Exam 3 - Lower & Upper Extremity Venous - 1
1-25
- 1.
In the evaluation of the axillary vein or subclavian vein, normal Doppler findings should demonstrate
- A.
Phasicity but not pulsatility
- B.
Continuous flow
- C.
Pulsatility but not phasicity
- D.
Pulsatility and phasicity
Correct Answer
D. Pulsatility and phasicityExplanation
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.Rate this question:
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- 2.
In the thigh, the superficial femoral vein becomes more difficult to follow and compress distally. What technique is most effective in this case?
- A.
Skip that segment of the vein, it's not important
- B.
Exert greater pressure with the transducer
- C.
Turn up the overal 2D gain
- D.
Move to a more anterior position and compress from behind
Correct Answer
D. Move to a more anterior position and compress from behindExplanation
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.Rate this question:
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- 3.
All of the following are considered to be normal findings in a duplex study of the lower extremity veins, EXCEPT
- A.
Pulsatility with the cardiac cycle
- B.
Augmentation with distal compression
- C.
Spontaneity
- D.
Competence
Correct Answer
A. Pulsatility with the cardiac cycleExplanation
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.Rate this question:
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- 4.
In the use of photoplethysmography for venous testing purposes, a change in blood volume is detected by light
- A.
Transmission
- B.
Reflection
- C.
Frequency
- D.
Refraction
Correct Answer
B. ReflectionExplanation
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.Rate this question:
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- 5.
In the finding of primary varicose veins, which veins have incompetent valves
- A.
Superficial veins
- B.
Deep veins
- C.
Perforating veins
Correct Answer
A. Superficial veinsExplanation
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.Rate this question:
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- 6.
Valves in veins are present in all of the following locations EXCEPT the
- A.
Perforating veins
- B.
Deep veins of the calf
- C.
Lesser saphenous vein
- D.
Inferior vena cava
Correct Answer
D. Inferior vena cavaExplanation
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.Rate this question:
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- 7.
Compressibility of veins is very important in the diagnosis of DVT. Which of the following veins are always difficult or impossible to compress?
- A.
Superficial femoral veins
- B.
Iliac veins
- C.
Common femoral veins
- D.
Popliteal veins
Correct Answer
B. Iliac veinsExplanation
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.Rate this question:
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- 8.
In identification of the deep veins of the lower extremity, which is most helpful?
- A.
The adjacent artery
- B.
The size of the vessel
- C.
The lenght of the vessel
- D.
The diameter of the vessel
Correct Answer
A. The adjacent arteryExplanation
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.Rate this question:
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- 9.
Which of the following vessels is NOT a deep vein of the lower extremity?
- A.
Superficial femoral vein
- B.
Anterior tibial vein
- C.
Lesser saphenous vein
- D.
Popliteal vein
Correct Answer
C. Lesser saphenous veinExplanation
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.Rate this question:
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- 10.
Lower extremity venous flow is aided in its return to the heart by all of the following mechanisms EXCEPT
- A.
Venous valves
- B.
Inspiration
- C.
Calf muscle contraction
- D.
Expiration
Correct Answer
B. InspirationExplanation
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.Rate this question:
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- 11.
Acute DVT is MOST related to which of the following findings?
- A.
Presence of collaterals
- B.
Highly echogenic thrombus in lumen
- C.
Presence of "floating" thrombus known as "tail of the dog"
- D.
A constricted vein
Correct Answer
C. Presence of "floating" thrombus known as "tail of the dog"Explanation
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.Rate this question:
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- 12.
Which of the following criteria will aid in the diagnosis of DVT
- A.
Vein enlargement
- B.
Visualization of echogenic thrombus in the lumen
- C.
Absence of color or spectral waveforms
- D.
All of the above
Correct Answer
D. All of the aboveExplanation
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.Rate this question:
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- 13.
The calf vein are sometimes difficult to image using Duplex sonography. Which of the following methods might be used to better visualizethese veins?
- A.
Proximal augmentation of the limb
- B.
Using the "heel toe" maneuver
- C.
Changing the transducer to a lower frequency
- D.
Asking the patient to dangle the legs over the side of the bed
Correct Answer
D. Asking the patient to dangle the legs over the side of the bed -
- 14.
Virchow's Triad relates to which of the following factors?
- A.
Smoking, atherosclerosis, and high blood pressure
- B.
Blood stasis, anxiety, and hypocoaguability of blood
- C.
Blood stasis, hypercoaguability of blood, and injury to vein walls
- D.
All of the aboe
Correct Answer
C. Blood stasis, hypercoaguability of blood, and injury to vein wallsExplanation
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.Rate this question:
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- 15.
In order to assess for vein wall compressibility, the preferred method is
- A.
Gentle probe pressure in SAG
- B.
Rocking probe pressure in TRV
- C.
Repetitive bouncing pressure in SAG
- D.
Gentle firm probe pressure in TRV
Correct Answer
D. Gentle firm probe pressure in TRVExplanation
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.Rate this question:
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- 16.
The most serious consequence of thrombus in the deep veins of the lower extremity is
- A.
Pulmonary embolus
- B.
Compression of the pelvic veins
- C.
Lymphedema
- D.
Venous hypertension
Correct Answer
A. Pulmonary embolusExplanation
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.Rate this question:
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- 17.
In venous duplex scanning, which of the following characteristics are of diagnostic value in scanning for deep vein thrombosis?
- A.
Echoes within the vessel lumen
- B.
Coaptation of vessel walls
- C.
Augmentation of flow with distal compression
- D.
All of the above
Correct Answer
D. All of the aboveExplanation
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.Rate this question:
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- 18.
If augmentation is performed in a DVT study distal to the transducer, this proves that complete obstruction by thrombus is not present
- A.
Between the location of the transducer and the point of augmentation
- B.
Between the location of the transducer and the heart
- C.
At any point along the path of the vein being imaged
- D.
In any of the deep veins of the lower extremity
Correct Answer
A. Between the location of the transducer and the point of augmentationExplanation
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.Rate this question:
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- 19.
The greater saphenous veins ascends along the _____ aspect of the entire lower limb, and empties into the ____ ____ just distal to the inguinal ligament
- A.
Lateral, internal iliac vein
- B.
Medial, profund vein
- C.
Medial, common femoral vein
- D.
Lateral, superficial femoral vein
Correct Answer
C. Medial, common femoral veinExplanation
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.Rate this question:
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- 20.
All of the following risk factors are associated with deep vein thrombosis EXCEPT for
- A.
Malignancy
- B.
Pregnancy
- C.
Recent major surgery
- D.
Diabetes
- E.
Trauma to the vein
Correct Answer
D. DiabetesExplanation
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.Rate this question:
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- 21.
Which of the following statements is FALSE in relation to chronic DVT?
- A.
Thrombosis is usually hyperechoic
- B.
Collateral veins may be in evidence
- C.
The vein's diameter may decrease in size
- D.
Augmentation guarantees that no thrombus at all is present
Correct Answer
D. Augmentation guarantees that no thrombus at all is presentExplanation
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.Rate this question:
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- 22.
Primary varicose veins are related to
- A.
Repeated episodes of DVT
- B.
Trauma
- C.
Heredity
- D.
Hypertension
Correct Answer
C. HeredityExplanation
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.Rate this question:
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- 23.
If the greater saphenous veins is found to be completely filled with clot to the level of the sapheno-femoral junction, the most probable course of treatment will be
- A.
Removal of the saphenous vein
- B.
A heparin dip
- C.
Coumadin therapy
- D.
Conservative treatment with US follow up
Correct Answer
A. Removal of the saphenous veinExplanation
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.Rate this question:
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- 24.
Which of the following is (are) physical signs and symptoms relating to DVT?
- A.
Edema
- B.
Brawny skin discoloration
- C.
Leg pain
- D.
Ulcerations on the toes
- E.
All of the above
- F.
Edema, brawny skin discoloration, leg pain
Correct Answer
F. Edema, brawny skin discoloration, leg painExplanation
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.Rate this question:
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- 25.
This vein is formed by the confluence of the peroneal veins and the tibial veins and becomes the SFV at the level of the adductor canal
- A.
Soleal vein
- B.
Popliteal vein
- C.
Lesser saphenous vein
- D.
Gastrocnemius vein
Correct Answer
B. Popliteal veinExplanation
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.Rate this question:
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