Term
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Definition
| VENOUS INSUFFICIENCY IS THE CLINICAL MANIFESTATION OF INCOMPETENT VENOUS VALVES IN THE DEEP, SUPERFICIAL, OR PERFORATORS OF THE VENOUS SYSTEM. IF THESE VALVES ARE NOT COMPETENT, BLOOD THAT IS SQUEEZED UPWARDS DUE TO MUSCLE CONTRACTION WILL SIMPLY FLOW BACK DOWN DURING MUSCLE RELAXATION DUE TO THE EFFECTS OF GRAVITY. WHEN THE BLOOD FLOWS RETROGRADE, THERE IS AN INCREASE IN DISTAL VENOUS PRESSURE. THIS RESULTS IN A MYRIAD OF SYMPTOMS. |
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Term
| CLASSIFICATIONS OF VENOUS INSUFFICIENCY |
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Definition
| VENOUS INSUFFICIENCY IS CLASSIFIED IN RELATION TO THE CAUSE OR ETIOLOGY. IN PRIMARY VENOUS INSUFFICIENCY, THE CAUSE IS RELATED TO THE CONGENITAL ABSENCE OF SOME OF THE VENOUS VALVES. IN SECONDARY VENOUS INSUFFICIENCY, THE CAUSE IS RELATED TO VALVE DAMAGE SUSTAINED DURING PREVIOUS THROMBOTIC EPISODES. |
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Term
| SIGNS AND SYMPTOMES OF VENOUS INSUFFICIENCY |
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Definition
Repeated episodes of swelling in calf, ankle, or foot
Chronic swelling of the limb
Varicosities - palpable distended veins of > 4 mm in diameter
Telangiectasias - intradermal venules of 1 mm or less
Reticular veins - dilated subdural veins of 1-4 mm
Venous claudication
Stasis dermatitis
Venous ulceration |
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Term
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Definition
| THROMBOPHLEBITIS IS AN INFLAMMATORY REACTION OF A VEIN UNDER THE SKIN. IT IS USUALLY A BENIGN AND SELF LIMITING CONDITION, AND THUS IS OF LESS CONCERN THAN DVT. |
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Term
| CAUSES, SIGNS AND SYMPTOMS OF THROMBOPHLEBITIS |
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Definition
| CAUSES INCLUDE TRAUMA, VARICOSE VEINS, AND INFECTION. PATIENT SIGNS AND SYMPTOMS MAY INCLUDE ERYTHEMA, INFLAMMATION, LOCALIZED TENDERNESS, AND A PALPABLE CORD OR MASS. IT IS INTERESTING TO NOTE THAT SUPERFICIAL THROMBOPHLEBITIS IS USUALLY MORE PAINFUL TO THE PATIENT THAN DVT. |
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Term
| CRITERIA FOR REVERSE FLOW |
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Definition
| THE PATIENT WHO IS POSITIVE FOR VENOUS INSUFFICIENCY WILL DEMONSTRATE REVERSAL OF FLOW WHEN PERFORMING THE VALSALVA MANEUVER, WITH DISTAL LIMB COMPRESSION, OR PROXIMAL LIMB COMPRESSION. THIS WILL BE DEMONSTRATED BY A COLOR CHANGE (BLUE TO RED) OR WITH THE WAVEFORM CROSSING BASELINE. |
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Term
| CRITERIA FOR DURATION OF REFLUX |
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Definition
| IF REFLUX LASTS MORE THAT .75 TO 1 SECOND, INCOMPETENT VALVES ARE CONFIRMED IN THE VEIN SEGMENT THAT IS PROXIMAL TO THE SAMPLE SITE. |
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Term
| INSUFFICIENCY OF SUPERFICIAL VEINS |
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Definition
Measure vein diameter at proximal, mid, and distal levels
Vein should not exceed 9 mm at proximal
Vein should not exceed 7.5 mm mid
Vein should not exceed 5 mm distally |
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Term
| CRITERIA FOR EVALUATION OF PERFORATOR VEINS |
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Definition
| IF THE DIAMETER IS > 3MM, THIS STRONGLY SUGGESTS INCOMPETENCE |
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Term
| WHY PPG IS NOT A TRUE METHOD TO MEASURE THE VOLUME CHANGE IN VENOUS FLOW? |
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Definition
| PPG IS NOT A TRUE PLETHYSMOGRAPHIC TECHNIQUE. A TRUE PLETHYSMOGRAPHIC TECHNIQUE MEASURES CHANGES IN LIMB VOLUME. PPG MEASURES REFLECTION CHANGES, NOT VOLUME CHANGES.THE REFLECTED SIGNAL STRENGTH IS PROPORTIONAL TO THE NUMBER OF RED BLOOD CELLS PRESENT IN CUTANEOUS CIRCULATION. |
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Term
| SUPERFICIAL VEINS OF UPPER EXTREMITY |
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Definition
| THE CEPHALIC VEIN IS FORMED BY THE DIGITAL VEINS OF THE FINGERS ON THE LATERAL SIDE OF THE FOREARM. THIS VEIN TRAVELS LATERALLY UP THE ARM TO JOIN WITH THE AXILLARY VEIN. + THE BASILIC VEIN ASCENDS MEDIALLY UP THE ARM. + THIS VEIN JOINS WITH THE BRACHIAL VEIN AT THE POINT WHERE THE BRACHIAL VEIN BECOMES THE AXILLARY VEIN. |
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Term
| CAUSES OF VENOUS THROMBOSIS IN THE ARM |
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Definition
COMPRESSION BY A MASS
VENOUS THORACIC OUTLET COMPRESSION
INTIMAL INJURY DUE TO TRAUMA, INTRALUMINAL CATHETER, OR PACER WIRES
FIBROSIS DUE TO RADIATION THERAPY
VENIPUNCTURE
IV DRUG ABUSE
IDIOPATHIC |
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Term
| PHASICITY IN THE UPPER EXTREMITY VEINS |
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Definition
| RESPIRATORY ACTIVITY HAS THE OPPOSITE EFFECT ON VENOUS FLOW IN THE UPPER EXTREMITIES THAN IN THE LOWER EXTREMITIES. WITH INSPIRATION, THE PRESSURE IN THE THORACIC CAVITY DECREASES WHICH CAUSES A RESULTING INCREASE IN VENOUS FLOW. WITH EXPIRATION, THE PRESSURE IN THE THORACIC CAVITY INCREASES WITH A RESULTING DECREASE IN VENOUS FLOW. |
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Term
| NORMAL ULTRASOUND FINDINGS IN UPPER EXTREMITY VEINS |
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Definition
COMPRESSIBLE
NO SIGN OF ECHOGENIC MATERIAL IN THE LUMEN
VESSLE FILLS WITH FLOW WITH INSPIRATION
SYMETRIC IN BOTH SIDES
INCREASE IN FLOW WITH AUGMENTATION
PHASIC AND PULSETILE |
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