Quiz #4.5 AKA Midterm / Week 6 DMS 223- Lower Extremity Venous

A normal vertebral artery spectral waveform commonly demonstrates which type of flow?

a sharp upstroke and good amount of diastolic flow

Surgery cannot be performed on a complete occlusion of the ICA.

true

list the pros to using ultrasound to evaluate lower extremity veins:

non-invasive

inexpensive

30 min exam

high sensitivity and specificity

list the cons to using ultrasound to evaluate lower extremity veins:

prone to be ordered for very vague symptoms

list some reasons for performing a lower extremity venous study:

R/O DVT

Prescence of PE

more than ____% of PE are caused by thrombi traveling from lower extremities

90

veins bring blood back to the:

heart

veins travel from the foot to the:

heart

veins have:

valves

veins have a ______________ tunica media than arteries

thinner

the lower extremity venous system has ___________ systems

3

list the three systems of the lower extremity:

deep

superficial

perforating

where is the deep system located?

in muscular sheath

the deep system follows the:

arterial tree

the superficial system does not have a:

arterial counterpart

the superficial system is located:

more superficial than dermis

the perforating veins connect:

superficial and deep systems

the superficial veins drain into the:

deep veins

list the three deep calf veins which correspond to arteries:

posterior tibial

peroneal

anterior tibial

the posterior tibial veins are located more:

lateral

which veins drain the back and medial aspect of the leg into the tibeoperoneal trunk?

posterior tibial

the posterior tibial veins are located just posterior to the:

medial malleolus

the peroneal veins are located more:

centrally

which veins are located posterolaterally close to the fibula?

peroneal

the anterior tibial veins are located:

anterolateral

which veins run anteriorly coursing between the tibia and fibula?

anterior tibial

the popliteal vein is formed by the confluence of the:

tibeoperoneal trunk and anterior tibial veins

the popliteal vein becomes the:

femoral vein

the superficial femoral vein becomes the:

CFV

where does the superficial femoral vein become the CFV?

at confluence of profunda and superficial femoral vein

the profunda is the:

deep femoral vein

the femoral vein being evaluated when performing a LE venous exam is the:

superficial

CFV

common femoral vein

which vein joins/drains into the CFV?

greater saphenous vein

GSV

greater saphenous vein

where does the GSV join the CFV?

just superior to the joining of the profunda and FV

the CFV is ______________ to the common femoral artery

medial

the EIV is slightly superior to the jointure of the:

CFV and GSV

the __________________ becomes the EIV

CFV

the EIV is joined by the IIV to become the:

common iliac vein

the IVC is formed by the confluence of the:

common iliac veins

what is the longest vein in the body?

greater saphenous vein

the GSV is a ______________ vein

superficial

the GSV runs from the:

inguinal to ankle

the GSV is one the ___________ side of the leg

medial

the GSV drains into the:

CFV

the GSV is easier to locate in which plane?

TRV

the lesser saphenous vein is a ________________ vein

superficial

the lesser saphenous vein is _______________ in diameter than the GSV

smaller

the lesser saphenous vein is located:

in posterior calf

the lesser saphenous vein runs from the:

ankle to pop

the lesser saphenous vein drains into the:

pop v

the communicating veins between the superficial system and deep paired veins are known as:

perforators

each perforator has at least ____________ valve

one

the perforators are very small vessels

true

double or multiple venous systems in the leg are common at the:

femoral

pop

GSV

venous flow is _________ pressure

low

tips of valves always point toward the:

heart

valves are attached to the:

intima

malfunctioning valves allow flow to:

reverse

when muscles contract blood is pushed:

toward the heart

when muscles relax blood flows:

away from heart

transmural pressure

difference between intraluminal pressure and interstitial pressure

transmural pressure determines the ______________ of veins

shape

the higher the intraluminal pressure the more ____________ the vein will be

circular

when a vein is compressed intraluminal pressure:

decreases

when a vein is compressed interstitial pressure:

increases

hydrostatic pressure

weight of the column of blood extending from the heart to the level where pressure is being measured

standing HP at the ankle:

-120 mmHg

_____________ can be an early sign of DVT or venous insufiency

edema

ulceration

tissue breakdown due to lack of oxygen and nutrients

ulceration is most commonly seen with:

incompetent perforators

ulceration causes venous:

stasis and pools of blood in the legs

gaiter zone

brownish discoloration of the lower leg to ankle

gaiter zone is a result of:

chronic insufiency

fluid, RBCs, and fibrinogen leak into surrounding tissues is most likely related to:

gaiter zone

phlebitis

inflammation of veins

phlebitis causes increased:

pressure

list some indications for a LE venous exam:

swelling

pain

redness

warmth

gaiter zone

the most common and best indicator for a LE venous exam is:

swelling/edema

superficial veins do not have:

arterial counterparts

varicose veins are located in the:

superficial system

varicose veins may be the result of:

genetic

DVT

obesity

pregnancy

list some differential diagnosis for LE DVT:

injury

muscle tear

baker cyst

cellulitis

lymphangitis

heart failure

extrinsic compression

list some risk factors for LE DVT:

age

obesity

pregnancy

trauma

varicose veins

infection

previous DVT

Virchow's triad

trauma

stasis

hypercoagulability

explain why trauma is part of Virchow's triad:

could be damage to intimal lining

aggregation of platelets

(can be any kind of trauma)

explain why venous stasis is part of Virchow's triad:

slows down blood promoting clotting

venous stasis may be the result of by:

increased viscosity

immobility

CHF

obesity

hypotension

hypercoagulability

increased blood viscosity, blood clots more rapidly

hypercoagulability may be the result of:

cancer

pregnancy

estrogen

smoking

blood disorders

list the 7 qualities of venous assessment:

patency

spontaneity

phasicity

nonpulsatility

compression

augmentation

competence

patency is used to evaluate:

Prescence of thrombus

the superficial femoral veins is a ____________ vein

deep

fresh thrombus can be anechoic

true

spontaneity

spectral doppler should show low flow that changes with respiration

spontaneity diminishes as the vein travels further away from the:

heart

if there is no spontaneity then blood flow may only be seen with:

augmentation

phasicity

response to respiration

phasicity should be:

non pulsatile