Depth of arterial vs venous ulcer

Answer 48

A: deep V: shallow

Question 49

Pain for a vs v

Answer 49

A: severe V: achy, heavy

Question 50

Pedal pulses for a vs v

Answer 50

A: decreased or absent V: normal

Question 51

Edema/girth for a vs v

Answer 51

A: normal V: increased

Question 52

Skin temps or a vs v

Answer 52

A: cool V: normal or mild warm

Question 53

Tissue changes for a vs v

Answer 53

A: yellow nails, shiny, no hair V: dry skin, hemosiderin staining

Question 54

Leg elevation in a vs v

Answer 54

A: increases pain V: decreases pain and swelling