PATHO - Blood Vessels 3 (Venous Diseases)

Raynaud phenomenon

What phenomenon is defined as exaggerated vasoconstriction of digital arteries?

Pallor

What color change is caused by reduced blood flow in Raynaud phenomenon?

Cyanosis

What color change reflects lack of oxygen in Raynaud phenomenon?

Erythema

What color change appears with reperfusion in Raynaud phenomenon?

Raynaud disease

What is the other name for Primary Raynaud Phenomenon?

15-30 years

What age range is most associated with Primary Raynaud Phenomenon?

Female

What sex is more commonly affected by Primary Raynaud Phenomenon?

Symmetric

Primary Raynaud Phenomenon shows what pattern of extremity involvement?

Atrophy

Chronic Primary Raynaud Phenomenon leads to what skin change?

Subcutaneous tissue

Chronic Primary Raynaud Phenomenon may lead to atrophy of what soft tissue?

Raynaud syndrome

What is the other name for Secondary Raynaud Phenomenon?

Systemic lupus erythematosus

Secondary Raynaud Phenomenon is associated with what autoimmune disease?

Buerger disease

Secondary Raynaud Phenomenon is associated with what vasculitis?

Asymmetric

What pattern of involvement occurs in Secondary Raynaud Phenomenon?

Severity

Secondary Raynaud Phenomenon progressively worsens in what two aspects?

Extent

Secondary Raynaud Phenomenon progressively worsens in what second aspect?

Myocardial vessel vasospasm

Excessive constriction of coronary arteries describes what condition?

SMC hyperreactivity

Increased reactivity of smooth muscle cells refers to what underlying mechanism?

Vasoactive mediators

High levels of what signaling molecules can cause vasospasm?

Thyroid hormones

Elevated levels of what hormone can cause coronary vasospasm?

Scleroderma

Autoantibodies in what connective tissue disease can cause vasospasm?

Psychologic stress

Severe emotional disturbance is what trigger for coronary vasospasm?

Fatal arrhythmia

Myocardial vessel vasospasm can cause sudden death due to what arrhythmic event?

Myocardial infarction

Prolonged vasospasm can lead to what myocardial injury?

Ischemic cardiomyopathy

Chronic ischemia from vasospasm may lead to what cardiomyopathy?

Thrombosis

Venous disease predisposes patients to what intravascular complication?

Pulmonary embolism

Thrombosis in veins can result in what pulmonary complication?

Dusky cyanosis

Venous stasis from thrombosis causes what color change?

Edema

Venous stasis results in what type of tissue fluid accumulation?

Varicose veins

What disorder describes dilated, tortuous superficial leg veins?

90%

What percent of venous diseases are due to varicose veins and thrombosis?

Deep veins

Which venous system handles the majority of venous blood in the legs?

Superficial veins

Which venous system is low-pressure and prone to valve failure?

Venous dilation

Weakness of venous walls and valves predisposes to what condition?

Genetic defects

What hereditary factor contributes to venous wall weakness?

Perivenous tissues

Aging causes atrophy of what tissues leading to varicose veins?

Prolonged standing

What posture-related factor is the most important influence on varicose veins?

Iliac veins

Pregnancy increases venous pressure due to compression of what veins?

Blood volume

Pregnancy increases venous pressure also due to increased what?

Elongated

Grossly, varicose veins appear dilated, tortuous, and what shape?

Nodular

What type of nodularity may be seen in varicose veins?

Valvular deformities

Valvular structural change found in varicose veins?

Phlebosclerosis

Degeneration of medial elastic fibers with calcification is called what?

Fibrosis

Which two histologic features indicate advanced varicose veins?

Thrombosis

Varicose veins frequently develop what intraluminal complication?

Ulceration

Impaired tissue nutrition from venous stasis leads to what?

Bluish-brown

Venous stasis causes what skin discoloration pattern?

Statis dermatitis

Severe venous insufficiency leads to what dermatologic condition?

Thromboembolism

Venous insufficiency causes edema, congestion, and what thrombosis risk?

Portosystemic shunts

Portal hypertension causes varices due to opening of what shunts?

Submucosal plexus

Portal hypertension causes dilation of what esophageal venous plexus?

Esophageal varices

What are dilated submucosal veins in the esophagus called?

Vomiting

Rupture of esophageal varices is commonly triggered by what event?

Lethal hemorrhage

Rupture of esophageal varices is commonly described as what complication?

Inferior hemorrhoidal plexus

External hemorrhoids arise from what venous plexus?

Squamous epithelium

External hemorrhoids are covered by what epithelium?

Internal hemorrhoidal plexus

Internal hemorrhoids arise from what submucosal plexus?

Portal system

Internal hemorrhoids drain into what venous system?

Columnar epithelium

Internal hemorrhoids are covered by what epithelium?

Engorged cushions

Mixed hemorrhoids involve both plexuses and produce what?

Anal cushions

What structures contain the hemorrhoidal venous plexuses?

Prolapse

What symptom occurs when anal cushions protrude externally?

Pampiniform plexus

Varicoceles involve dilation of what venous network?

Left

Varicocele is more common on what side of the body?

Bag of worms

Varicocele causes scrotal swelling described as what?

Infertility

Varicoceles may impair spermatogenesis leading to what?

Endothelial injury

What is the first event in venous thrombosis development?

Immobilization

Venous stasis commonly results from what condition related to mobility?

Factor V Leiden

What gene mutation causes resistance of Factor V to Protein C?

Thrombosis

Factor V Leiden mutation leads to increased risk of what?

Prothrombin mutation

What mutation increases prothrombin levels and thrombosis risk?

Hypercoagulability

What malignancy-associated state increases thrombosis?

Heart failure

What cardiac condition with poor output predisposes to thrombosis?

Thrombosis

Obesity increases risk of what venous pathology?

Firm

A thrombosed vein is typically distended and what?

Vessel wall

A venous thrombus is easily separated from what structure?

Reparative change

Inflammation attached to a thrombus indicates what process?

Deep leg veins

What location accounts for 90% of venous thromboses?

Periprostatic plexus

In males, secondary thrombosis occurs in what venous plexus?

Pelvic veins

In females, thrombophlebitis often occurs in what venous system?

Dural sinuses

Thrombophlebitis may occur in what cranial venous channels?

Edema

What limb sign results from venous congestion and fluid accumulation?

Homan sign

What classic but nonspecific sign of DVT involves dorsiflexion pain?

Superficial thrombophlebitis

What type of thrombophlebitis occurs in superficial varicose veins?

Thrombophlebitis migrans

What type of thrombophlebitis manifests with recurrent venous clots?

Malignancy

Thrombophlebitis migrans is associated with what underlying disease?

Phlegmasia alba dolens

What condition is known as “painful white leg”?

Iliofemoral veins

Phlegmasia alba dolens usually involves thrombosis of what veins?

Phlegmasia cerulea dolens

What condition is known as “painful blue inflammation”?

Venous gangrene

Phlegmasia cerulea dolens presents with what critical limb event?

Lung cancer

Most common malignancy causing SVC syndrome?

Aneurysm

What vascular pathology may compress the SVC?

Facial edema

SVC obstruction causes edema of what region of the face?

Jugular veins

SVC syndrome causes venous distention in what neck structure?

Dyspnea

What respiratory symptom results from impaired SVC drainage?

Headache

What neurological symptom worsens when bending over?

Renal veins

IVC syndrome may occur due to thrombosis in what abdominal organs?

Peripheral edema

IVC obstruction causes what lower extremity condition?

Fetal hypoxia

Pregnant women with IVC syndrome may develop what fetal complication?

Supine hypotensive syndrome

Supine IVC compression during pregnancy causes what syndrome?