Venous Imaging & Insufficiency
Chapter 6 & 7
Questions and Answers
- 1.
A venous Doppler exam of the popliteal vein reveals a sustained flow signal upon release of distal compression. This would indicate which of the following:
- A.
Proximal Obstruction
- B.
Venous Reflux
- C.
Normal Venous Flow
- D.
Distal Obstruction
Correct Answer
B. Venous RefluxExplanation
A sustained flow signal upon release of distal compression in a venous Doppler exam of the popliteal vein indicates venous reflux. Venous reflux refers to the backward flow of blood in the veins, which can be caused by faulty valves in the veins or weakened vein walls. This can lead to pooling of blood and increased pressure in the veins, potentially causing symptoms such as swelling, pain, and varicose veins.Rate this question:
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- 2.
Virchow's Triad is best described as the following:
- A.
Circulatory stasis and hypocoagulability with intimal injury
- B.
Circulatory stasis, hypercoagulability and intimal injury
- C.
High cardiac output and intimal injury
- D.
Intimal injury, hypercoagulability and poor stroke volume
Correct Answer
B. Circulatory stasis, hypercoagulability and intimal injuryExplanation
Virchow's Triad is a concept used to explain the development of blood clots or thrombosis. It consists of three factors that contribute to the formation of a clot: circulatory stasis, hypercoagulability, and intimal injury. Circulatory stasis refers to the slowing or stagnation of blood flow, which can occur in conditions such as immobility or venous insufficiency. Hypercoagulability refers to an increased tendency of the blood to clot, which can be caused by various factors such as genetic disorders or certain medications. Intimal injury refers to damage to the inner lining of blood vessels, which can be caused by trauma or inflammation. The combination of these three factors increases the risk of clot formation.Rate this question:
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- 3.
Continuous, non-phasic venous flow unilaterally in a common femoral vein suggests which of the following conditions.
- A.
Normal Flow
- B.
Femoral Vein Thrombosis
- C.
IVC Obstruction
- D.
Iliac Vein Obstruction
Correct Answer
D. Iliac Vein ObstructionExplanation
Continuous, non-phasic venous flow unilaterally in a common femoral vein suggests Iliac Vein Obstruction. This is because when there is an obstruction in the iliac vein, blood flow from the femoral vein is hindered, causing continuous and non-phasic flow in the femoral vein. This is in contrast to normal flow, where the flow is phasic and intermittent. Femoral Vein Thrombosis and IVC Obstruction may also cause venous flow abnormalities, but they would not specifically result in continuous, non-phasic flow in the femoral vein.Rate this question:
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- 4.
What is another name of the abnormal popliteal structure containing synovial fluid?
- A.
Hematoma
- B.
Ganglion Cyst
- C.
Baker's Cyst
- D.
Lymph Node
Correct Answer
C. Baker's CystExplanation
A Baker's cyst is an abnormal structure located in the popliteal area of the knee joint that contains synovial fluid. It is also known as a popliteal cyst. This cyst forms as a result of excess synovial fluid accumulation in the knee joint, often caused by conditions such as arthritis or knee joint inflammation. The cyst appears as a lump behind the knee and can cause discomfort or pain. Treatment may involve addressing the underlying cause and managing symptoms through rest, ice, compression, and elevation.Rate this question:
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- 5.
The presence of respiratory variation in the femoral vein rules out DVT in the ipsilateral popliteal vein.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
The presence of respiratory variation in the femoral vein does not rule out DVT in the ipsilateral popliteal vein. This is because respiratory variation in the femoral vein can still occur even in the presence of DVT in the popliteal vein. Therefore, it is incorrect to say that the presence of respiratory variation in the femoral vein rules out DVT in the ipsilateral popliteal vein.Rate this question:
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- 6.
A condition resulting in a grossly swollen and cyanotic leg that is caused by iliofemoral venous thrombosis is known as:
- A.
Stasis Dermatitis
- B.
Lymph Edema
- C.
Homan's Sign
- D.
Phlegmasia Cerulea Dolens
Correct Answer
D. Phlegmasia Cerulea DolensExplanation
Phlegmasia Cerulea Dolens is a condition characterized by a grossly swollen and cyanotic leg caused by iliofemoral venous thrombosis. Stasis Dermatitis refers to inflammation of the skin due to poor blood flow, Lymphedema is swelling caused by a buildup of lymph fluid, and Homan's Sign is a clinical sign of pain in the calf upon dorsiflexion of the foot, which can be indicative of deep vein thrombosis. Therefore, the correct answer is Phlegmasia Cerulea Dolens.Rate this question:
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- 7.
What is the name of the perforating veins located in the upper Thigh?
- A.
Cockett's
- B.
Boyd's
- C.
Hunterian
- D.
Dodd's
Correct Answer
D. Dodd'sExplanation
Dodd's veins are the perforating veins located in the upper thigh. These veins connect the superficial veins to the deep veins in the thigh. They play a crucial role in maintaining proper blood flow and preventing blood pooling in the lower extremities. Cockett's veins, Boyd's veins, and Hunterian veins are not associated with the upper thigh perforating veins.Rate this question:
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- 8.
Incompetence in this valve often leads to the entire GSV being incompetent. Name this valve?
- A.
External Iliac Valve
- B.
Terminal Valve
- C.
Mitral Valve
- D.
Sapheno-Popliteal Valve
Correct Answer
B. Terminal ValveExplanation
Incompetence in the terminal valve often leads to the entire GSV being incompetent.Rate this question:
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- 9.
In addition to incompetent valves, which of the following is a cause of Venous Insufficiency?
- A.
Arterial Occlusive Disease
- B.
IVC Filter
- C.
Chronic Venous Outflow Obstruction
- D.
Atresic Great Saphenous Vein
Correct Answer
C. Chronic Venous Outflow ObstructionExplanation
Chronic Venous Outflow Obstruction is a cause of Venous Insufficiency. Venous insufficiency occurs when the veins in the legs are unable to efficiently return blood back to the heart. In addition to incompetent valves, chronic venous outflow obstruction can also lead to venous insufficiency. This obstruction can be caused by various factors such as blood clots, tumors, or compression of the veins by surrounding structures. When the outflow of blood from the veins is obstructed, it can result in increased pressure and pooling of blood in the legs, leading to symptoms of venous insufficiency.Rate this question:
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- 10.
With the patient standing, what time value is the threshold between normal and abnormal reflux in the deep veins?
- A.
0.35 second
- B.
0.5 second
- C.
1 second
- D.
2 seconds
Correct Answer
C. 1 secondExplanation
The threshold between normal and abnormal reflux in the deep veins while the patient is standing is 1 second. This means that if the reflux lasts for less than 1 second, it is considered normal, but if it lasts for 1 second or longer, it is considered abnormal.Rate this question:
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- 11.
Perforating veins exceeded this diameter have a high predictive value for being incompetent.
- A.
> 1 mm
- B.
> 1.5 mm
- C.
> 2 mm
- D.
> 2.5 mm
- E.
> 3.5 mm
Correct Answer
E. > 3.5 mmExplanation
Perforating veins that exceed a diameter of 3.5 mm are highly likely to be incompetent. This means that they are not functioning properly and are unable to prevent blood from flowing in the wrong direction. Incompetent veins can lead to conditions such as varicose veins and venous insufficiency. Therefore, identifying perforating veins with a diameter greater than 3.5 mm can be a useful predictor of venous incompetence.Rate this question:
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- 12.
Which of the following describes the anatomical position of the popliteal vein compared to the popliteal artery?
- A.
It lies Posterior to the Artery
- B.
It's Lateral to the Artery
- C.
It's Medial to the Artery
- D.
It lies Anterior to the Artery
Correct Answer
A. It lies Posterior to the ArteryExplanation
The popliteal vein lies posterior to the popliteal artery. This means that the vein is positioned behind the artery when considering the anatomical position of the leg.Rate this question:
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- 13.
Thrombosis of the Left Common Iliac Vein by extrinsic compression of the Right Iliac Artery
- A.
Marfan's Syndrome
- B.
Nutcracker Syndrome
- C.
Arcuate Ligament Syndrome
- D.
May-Thurner Syndrome
Correct Answer
D. May-Thurner SyndromeExplanation
May-Thurner Syndrome is a condition characterized by the compression of the left common iliac vein by the right iliac artery. This compression can lead to the formation of a blood clot in the left common iliac vein, known as thrombosis. Marfan's Syndrome is a genetic disorder that affects the connective tissues, Nutcracker Syndrome is a condition where the left renal vein is compressed between the aorta and the superior mesenteric artery, and Arcuate Ligament Syndrome is a condition where the celiac artery is compressed by the median arcuate ligament. None of these conditions are directly related to the compression of the left common iliac vein by the right iliac artery, which is characteristic of May-Thurner Syndrome.Rate this question:
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- 14.
Which of the following best describes Primary Venous Insufficiency?
- A.
Insufficiency caused by chronic outflow obstruction
- B.
Insufficiency caused by congenital absence of valves
- C.
Insufficiency resulting from previous deep vein thrombosis
- D.
Insufficiency resulting from poor arterial inflow
Correct Answer
B. Insufficiency caused by congenital absence of valvesExplanation
Primary Venous Insufficiency is best described as insufficiency caused by congenital absence of valves. This means that the valves in the veins, which are responsible for preventing blood from flowing backward, are not present from birth. This condition can lead to blood pooling in the veins and increased pressure, causing symptoms such as swelling, pain, and ulcers. It is important to note that primary venous insufficiency is different from secondary venous insufficiency, which can be caused by factors such as deep vein thrombosis or chronic outflow obstruction.Rate this question:
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- 15.
Which of the following veins should not be evaluated with the Valsalva Maneuver for Reflux?
- A.
Popliteal
- B.
Great Saphenous
- C.
Common Femoral
- D.
Proximal Femoral
Correct Answer
A. PoplitealExplanation
The Valsalva Maneuver is a technique used to assess for venous reflux, which is the backward flow of blood in the veins. It involves the patient forcefully exhaling against a closed airway, increasing intra-abdominal pressure and causing blood to flow in the opposite direction. The Popliteal vein, located behind the knee, should not be evaluated with the Valsalva Maneuver for reflux because it is a deep vein and reflux in deep veins is typically assessed using other techniques such as duplex ultrasound.Rate this question:
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- 16.
Perforating Veins should be evaluated with the patient in which of the following positions?
- A.
Supine
- B.
Sitting, leg dependent
- C.
Trendelenburg
- D.
Semi-Fowler's
Correct Answer
B. Sitting, leg dependentExplanation
Perforating veins should be evaluated with the patient in a sitting, leg dependent position. This position allows for gravity to assist in the evaluation of the perforating veins, as the blood flow in these veins is influenced by the force of gravity. By having the patient sit with their legs dependent, the veins are more visible and any abnormalities can be easily identified.Rate this question:
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- 17.
Why is Doppler Angle correction not necessary in Venous Imaging?
- A.
Velocity is already known
- B.
Velocity calculation is not necessary
- C.
Doppler angle can be at 90 degrees
- D.
Flow direction is not important
Correct Answer
B. Velocity calculation is not necessaryExplanation
In venous imaging, the velocity calculation is not necessary because the focus is not on measuring the speed of blood flow but rather on examining the structure and patency of the veins. Unlike arterial imaging where the velocity of blood flow is crucial for diagnosing stenosis or occlusion, in venous imaging, the primary concern is the presence of blood clots or other abnormalities. Therefore, Doppler angle correction, which is used to accurately measure blood flow velocity, is not required in venous imaging.Rate this question:
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