Chapter 26 TESTING CONSIDERATIONS FOR NONINVASIVE VENOUS TESTING

Question 1

What are some examples of pertinent clinical history?

Answer 1

1. past studies
2. past procedure

Question 2

Physical examinations findings

Answer 2

1.swelling
2. redness
3. warmth

Question 3

What are laboratory findings?

Answer 3

blood work

Question 4

What is the degree of tension in vein walls?

Answer 4

Venomotor tone

Question 5

A sonographer is responsible for knowing?

Answer 5

1. laboratory protocols/standards
2. study capabilities
3. Study limitations
4. correct patient positioning
5. Correct technique
6. correct interpretation

Question 6

What does an IAC must have?

Answer 6

1. uniform diagnostic criteria
2. interpret all data obtained

Question 7

What are common findings for a DVT?

Answer 7

1. swelling
2. Pain
3. Redness
4. Erythema
5. Warmth

Question 8

What does the Wells Score determine?

Answer 8

The likelihood of an acute DVT

Question 9

What are some other conditions that mimic DVT’s?

Answer 9

1. muscle strain
2. direct injury to the leg
3. muscle tear
   4.Bakers cyst
4. Cellulitis
5. Lymphangitis
6. Heart Failure
7. Extrinsic compression
8. Compilations of the chronic venous insufficiency
9. Adventitial cystic disease

Question 10

What are the symptoms of Chronic Venous Thrombosis?

Answer 10

1. swelling
2. Erythema
3. Heaviness/aching
4. Discoloration of ulcerations
5. varicosities

Question 11

What is Virchow’s Triad

Answer 11

Trauma to the vessel

Question 12

What are the three conditions of Virchow’s Triad

Answer 12

1.Stasis
2. Vessel Wall injury
3. hypercoagulability

Question 13

What does intrinsic trauma entail?

Answer 13

1. intravenous drugs
2. catheter
3. Central venous catheter

Question 14

Extrinsic trauma is a result of what?

Answer 14

an accident

Question 15

Venous stasis can be a result of what?

Answer 15

1. Bed rest
2. myocardial infarction
3. congestive heart failure
4. hypotension
5. chronic obstructive pulmonary disease
6. obesity
7. pregnancy
8. Previous DVT
9. Extrinsic compression

Question 16

Hypercoagulability is a result of what?

Answer 16

1. Pregnancy
2. Cancer
3. Oral contraceptives
4. hormone replacement therapy
5. inherited states

Question 17

Where does thrombosis like to form?

Answer 17

Valve cusps/ soleal sinuses

Question 18

What is Paget-Schroetter syndrome?

Answer 18

Thrombosis of SCV/Axillary Vein due to intense repetitive activity.

Question 19

May-Thurner syndrome is now known as what?

Answer 19

Left Common iliac vein compression

Question 20

What does May Thurner syndrome entail?

Answer 20

Left common iliac vein (LCIV) compression by the Right common iliac vein (RCIV).

Question 21

What is Left renal vein compression?

Answer 21

aka nutcracker syndrome
compressed between the aorta and SMA.

Question 22

What is the great clinical danger of DVT?

Answer 22

Pulmonary Emoblism

Question 23

What are some ways valvular incompetence occurs?

Answer 23

Damaged valves by DVT or venous HTN.

Question 24

Chronic Venous insufficiency involves what?

Answer 24

1.both deep and superficial systems
2. Incompetent venous valves

Question 25

CVI is secondary to what?

Answer 25

DVT

Question 26

What type of environment decreases vasoconstriction?

Answer 26

warmer temperatures

Question 27

This condition, which leads to thrombosis, is caused by intense repetitive activity of the muscles in the thoracic outlet region.

Answer 27

Paget-Schroetter Syndrome

Question 28

This condition, which may lead to thrombosis, involves a gene mutation increasing risk for clot formation.

Answer 28

Factor V Leiden

Question 29

What is the only condition that is secondary to another condition?

Answer 29

post thrombotic syndrome

Question 30

Your next patient comes to you with a painful, swollen left leg. The swelling is extensive and involves the entire extremity. She's a very healthy 19 year old who plays varsity soccer, and has been for the past 5 years. She has no history of clotting disorders in her family. What do you think you should look for with this patient?

Answer 30

check her iliac vessels

Question 31

You're performing a renal duplex on a patient when obtain this image. You examine all vessels with color and spectral Doppler only to discover that there is no flow observed in the LRV. What do you think is happening here?

Answer 31

Nut cracker syndrome. LRV is compressed by the SMA and aorta.

Question 32

What essentially are we seeing with edema here in the tissue?

Answer 32

interstitial fluid in tissue

Question 33

What is Klippel-Trenaunay Syndrome?

Answer 33

hypoplastic or absent deep veins. Congenital Venous Disease.

Question 34

Portal hypertension will have what?

Answer 34

obstructed flow through the portal vein. Flow is hepatofugal

Question 35

Explain Superior Vena Cava Syndrome

Answer 35

Obstructed SVC, Head, neck, and arm congestion

Question 36

What is the most common cause of IVC Tumor?

Answer 36

Renal cell carcinoma

Question 37

A venous aneurysm will have a focal dyameter of what?

Answer 37

>50%

Question 38

What is the main site of swelling discoloration and ulcer formation?

Answer 38

The gaiter zone

Question 39

Erythema (red edema) is what?

Answer 39

inflammatory process and/ or cellulitis

Question 40

Brawny (brownish edema) represents what?

Answer 40

chronic venous insuficiency

Question 41

Lipodermatosclerosis is what?

Answer 41

Skin thickening/ hardening Due to longstanding venous hypertension

Question 42

Explain Phlegmasia Alba Dolens.

Answer 42

Whiteness/Pallor limb is very swollen, pale and painful. Has Pandiastolic flow Arterial compromise EXTENSIVE ACUTE PROXIMAL THROMBOSIS.

Question 43

Phlegmasia Ceruela Dolens

Answer 43

Blueish coloration Caused by an acute proximal vein thrombosis. Limb is very swollen, dark colored and painful

Question 44

Venouse ulcerations is due to what?

Answer 44

lack of oxygenated blood

Question 45

Ulcerations are commonly found where?

Answer 45

near the medial malleolus aka Gaiter zone

Question 46

Pitting edema is what?

Answer 46

an accumulation of fluid and subcutaneous tissue is displaced with manual pressure

Question 47

Non-Pitting edema is what?

Answer 47

Tissue is fully engorged with fluid and can't be displaced with manual pressure.