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112
LE Venous
28
Medical
Professional
03/31/2012

Additional Medical Flashcards

 


 

Cards

Term
What are the 2 main reasons to perform LE Venous Studies?
Definition
  1. Deep venous thrombosis (DVT)
  2. Pulmonary embolism (PE)
Term
  1. In the US, PE is associated with how many hospitalizations each year? 
  2. How many result in death?
Definition
  1. 600,000
  2. 200,000
Term
What percentage of PE cases are caused by thrombi traveling from the LE as a result of DVT?
Definition
90%
Term
About how many cases of DVT patients are reported each year?
Definition
6,000,000
Term
What is the percentage range of patients that develop DVT as a result of surgery?
Definition
10%-50%
Term
What percentage of patients with PE die within the first hour?
Definition
10%
Term
Who was the Vascular Sonographer that first pioneered using carotid scanning techniques to assess the veins in the legs?
Definition
Steve Talbot
Term
Name the risk factors for DVT; aka "The Baker's Dozen"
Definition
  • age
  • obesity
  • pregnancy
  • oral contraceptive
  • trauma
  • varicose veins
  • congestive heart failure
  • surgery, especially orthopedic and abdominal
  • infection
  • previous DVT
  • prolonged bed rest or sitting (i.e., stasis)
  • cancer (often causes intermittent thrombosis, especially proximally, and bilateral thrombosis
  • dehydration
Term
Where do clots begin?
Definition
"It is thought that most leg thrombi begin in the calf, especially in the soleal sinuses" (Ridgway 69).
Term
What constitutes a negative LE venous study?
Definition
  1. compressability
  2. no intraluminal echos
  3. normal Doppler/color
Term
What are the 5 Image Characteristics associate with acute (fresh) thrombus?
Definition
  1. Homogeneous appearance
  2. Lightly speckled soft/dark echoes
  3. Partly compressible--spongy
  4. Incomplete adherence to wall--possible presence of "tail"
  5. Distended vein
Term
What are the 8 Image Characteristics associated with chronic thrombus
Definition
  1. Heterogeneous appearance
  2. Bright echos
  3. Incomprssible--rigid
  4. Firmly attached to wall
  5. Possibly partly recanalized; may see anything from rather tiny residual lumen to thin, bright flap in the middle of the lumen
  6. Brightly echodense, irregular-appearing walls
  7. No evidence of any venous lumen adjacent to the corresponding artery--thrombus may have echo character similar to surrounding tissue
  8. Presence of large collaterals
Term
What type of Doppler should be used to assess DVT?
Definition
PW
Term
What type of Doppler should be used to assess CVI?
Definition
color
Term
What is the single best indicator for diagnosing acute DVT?
Definition
acute unilateral edema
Term
What are some symptoms of PE?
Definition
  1. SOB
  2. chest pain
  3. sweating
  4. cough
  5. fever
  6. shock
Term
Why is tranverse scanning the prefered method for LE venous studies?
Definition

"the transverse plane is far better for demonstrating compressibility than the longitudinal plane, since the walls are always visible," (Ridgway 70).

 

"[transverse] is the most reliable view for demonstrating compressibility, and therefore patency, of the veins," (Ridgway 129).

Term
How should the patient be positioned for a LE venous study and why?
Definition
"head up, feet down, so that blood pools in the leg veins," (Ridgway 128).
Term
Describe the approaches on the legs and why?
Definition
"I find a more medial approach often works best in the mid portion of the thigh, coming back to a more anterior approach usually improves the image greatly in the distal third of the thigh," (Ridgway 131)
Term
How do you hold the probe to scan the popliteal vein?
Definition
When moving from an anterior approach to a posterior to scan the popliteal vein, rotate probe 180° and place probe in transverse in the popliteal space.  Hold probe overhand to scan proximal to overlap vein where it was left off from the anterior scan.  Bring probe back to popliteal space and switch to underhand to scan distally.
Term
What is a Baker's cyst?
Definition
"accumulations of fluid from the knee joint, can cause symptoms similar to those of DVT, especially in the calf and behind the knee," (Ridgway 137).
Term
What are the 6 characteristics of LE Doppler?
Definition

Without manuvers

  1. Patency: the vessel is open and flowing (Medicine/Medical . the condition of not being blocked or obstructed.)
  2. Spontaneity: the signal is readily available (spontaneities, spontaneous impulses, movements, or actions.)
  3. Phasicity: signal ↑↓ in phase w/ respiration
  4. Nonpulsatility: does not vary w/ cardiac cycle

With manuvers

  1. Augmentation: signal ↑ sharply w/ distal compression or proximal release
  2. Competence: no flow signal with proximal compression or valsalva manuver
Term
What is "patency" as regard to LE venous Doppler?
Definition
The vessel is open and flowing

(Medicine/Medical . the condition of not being blocked or obstructed. )
Term
What is "spontaneity" as regard to LE venous Doppler?
Definition
The signal is readily available without eliciting a a flow signal by compression
Term
What is "phasicity" as regard to LE venous Doppler?
Definition
The signal rises and falls in phase with the patient's repiration.
Term
What is "nonpulsatility" as regard to LE venous Doppler?
Definition
The normal venous signal does not vary with the cardiac cycle; that is, unlike the normal arterial signal, the normal venous signal is not pulsatile.
Term
What is "augmentation" as regard to LE venous Doppler?
Definition
The normal venous flow signal rises sharply in pitch when you compress the limb or foot distal to the probe.
Term
What is "competence" as regard to LE venous Doppler?
Definition
Normally, there is not flow signal when you compress the limb proximal or release distal to the probe, because competent valves are doing their job of preventing backflow down the vein.
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