Chapter 25- Venous Duplex Imaging

Question 1

What is the correct word for when were pushing down on the vein to make it “collapse”?

The wording is important !!

Answer 1

COAPTING the wall.

Question 2

What is a “Baker’s Cyst”?

Answer 2

Baker’s cyst is a synovial cyst found behind the knee

Question 3

If we see a femoral vein obstruction, what vessel might we expect to have become a collateral to help compensate?

Answer 3

Profunda

Question 4

Thrombus in the GSV vein can require more aggressive treatment if near the junction.

True or False

Answer 4

True

Question 5

In the image where we have the popliteal vein and artery, what are the vessels often seen anterior to that?

Answer 5

the SS and the gastrocnemium veins and arteries.

Question 6

Thrombus is very common in the Anterior tibial veins

True or False

Answer 6

FALSE, very rare

Question 7

These veins serve as a reservoir for the legs

Answer 7

Sural veins

Question 8

Gastrocnemium veins drain into the popliteal

True or False

Answer 8

TRUE

Question 9

Do soleal veins have arteries paired with them?

Answer 9

no

Question 10

the IJV terminates into the

Answer 10

subclavian vein

Question 11

The innominate vein is formed by what to vessels?

Answer 11

the IJV and subclavian vein

Question 12

Why does a vessel get larger when it has a DVT?

Answer 12

Veins are elastic, when the lumen is obstructed and pressure increases, the vein dilates to compensate.

Question 13

If we see continuous flow in the lower extremity, what abnormality should we be thinking?

Answer 13

proximal obstruction to the sample site

Question 14

What is the Rouleaux Formation?

Answer 14

it is when we see sluggish flow moving in vein, such like a roll of coins in a stack.

Question 15

rouleaux formation is often seen when there is a proximal obstruction.

True or Falsed

Answer 15

True

Question 16

Because the upper extremities are closer to the heart, what kind of waveform is often seen

More phasic or pulsatile?

Answer 16

Anyting closer to heart is more pulsatile such as the innominate, subclavian, and sometimes axillary.

Question 17

What is a quick trick to make the subclavian vein collpase if we cannot manually compress it?

Answer 17

pursing the lips and taking a quick breath in

Question 18

If we see continous flow in the axillary vein, what should our first though be?

Answer 18

proximal obstruction

Question 19

Which of the abdominal veins are pulsatile?

There is 3

Answer 19

IVC, Hepatic and Renal Veins

Question 20

The____ renal vein is closer to the IVC, therefore more pusatile flow will be seen there.

Left or Right?

Answer 20

Right renal vein, the left renal vein is further

Question 21

Which three abdominal veins have continous flow

Answer 21

Portal, Splenic, and mesenteric

Question 22

What is chronic phlebosclerosis?

What is it commonly associated with?

Answer 22

The scarring of the vein often seen with a history of DVT.

Question 23

Pulsatile flow is normal in the ___ extremities, but not in the ___ extremity.

Answer 23

pulsatile flow in the upper extremities not the lower extremities

Question 24

Reflux/retrograde flow is normal in patients with phlebosclerosis

True or False?

Answer 24

True

Question 25

If we see abnormal pulsatile flow in the lower extremity, what disorder should come to mind?

Answer 25

Venous hyptertension/right heart failure.

Question 26

What is the syndrome in which there is an iliac compression?

Answer 26

May- Thurner syndrome

Question 27

What are some common causes for May-Thurner syndrome?

Answer 27

Pregnancy, mass, enlarged lymph node, tumor , pregnancy

Question 28

What is an IVC filter used for?

Answer 28

used to catch and hold thrombus emboli to prevent pulmonary embolus

Question 29

Where are IVC filters usually located?

Answer 29

In the IVC below the level of the renal veins

Question 30

occlusion of the hepatic veins is called?

Answer 30

Budd Chiari

Question 31

What are some indications for “chronic” venous insufficiency?

Answer 31

leg heaviness/achiness, discomfrot, itching, burning, edema, varicosities, skin changes

Question 32

A patient comes in with a sudden onsite of ascites, abdomen pain, and liver enlargement. what disorder does this sound like?

Answer 32

Budd-Chiari- occlusion or thrombus of hepatic veins

Question 33

When doing a “insufficiency study”, we see no flow in the waveform during distal compression. Is this normal or abnormal?

Answer 33

Normal

Question 34

When doing an insufficiency study, we see retrograde flow, what does this mean?

Answer 34

patient has incompetent valves not controlling the flow going through

Question 35

In the superficial system, what is the criteria to determine “reflux”?

Answer 35

Retrograde flow more than 0.5 seconds

Question 36

In the deep system, what is the criteria to determine “reflux”

Answer 36

Retrograde flow more than 1 second.