Venous and Lymphatic Disorders

Question 1

acute thrombophlebitis

Answer 1

inflammation c occlusion of sficial or deep veins in LE

from immob or trauma

pain, swelling and warmth

Question 2

what connects superficial and deep veins

Answer 2

perforating vessels

Question 3

venous thromboembolism or DVT predisposing factors

Answer 3

prolonged immob

estrogen use

previous DVT

family hx of thrombosis

hypercoagulable state

Question 4

once thrombosis forms, what can happen

Answer 4

propagate

dislodge and embolize

removed by fibrinolytic activity

organization - recanalization and retraction

probs in other vein structures

Question 5

implication of DVT to PT

Answer 5

exercises are contraindicated unless cleared

Question 6

well’s criteria for DVT

Answer 6

> or equal 2 - DVT is likely
< 2 - DVT is unlikely

Question 7

components of well’s criteria

Answer 7

active cancer

recent bedridden > 3 d and major surgery within 4 wks

calf swelling > 3 cm vc other leg

collateral superficial veins present - non varicose

local tenderness

pitting edema

paralysis, paresis or recent plaster immob of LE

previous DVT

Question 8

discuss chronic venous insufficiency

Answer 8

inadequate venous return d/t
- insufficient peripheral venous valves
- problem c tunica media

leads to venous HTN and stasis in the LE - blood goes back and pools in leg

Question 9

cause of chronic venous insufficiency

Answer 9

cause: severe DVT, varicose veins and trauma

Question 10

ssx of chronic venous insufficiency

Answer 10

dependent peripheral edema

dull and aching pain

tiredness

venous distention

skin discoloration/pigmentation

skin ulcerations

Question 11

discuss lymphatic disorders

Answer 11

congenital malformation of lymphatic system

infection and inflammation from obstruction or fibrosis

Question 12

lymphedema

Answer 12

most frequent form

primary - hereditary or congenital

secondary - d/t infection, trauma, tumor, cancer, obstruction, surgery, radiation

Question 13

lymphedema at birth, puberty or pregnancy and after 35 yo

Answer 13

at birth - congenital

puberty or pregnancy - praecox

p 35 yo - tarda

Question 14

grading of lymphedema

Answer 14

0: no edema, tissue and skin normal

1: easily pits and reduced by elevation; (-) stemmer

2: does not easily pit and reduce c elevation; (+) stemmer

3: fibrosis and sclerosis of skin

Question 15

clinical manifestations of edema

Answer 15

painless swelling

heavy limb

stiffness of fingers and toes

LOM

tautness of skin

sensory disturbance

skin breakdown and infection