Exam 3 - Lower & Upper Extremity Venous - 1

All of the above criteria will aid in the diagnosis of DVT. Vein enlargement can indicate the presence of a blood clot, while visualization of an echogenic thrombus in the lumen can provide direct evidence of a clot. The absence of color or spectral waveforms suggests that there is no blood flow in the affected area, which is another indication of DVT. Therefore, considering all three criteria together can help in the accurate diagnosis of DVT.

Thrombus in the deep veins of the lower extremity can lead to a serious condition called pulmonary embolus. A pulmonary embolus occurs when a blood clot breaks off from the deep veins and travels to the lungs, blocking the blood flow. This can result in difficulty breathing, chest pain, and even death if not promptly treated. Compression of the pelvic veins, lymphedema, and venous hypertension are potential consequences of thrombus, but they are not as severe or life-threatening as a pulmonary embolus.

Virchow's Triad is a concept that explains the factors contributing to the formation of blood clots in veins. It consists of three components: blood stasis, hypercoagulability of blood, and injury to vein walls. Blood stasis refers to the slowing or pooling of blood flow, which can occur due to immobility or obstruction in the veins. Hypercoagulability of blood refers to an increased tendency of the blood to clot, which can be caused by various factors such as genetic disorders or certain medications. Injury to vein walls can result from trauma or inflammation. When these three factors are present, the risk of developing blood clots, particularly deep vein thrombosis (DVT), increases significantly.

The popliteal vein is formed by the confluence of the peroneal veins and the tibial veins. It then becomes the SFV (short saphenous vein) at the level of the adductor canal. This means that the correct answer is the popliteal vein.

Moving to a more anterior position and compressing from behind would be the most effective technique in this case. As the superficial femoral vein becomes more difficult to follow and compress distally in the thigh, changing the position and compressing from behind can help improve visualization and compression of the vein. This technique allows for better access and manipulation of the transducer to obtain a clearer image and compress the vein effectively.

The adjacent artery is most helpful in the identification of the deep veins of the lower extremity. This is because the veins and arteries in the body often run parallel to each other, and the location of an adjacent artery can help in locating the corresponding deep vein. By identifying the adjacent artery, healthcare professionals can accurately identify and locate the deep veins, aiding in various medical procedures and treatments.

The lesser saphenous vein is not a deep vein of the lower extremity. It is a superficial vein that runs along the back of the leg, connecting to the popliteal vein. The other options listed are all deep veins of the lower extremity, responsible for carrying blood from the lower leg back to the heart.

The greater saphenous veins ascend along the medial aspect of the entire lower limb, which means they are located closer to the midline of the body. These veins then empty into the common femoral vein just distal to the inguinal ligament.

The preferred method for assessing vein wall compressibility is gentle firm probe pressure in TRV. This means that when examining the veins, the examiner should apply a gentle but firm pressure with the probe in a transverse (TRV) orientation. This technique allows for the evaluation of the vein's ability to compress under pressure, which can provide important information about its health and function.

The iliac veins are always difficult or impossible to compress. This is because they are deep veins located in the pelvis, and their thick walls and large size make them less compressible compared to superficial veins. This lack of compressibility is important in the diagnosis of deep vein thrombosis (DVT), as the inability to compress the iliac veins may indicate the presence of a blood clot.

All of the given characteristics are of diagnostic value in scanning for deep vein thrombosis. Echoes within the vessel lumen can indicate the presence of a thrombus. Coaptation of vessel walls refers to the ability of the vessel walls to come together, which can be disrupted by a thrombus. Augmentation of flow with distal compression can help determine if there is a blockage in the vein. Therefore, all three characteristics are important in diagnosing deep vein thrombosis.

If augmentation is performed in a DVT study distal to the transducer, it indicates that complete obstruction by thrombus is not present between the location of the transducer and the point of augmentation. This means that there is no blockage in the vein being imaged in that specific section.

Valves in veins are present to prevent the backflow of blood and ensure unidirectional flow towards the heart. The perforating veins, deep veins of the calf, and lesser saphenous vein all have valves. However, the inferior vena cava, which is the largest vein in the body and carries deoxygenated blood from the lower body to the heart, does not have valves. This is because the flow of blood in the inferior vena cava is mainly due to the pressure difference between the veins and the right atrium of the heart, rather than the action of valves.

Primary varicose veins are related to heredity. This means that individuals are more likely to develop varicose veins if they have a family history of the condition. Heredity plays a significant role in the development of primary varicose veins, as certain genetic factors can contribute to the weakening of the vein walls and valves. While factors such as repeated episodes of deep vein thrombosis (DVT), trauma, and hypertension can contribute to the development of varicose veins, they are more commonly associated with secondary varicose veins.

A duplex study of the lower extremity veins is a non-invasive imaging technique used to evaluate the blood flow in the veins. Normal findings in this study include augmentation with distal compression, spontaneity, and competence of the veins. However, pulsatility with the cardiac cycle is not considered a normal finding in a duplex study of the lower extremity veins. Pulsatility refers to the rhythmic expansion and contraction of blood vessels, which is more commonly seen in arteries rather than veins. In the context of a duplex study of the lower extremity veins, pulsatility with the cardiac cycle may indicate abnormal blood flow and could be a sign of venous insufficiency or other vascular disorders.

Acute DVT is most related to the presence of a "floating" thrombus known as the "tail of the dog." This finding refers to a thrombus that is not attached to the vessel wall and appears to float within the lumen of the vein. This is a characteristic feature of acute deep vein thrombosis and is often seen on imaging studies such as ultrasound. The presence of collaterals, a highly echogenic thrombus in the lumen, and a constricted vein are not specific findings for acute DVT.

Superficial veins have incompetent valves in the finding of primary varicose veins. In primary varicose veins, the valves in the superficial veins fail to function properly, leading to blood pooling and the development of varicose veins. Deep veins and perforating veins do not have incompetent valves in this context.

Deep vein thrombosis (DVT) is a condition where blood clots form in the deep veins of the body, typically in the legs. Risk factors for DVT include malignancy, pregnancy, recent major surgery, and trauma to the vein. However, diabetes is not typically associated with an increased risk of DVT. While diabetes is a risk factor for other cardiovascular conditions, such as heart disease and stroke, it does not directly contribute to the formation of blood clots in the veins. Therefore, diabetes is the exception among the given risk factors for DVT.

The statement that augmentation guarantees that no thrombus at all is present is false. Augmentation refers to the use of compression during ultrasound examination to help detect thrombus in the veins. However, it does not guarantee that no thrombus is present. There may still be thrombus present even if augmentation is used.

In the evaluation of the axillary vein or subclavian vein, normal Doppler findings should demonstrate pulsatility and phasicity. Pulsatility refers to the presence of periodic variations in blood flow, while phasicity refers to the presence of variations in blood flow with respiration. These findings indicate that the blood flow in the veins is normal and functioning properly. Continuous flow would suggest an abnormality, as there should be variations in blood flow with respiration. Therefore, the correct answer is pulsatility and phasicity.

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Lower extremity venous flow is aided in its return to the heart by venous valves, calf muscle contraction, and expiration. Inspiration, however, does not directly aid in the return of venous flow. During inspiration, the diaphragm contracts and moves downward, increasing the volume of the thoracic cavity and causing a decrease in thoracic pressure. This decrease in pressure helps facilitate the flow of blood from the lower extremities towards the heart, but it is not a direct mechanism for aiding venous flow.

Photoplethysmography is a technique that uses light to measure changes in blood volume. When light is reflected off the skin, it can provide information about the blood volume in the underlying veins. This is because changes in blood volume alter the amount of light that is reflected back. Therefore, reflection is the correct answer as it accurately describes how photoplethysmography detects changes in blood volume for venous testing purposes.

If the greater saphenous veins are completely filled with clot to the level of the sapheno-femoral junction, the most probable course of treatment would be the removal of the saphenous vein. This is because a complete clot in the vein indicates a severe blockage, which can lead to complications such as deep vein thrombosis or pulmonary embolism. Removing the affected vein would help improve blood flow and prevent further complications. Other options like heparin dip, coumadin therapy, or conservative treatment with ultrasound follow-up may not be sufficient in this case.

Edema, brawny skin discoloration, and leg pain are all physical signs and symptoms relating to DVT. Edema refers to swelling caused by the accumulation of fluid, which can occur in the affected leg due to DVT. Brawny skin discoloration refers to a dark, reddish-brown skin color that can develop due to the blockage of blood flow in the veins. Leg pain is a common symptom of DVT and can be caused by the inflammation and clot formation in the veins. These signs and symptoms can help healthcare professionals diagnose and treat DVT.