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Flashcards in Venous testing Deck (45)
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1

most common findings of DVT?

swelling, pain, redness, warmth

2

differential diagnoses of DVT?

muscle strain
direct injury
muscle tear
bakers cyst
cellulitis
lymphangitis
heart failure
extrinsic compression

3

Most common findings of chronic DVT?

swelling, heaviness, discoloration, ulcers, varicosities

4

what does erythema indicate?

inflammatory process, cellulitis

5

what does brawny (brown) color indicate?

venous stasis usually lower leg to ankle area

6

what does pallor indicate?

arterial spasms secondary to extensive, acute iliofemoral thrombosis; limb threatening; called phelgmasia alba dolens

7

what does cyanosis indicate?

severely reduced venous outflow from iliofemoral thrombosis markedly reduces arterial inflow; limb threatening; called phlegmasia cerulea dolens (venous gangrene)

8

characteristics of venous ulcers?

often near medial malleolus, shallow and irregular
mild pain
venous oozing
stasis changes: inflammation, infection, brawny, presence of varicos

9

characteristics of arterial ulcers?

-tibial, toes, and bony prominences are common areas
-deep, regular shape, punch-out appearence
-trophic changes: dryness, scaly, atrophy, shiny skin, loss of hair, thickened toenails
-severe pain
-little bleeding

10

What are the characteristics of pitting edema?

-fluid in subcutaneous tissue
-depression of skin surface with manual pressure
-can be related to CHF, fluid retention, elevated venous pressure

11

What is lymph edema?

when fluid accumulates after lymph nodes and/or lymph vessels are removed or damaged
frequency seen after many types of cancer surgery
non-pitting edema

12

What is virchow's triad made up of?

trauma to the vessel/ endothelial damage
venous stasis
hypercoagulability

13

Why might surgery be a risk factor for DVt?

may be due to alteration in endothelial cell funciton

14

What can cause hypercoagulability?

certain protein deficiencies
pregnancy
cancer
hormones (estrogen)

15

What are the components of Paget-Schroetter syndrome?

- stress/effort thrombosis
-involves axillary or subclavian vein
-venous component of TOS

16

What are signs of superior vena cava syndrome?

-obstruction by neoplasm
-edema and engorgement of vessels evident
-patient may have cough and/or difficulty breathing
-flow in UE remains the same during inspiration (continuous)

17

Acute intraluminal thrombi frequently begin where?

at valve cusps or in soleal sinuses secondary to stagnation

18

Where do thrombi resulting from trauma occur?

at any site

19

Stretching of walls results in damage to valves and increased venous pressure causes flow changes, this is what?

chronic venous insufficiency

20

What is post-phlebitic syndrome?

-chronic flow changes result in persistent edema, stasis changes, and pain
-may also lead to ulceration

21

What are the most definitive diagnostic tools for diagnosing a PE?

CTA chest and pulmonary angiography

22

Primary varicose veins are what?

dilated veins secondary to valvular incompetence of superficial system
deep system is intact

23

What are secondary varicose veins?

dilated veins caused by incompetence of the superficial system resulting from deep venous obstruction
deep system is not intact

24

what are congenital venous diseases

-avalvular veins
-arteriovenous malformations
Klippel-trenaunay: can include multiple varicosities of superficial system and hypoplastic or absent deep veins

25

What is portal hypertension?

elevated venous pressure results from obstruction of blood flow, may result in reverse flow in the portal vein and increased portal venous pressure that impedes blood flow into the liver

26

What is DC coupling for PPG's?

-direct current
-electric voltage that is either positive or negative
-current flows in only one direction
-batteries are DC
-detects slow changes in blood content
-used for venous studies

27

What is AC coupling for PPG's

-alternating current
-electric voltage that reverses polarity 60 times a second
-current flows in both directions
-wall plugs deliver 120 volts of AC
-detects fast changes in blood content
-used for arterial studies

28

Where is the PPG sensor applied for veins?

lower leg, approx 5-10cm above medial malleolus

29

What is a normal venous refill time/venous reactive time?

> 20 sec without tourniquet

30

What is the result of the VRT for superficial system incompetence?

VRT 20 sec with tourniquet