Leg Edema and Cramping Flashcards Preview

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Flashcards in Leg Edema and Cramping Deck (23)
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1

Normal venous pressure

80mm Hg in deep veins
20-30mm Hg in superficial veins

2

Cephalad venous blood flow
(what brings blood back up from veins towards heart)

Biscuspid venous valves
Effective muscle contractions
Normal respirations

3

Dark areas on face or ankles

blood pooling, can’t move onto next location and is stuck in one area breaking down= dark purple/brown (may see this under eyes when someone has allergies)

4

LE edema occurs in response to

Increased venous or lymphatic pressures
Decreased intravascular oncotic pressure
Increased capillary leak
Local injury or infection

5

Most common cause of LE edema

chronic venous insufficiency

6

Always check....

Always check potassium AND magnesium levels
May need to give magnesium too

7

How hyperthyroidism

-If pt hypothyroid, taking TOO MUCH medication, TSH is low and they have induced hypothyroidism= may get leg CRAMPING

-If someone isn’t taking ENOUGH thyroid medication= may see leg SWELLING

8

DVT causes

Malignancy, esp untreated
Recent limb immobilization or paralysis
Bedridden >3 days due to surgery in past 4wk
Previous DVT

9

DVT Signs/Symptoms

Localized tenderness along deep veins
Swelling of entire leg
Swelling of one calf >3cm (normal for ___ calf to be larger than ___)
Ipsilateral pitting edema
Collateral superficial veins

10

For DVT, you MUST use _______

NEED to use DVT prophylaxis (ex: heparin, lovanox, compression stockings)

Check for Homann sign

11

DVTs and women over 35 years old

Oral contraceptives over the age of 35, be careful (larger amount of hormone predisposes them to coagulopathy)

12

Bilateral involvement with improvement after awakening may be caused by

Systemic (heart failure, cirrhosis)

13

Heavy legs or itching may be caused by

Chronic venous insufficiency

14

LE swelling or inflammation with recent DVT may be caused by

Postphlebetic syndrome

15

Ultrasound is used diagnostically to test for

arterial or venous insufficiency depending on cause

DVT- venous doppler
Arterial- arterial or venous doppler
Checking for clots and narrowing

16

D-dimer

usually done in ER only, if VERY high may indicate coagulopathy or inflammation

17

Other diagnostic testing for LE edema

-Ankle brachial pressure index
-CT (can see muscle tear, subcutaneous swelling)
-D-dimer
-Ultrasound
-Kidney function/urine analysis (looking for protein first, and also RBC or WBC casts, looking for signs of nephritis)

18

Chronic liver cirrhosis, LFTs will _______

NOT be elevated, it wont be putting anything out anymore (due to excessive damage over time)

19

Treatment- Compression stockings are used for

for VENOUS issue, not usually arterial issues; helps bring blood back UP to heart, reason it doesn’t help with arterial problems, because in arteries blood is moving AWAY from heart

20

Treatment- OMM is better for

-better for VENOUS issues, don’t do OMM for ARTERIAL issues; venous stasis, lymphedema, etc. can do OMM
-will see skin changes, can feel changes in muscle

21

Treatment- Aspirin and walking helps for

-PAD: for ARTERIAL disease, walking helps because if you have a clogged vessel and force a lot of blood through, eventually breakdown of clot will occur, it will open up the vessel more, OR it will create microcirculation, more new vessels form around the area of blockage to help perfuse the area better, lessens pain eventually. Aspirin thins blood which helps it move through easier

22

If left untreated, cellulitis may lead to

compartment syndrome (infection can spread from this, it’s a medical emergency, may cause sepsis)
-Can use CT to check for compartment syndrome if you suspect this (can see infection or changes in muscle and fascia)

23

LIFE THREATENING cases of LE edema

-High risk for DVT
-Compartment syndrome
-Acute edema that impairs ability to function