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Vascular Exam 2: Lower Extremity Venous Evaluation
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Vascular Exam 2: Lower Extremity Venous Evaluation

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Questions and Answers

What is the primary purpose of performing a lower extremity venous evaluation?

  • To evaluate superficial venous thrombosis
  • To rule out deep venous thrombosis (correct)
  • To diagnose venous insufficiency
  • To diagnose pulmonary embolism
  • What is the chronic process that occurs following a deep vein thrombosis?

  • Post-thrombotic syndrome (correct)
  • Pulmonary embolism
  • Venous insufficiency
  • Deep vein thrombosis
  • What is the approximate number of people affected by deep vein thrombosis every year?

  • 200,000
  • 750,000
  • 500,000 (correct)
  • 1,000,000
  • What is a potentially lethal complication from acute deep vein thrombosis?

    <p>Pulmonary embolism</p> Signup and view all the answers

    Which of the following is a risk factor for deep vein thrombosis?

    <p>History of cancer</p> Signup and view all the answers

    What is a symptom of deep vein thrombosis?

    <p>Persistent calf or leg swelling</p> Signup and view all the answers

    What is a characteristic of deep vein thrombosis?

    <p>It can occur in either the upper or lower extremities</p> Signup and view all the answers

    What is a key difference between deep vein thrombosis and superficial venous thrombosis?

    <p>Risk of pulmonary embolism</p> Signup and view all the answers

    What is a common symptom of a Deep Vein Thrombosis?

    <p>Palpable subcutaneous cord</p> Signup and view all the answers

    What is the primary goal of the compression image in a venous study?

    <p>To bring the two sides of the venous wall together to prove that there is no thrombus obstructing the vein</p> Signup and view all the answers

    What is the purpose of the augmentation technique in a venous study?

    <p>To compress the lower leg and increase flow up the leg</p> Signup and view all the answers

    What is the correct order of venous segments to be scanned in a venous study?

    <p>CFV, GSV, Prof V, Fem V, Pop V, Per V, PTV, ATV</p> Signup and view all the answers

    What is the purpose of the TRV split screen image in a venous study?

    <p>To assess the length of the CFV</p> Signup and view all the answers

    What is a common symptom of a Pulmonary Embolism?

    <p>Dyspnea</p> Signup and view all the answers

    What is the correct position of the patient during a venous study?

    <p>Supine with the leg rotated outward like a frog</p> Signup and view all the answers

    What is the correct location to begin scanning in a venous study?

    <p>At the crease of the groin</p> Signup and view all the answers

    Study Notes

    Venous Extremity Evaluation

    • Lower extremity venous evaluation examines the deep and superficial venous systems in the legs to rule out deep venous thrombosis (DVT) and evaluate venous insufficiency.

    Venous Disease

    • Venous disease can be categorized into acute or chronic processes.
    • Deep Vein Thrombosis (DVT) is the acute process.
    • Post-thrombotic syndrome is the chronic process and a complication of DVT.

    Deep Vein Thrombosis (DVT)

    • Approximately 500,000 people are affected by DVTs every year.
    • Pulmonary Embolisms (PEs) are a potentially lethal complication of acute DVTs.
    • DVTs can occur in the upper or lower extremities.
    • Risk factors for DVT include:
      • Age (increased risk over 40)
      • Past or current cancer/cancer treatment
      • History of DVT or PE
      • Immobilization
      • Fracture of pelvis, hip, or long bones
      • Myocardial infarction (heart attack)
      • Stroke
      • Congestive heart failure
      • Respiratory failure
      • Pregnancy and postpartum
      • Oral contraceptive use
      • Hormone Replacement Therapy
      • Extensive dissection/damage to veins at major surgery
      • Trauma
      • Hereditary factors (clotting disorders)
      • Obesity
      • Central venous lines, pacemakers, etc.
      • Intravenous drug use

    Signs and Symptoms of DVT

    • Persistent calf, leg, or arm swelling
    • Pain or tenderness of the leg or arm-shoulder region
    • Calf pain/arm pain
    • Venous distention
    • Increased warmth in extremity
    • Superficial venous dilation
    • Symptoms are typically distal to the affected portion of the vein
    • DVTs and PEs may also be asymptomatic

    Superficial Venous Thrombosis

    • A clot in the superficial veins of the extremities
    • Cannot usually cause a PE
    • Signs and symptoms:
      • Local erythema (redness)
      • Tenderness or pain
      • Palpable subcutaneous cord

    Pulmonary Embolism (PE)

    • Signs and symptoms:
      • Dyspnea (shortness of breath)
      • Chest Pain
      • Hemoptysis (spitting of blood from the lungs or bronchial tubes)
      • Sweating
      • Cough

    Performing a Venous Study

    • Scan the leg twice:
      • First: Scan transversely down the leg, taking two images: one with the vein patent and one with compression
      • Second: Complete a b-mode, color, and Doppler image of each venous segment
      • Doppler image includes phasic flow documentation and augmentation of venous flow
      • Augmentation: compress the lower leg to increase flow up the leg
      • Patient positioning: supine with leg rotated out from the hip like a frog
      • Scanning begins at the crease of the groin
      • Venous segments to be evaluated:
        • Common Femoral Vein (CFV)
        • Greater Saphenous Vein (GSV)
        • Profunda Vein (usually only visible in the high thigh)
        • Femoral Vein (upper, mid, lower/high thigh, mid thigh, low thigh)
        • Popliteal Vein
        • Peroneal, PTV, ATV if required

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    Description

    This quiz covers the evaluation of the deep and superficial venous system in the legs, primarily to rule out deep venous thrombosis and evaluate venous insufficiency.

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