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RVT Review > Chapter 24 > Flashcards

Chapter 24 Flashcards

1
Q

what are the most common findings of acute DVT?

A

swelling
pain
redness
warmth

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2
Q

what are differential diagnoses for acute DVT?

A 
muscle strain 
direct injury to the leg
muscle tear
Bakers cyst
cellulitis 
lymphangitiis
heart failure
extrinsic compression
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3
Q

what are most common findings with chronic DVT?

A 
swelling
heaviness
discoloration 
ulcers 
varicosities
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4
Q

what is induration of skin /edema?

A

fluid accumulcation

body tissue contains excessive amount of fluid

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5
Q

what is erythema?

A

redness
inflammatory process
e.g celluitis

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6
Q

what is browish dicoloration from?

A

venous stasis usually in lower leg to ankle area (gaiter zone)

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7
Q

where is the gaiter zone?

A

lower leg to ankle

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8
Q

what is pallor?

A

whiteness

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9
Q

what is pallor caused from?

A

arterial spasms secondary to extensive, acute iliofemoral thrombosis.
limb threatening

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10
Q

what is phlegamsia alba dolens?

A

pallor/ whiteness

limb threatening

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11
Q

what is cyanosis?

A

bluish discoloration

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12
Q

what is cyanosis caused by?

A

severely reduced venous outflow from iliofemoral thrombosis markedly reduces arterial inflow
limb threatening

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13
Q

what is phegmasia cerulea dolens?

A

cyanosis leading to venous gangrene

tissue hypoxia can develop

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14
Q

what are locations of venous ulcers versus arterial?

A

venous: often near medial malleolus
arterial: tibial area, toes, bony prominences

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15
Q

what are the appearance of venous ulcers versus arterial?

A

V; shallow, irregular shape

A: deep regular shape punched out appearance

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16
Q

what are skin changes in venous ulcers versus arterial?

A

V: stasis changes: inflammation, infection, brawny discoloration, presence of varicosities
A: trophic changes: dryness, scaly, atrophy, shiny skin, loss of hair, thickened toenails

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17
Q

what is the pain level on venous ulcers vs arterial?

A

V: mild
A: severe

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18
Q

what is bleeding level on venous ulcers vs arterial?

A

V; venous ooze

A: little

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19
Q

what is pittying edema?

A

fluid in sub tissue
depression of skin surface with manual pressure
can be related to may conditions

20
Q

what conditions can cause pitting edema?

A

fluid retention
CHF
elevated venous pressure

21
Q

what is lymphedema?

A

fluid accumulates when lymph nodes and lymph vessel are removed or damaged

22
Q

what drains excess fluid from tissue?

A

lymphatic system

23
Q

when is lymphedema freq seen?

A

after many types of cancer surgery

24
Q

T/F lymphema is a non pitting edema

A

true

25
Q

what is paget-schroetter syndrome?

A

stress. effort thrombosis
involves the axillary or subclavian vein
venous component of TOS
young athletes

26
Q

based on virchows triad what is a trauma to the vessel/ endothelial damage?

A

paget-schroetter syndrome

27
Q

what is an example of venous stasis based on virchows triad?

A

SVC syndrome

28
Q

what are examples of venous stasis?

A

immbolility, chronic obstructive pulmonary disease, obesity, pregnancy, previous DVT, extrinsic compression

29
Q

what is SVC syndrome?

A

obstruction by neoplasm (benign or malignant)
edema and engorgement of vessels evident)
pt may have cough or difficulity breathing
flow to the UE remains the same during inspiration i.e continuous flow

30
Q

why is surgery a risk factor for DVT?

A

may be due to alteration in endothelial cell function

31
Q

what are examples of hypercoagulabilty?

A

certain protein deficiencies, pregancy, cancer, hormones i.e estrogen intake

32
Q

where is acute thrombosis freq seen

A

intraluminal thromi frq begin at valve cusps or in soleal sinuses secondary to stagnation

33
Q

T/F thromi resulting from trauma do not occur at any site

A

false

34
Q

what is chronic venous insufficiency?

A

stretching of walls results in damage to valves

increased venous pressure causes flow changes

35
Q

what is post-phlebitic syndrome?

A

chronic flow changes result in persistent edema, stasis changes and pain
may also lead to ulceration

36
Q

what is pulmonary embolism?

A

thrombus breaks loose

travels into pulmonary circulation

37
Q

how do they diagnosis PE?

A

CTA chest and pulmonary angiography are currently the definitive diangosit tools
can be life threatening

38
Q

what is valvular incompetence?

A

valves no longer maintain uni-directional flow

calf muscle pump no longer forces blood cephalad toward heart or from superficial system into deep

39
Q

what are results of valvular incompetence?

A

increase pressure/ venous HTN
ambulatory venous HTN: increasing pressure when patient stands or walks
precipiates edema, varicosities and ulcers
fluid, red blood cells and fibrinogen may leak into surrounding tissue. hemosiderin from breakdown of stagnant red blood cells cause brawny discoloration
breakdown of other substances prevents proper tissue nutrition and oxygenation

40
Q

what is primary varicose veins>

A

dilated veins secondary to valvular incompetence of superfical system. deep system intact

41
Q

what is secondary varicose veins

A

dilated veins caused by incompetence of the superficial system resulting from a deep venous obstruction. deep system not intact

42
Q

what are congential venous diseases?

A

avalvular (valveless) veins
AVM
klippel trenaunay

43
Q

what is klippel trenaunay syndrome>

A

can include multiple varicosites of the superficial system and hypoplastic or absent deep veins

44
Q

what is portal HTN?

A

elevated venous pressure
results from obstruction of blood flow
may result in reverse flow in the portal vein and increased portal venous pressure that impedes blood flow into the liver

45
Q

what is portal HTN related to>

A

to some form of advances chronic liver disease
cirrhosis
hepatitis

46
Q

what causes IVC tumor>

A

RCC

RVT Review (30 decks)

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