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?

Pulmonary embolism Signup and view all the answers

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

History of cancer Signup and view all the answers

What is a symptom of deep vein thrombosis?

Persistent calf or leg swelling Signup and view all the answers

What is a characteristic of deep vein thrombosis?

It can occur in either the upper or lower extremities Signup and view all the answers

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

Risk of pulmonary embolism Signup and view all the answers

What is a common symptom of a Deep Vein Thrombosis?

Palpable subcutaneous cord Signup and view all the answers

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

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

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

To compress the lower leg and increase flow up the leg Signup and view all the answers

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

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

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

To assess the length of the CFV Signup and view all the answers

What is a common symptom of a Pulmonary Embolism?

Dyspnea Signup and view all the answers

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

Supine with the leg rotated outward like a frog Signup and view all the answers

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

At the crease of the groin 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.