Term
| What are the 2 main reasons to perform LE Venous Studies? |
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Definition
- Deep venous thrombosis (DVT)
- Pulmonary embolism (PE)
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Term
- In the US, PE is associated with how many hospitalizations each year?
- How many result in death?
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Definition
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Term
| What percentage of PE cases are caused by thrombi traveling from the LE as a result of DVT? |
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Definition
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Term
| About how many cases of DVT patients are reported each year? |
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Definition
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Term
| What is the percentage range of patients that develop DVT as a result of surgery? |
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Definition
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Term
| What percentage of patients with PE die within the first hour? |
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Definition
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Term
| Who was the Vascular Sonographer that first pioneered using carotid scanning techniques to assess the veins in the legs? |
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Definition
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Term
| Name the risk factors for DVT; aka "The Baker's Dozen" |
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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
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Term
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Definition
| "It is thought that most leg thrombi begin in the calf, especially in the soleal sinuses" (Ridgway 69). |
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Term
| What constitutes a negative LE venous study? |
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Definition
- compressability
- no intraluminal echos
- normal Doppler/color
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Term
| What are the 5 Image Characteristics associate with acute (fresh) thrombus? |
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Definition
- Homogeneous appearance
- Lightly speckled soft/dark echoes
- Partly compressible--spongy
- Incomplete adherence to wall--possible presence of "tail"
- Distended vein
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Term
| What are the 8 Image Characteristics associated with chronic thrombus |
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Definition
- Heterogeneous appearance
- Bright echos
- Incomprssible--rigid
- Firmly attached to wall
- Possibly partly recanalized; may see anything from rather tiny residual lumen to thin, bright flap in the middle of the lumen
- Brightly echodense, irregular-appearing walls
- No evidence of any venous lumen adjacent to the corresponding artery--thrombus may have echo character similar to surrounding tissue
- Presence of large collaterals
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Term
| What type of Doppler should be used to assess DVT? |
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Definition
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Term
| What type of Doppler should be used to assess CVI? |
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Definition
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Term
| What is the single best indicator for diagnosing acute DVT? |
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Definition
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Term
| What are some symptoms of PE? |
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Definition
- SOB
- chest pain
- sweating
- cough
- fever
- shock
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Term
| Why is tranverse scanning the prefered method for LE venous studies? |
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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). |
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Term
| How should the patient be positioned for a LE venous study and why? |
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Definition
| "head up, feet down, so that blood pools in the leg veins," (Ridgway 128). |
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Term
| Describe the approaches on the legs and why? |
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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) |
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Term
| How do you hold the probe to scan the popliteal vein? |
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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. |
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Term
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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). |
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Term
| What are the 6 characteristics of LE Doppler? |
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Definition
Without manuvers
- Patency: the vessel is open and flowing (Medicine/Medical . the condition of not being blocked or obstructed.)
- Spontaneity: the signal is readily available (spontaneities, spontaneous impulses, movements, or actions.)
- Phasicity: signal ↑↓ in phase w/ respiration
- Nonpulsatility: does not vary w/ cardiac cycle
With manuvers
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Augmentation: signal ↑ sharply w/ distal compression or proximal release
- Competence: no flow signal with proximal compression or valsalva manuver
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Term
| What is "patency" as regard to LE venous Doppler? |
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Definition
The vessel is open and flowing
(Medicine/Medical . the condition of not being blocked or obstructed. ) |
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Term
| What is "spontaneity" as regard to LE venous Doppler? |
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Definition
| The signal is readily available without eliciting a a flow signal by compression |
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Term
| What is "phasicity" as regard to LE venous Doppler? |
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Definition
| The signal rises and falls in phase with the patient's repiration. |
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Term
| What is "nonpulsatility" as regard to LE venous Doppler? |
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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. |
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Term
| What is "augmentation" as regard to LE venous Doppler? |
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Definition
| The normal venous flow signal rises sharply in pitch when you compress the limb or foot distal to the probe. |
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Term
| What is "competence" as regard to LE venous Doppler? |
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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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