Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

CP3 SURGERY > Vascular - Venous pathology > Flashcards

Vascular - Venous pathology Flashcards

(83 cards)

Start Studying
1
Q

What are the 2 venous systems taking blood from the lower limbs back to the trunk?

A

Superficial + deep vv system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Superficial vv system

A

Medial: long great saphenous vv
Lateral: short saphenous vv

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where does the long great saphenous vv drain into

A

Into saphenofemoral jct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where does the short saphenous vv drain into

A

popliteal vv

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does the deep venous system drain?

A

The muscle compartment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does the superficial vv system drain?

A

Skin + surrounding tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Where are the superficial and deep vv systems joined?

A

Saphenofemoral + saphenopopliteal jct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What comprises the additional communications between the deep + superficial vv systems

A

Periforating vv

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What prevents backflow in the leg vv

A

valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which vv do not have valvves (2)

A

Vena cava

COmmon iliac vv

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What drives vv return to the heart?

A

Pressure from mm pumps below

_+ inspiration decreasing intrathoracic P

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does vv disease in deep vv lead to?

A

Deep venous insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does vv disease in superficial vv lead to

A

Simple varicose vv

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are both varicose vv and deep vv insufficiency a result of?

A

Valvular incompetence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Def varicose vv

A

Abnormally dilated and lengthened superficial vv

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the 2 types of varicose vv

A

Primary (idiopathic)

Secondary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the most common type of varicose vv

A

Primary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

M:F 1’ varicose vv

A

1:2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are 1’ varicose vv due to

A

1’ superficial valve defects with familial elements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What do 2’ varicose vv occur 2’ to

A

Deep vv incompetence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Causes of 2’ varicose vv

A

Prev DVT

Raised systemic vv P (b/c compression)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Sx of varicose vv (4)

A

Unsightly
Tired, aching, throbbing legs
Oedema ankles, partic after standing for long periods
Signs of deep vv insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Are varicose vv usually painful

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When are varicose vv painful

A

If thrombophlebitis is present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is thrombophlebitis
Inflamm of superficial vv due to venous stasis
26
Why does deep vv insufficiency occur
Valves of deep vv system are incompetent, so calf can't efficiently return blood to thoracic cavity
27
What is 1' deep vv insufficiency due to
Congenital absence valves
28
What is 2' deep vv insufficiency due to
DVT --> valvular damage or AVF raising vv pressure
29
Features deep vv insufficiency (8)
``` Limb aching/discomfort Oedema lower leg Superficial varicose vv Haemosiderin deposition Eczema over pigmented area --> pruritis Atrophic blanche Lipodermatosclerosis Ulceration ```
30
Ix deep vv insufficiency
Duplex sonography | Or venography
31
Different Ix for diagnosing vv diseaase
Hand held doppler Duplex scanning - using B mode Venography Trendelenberg
32
What does hand-held doppler do
ID reflux at saphenofemoral/saphenopoliteal jct
33
What does dupplex scanning (b mode) do
Diagnose valvular and perforating vv incompotence as well as large vv occlusion
34
How does venography work
Tourniquet placed around ankle to occlude superficial vv, then contrast injected into foot
35
Tx indications varicose vv (4)
Grossly dilated/ Sx varicosities Haemorrhage Concomitant deep vv insuffiency Incompetent perforator vv
36
Tx options varicose vv (5)
``` 1 - lifestyle advice 2 - graded stocking 3 - endothermal ablation - Tx of choice 4 - Sclerotherapy 5 - surgery ```
37
What lifestyle advice can you give for Mx varicose vv (3)
Avoid prolonged standing Exercise regularly Lose W
38
What is the gold standard Mx of varicose vv
Surgery
39
Complications of varicose vv
Haemorrhage (from minor trauma) | Phelbitis
40
Sx of phlebitis
VV becomes harder + tender + erythema + systemic upset
41
Most common sites of DVT (5)
``` Anterior tibiial Posterior tibial Perineal Superior femoral Popliteal vv ```
42
RF DVT (9)
``` Age Immobility Pregnancy OCP Malignancy Obesity Surgery Prev DVT ```
43
CF DVT (7)
``` Mostly silent Calf tenderness + firmness Oedema Erythema + calor Distention superficial vv Superficial thrombophlebitis Homans sign ```
44
What is Homans sign + why doesn't it be tested
Pain on dorsiflexion ankle | Shouldn't be tested in case of dislodging
45
How can iliofemoral thrombosis PS
Severe pain
46
PS PE (3)
Sudden onset unexplained dyspnoea Pleuritic chest pain Haemoptysis
47
Ix DVT
D-dimer Compression USS Thrombophilia screen
48
Is D-dimer sensitive or specific to DVT's
Sensitive
49
Other conditions --> raised D-DImer
Infection Pregnancy Malignancy Post0op
50
Preventing DVT's post op (4)
STOP COCP 4w pre-op Mobilise ASAP If immobile - herapinize pt Support hosiery
51
Tx of proven DVT
LMWH - then stop when INR 2-3 | Heparin
52
How long to take WARFARIN for - provoked DVT
3m
53
How long to take Warfarin for - unprovoked DVT
6m
54
How long to take Warfarin for - rec DVT/known thrombophilia
LIfe
55
DDx - pt who ps w/ bilateral leg swelling
``` Lymphoedema Cellulitis Varicose vv Phlebitis Acute aa ischaemia HF Hyponatraemia ```
56
Chronic vv insufficiency - VVV LAPS
``` Varicose vv Venous ulcers Venous stars Lipodermatosclerosis Atrophy blanche Pitting oedema Scars ```
57
Venous ulcer appearance
Shallow with irregular borders + granulating base | Esp over medial malleolus
58
Arterial ulcer appearance
Often small deep lesions with well defined borders and a necrotic base
59
Neuropathic ulcer appearance
Punched out appearance, most commonly on site of P in foot (glove + stocking distribution)
60
What is cellulitis
Infection of skin + underlying soft tissue
61
What are PE's usually caused by?
DVT's in legs
62
PS PE
Sudden onset breathlessness Pleuritic pain Haemoptyisis
63
How many days post surgical do PE's tend to occur
c day 10
64
Def massive PE (5%)
>60% pulmonary circulation is blocked
65
Outcome of massive PE
Rapid CV collapse
66
Def major PE (10% )
Middle sized pulm aa is blocked
67
Sx Major PE (3)
Breathlessness Pleuritic chest pain Haemoptysis
68
Def minor PE (85%)
Small peripheral vessels are blocked
69
What is a premonitory embolus
Massive PE may ensue following a minor PE
70
Signs PE (3)
DVT Raised JVP Cyanosis if embolus is large
71
Ix - suspected PE (9)
``` FBC, U+E, clotting, D-dimer ABG CXR ECG Echo CTPA ```
72
CXR findings PE (3)
Often norm Or dilated pulm aa Wedge shape opacities
73
ECG findings PE
Tachy C RBBB RV strain - SI, QIII, TIII = rare
74
What is SI, QIII, TIII
Large S wave lead I Q wave lead III T wave inversion III
75
What is the gold standard Ix PE
CTPA
76
Mx massive PE
``` A-E IV morphine + anti-emetic LMWH If SBP >90 --> Warfarin If <90 - start vasopressors first ```
77
Def lymphoedema
Swelling which results from an increased quantity of fl in the interstitial space of soft tissues, due to failure of lymphatic drainage
78
Congenital cause of primary lymphodema?
Milroys - congen abnormality of lymphatic vessels
79
2' causes of lymphoedema
``` B/c obstruction of lymphatic vessels Filaria infection Repeated cellulitis Malignancy Post op ```
80
What is Stemmer's sign
Pinch + lift skin on 2nd toe to establish presence of lymphoedema
81
Ix lymphoedema
Lymphoscintography
82
Mx lymphoedema
Elevation Compression stockings Massage
83
Risks of angiography (5)
``` Contrast reaction Haematoma Pseudoaneurysm AVF formation Aa occlusion ```

CP3 SURGERY (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions