Deep veinComplication of immobility coupled with incompetent valves Superficial

Deep veincomplication of immobility coupled with

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Deep vein:Complication of immobility coupled with incompetent valves Superficial vein: Complication of IV therapy and can be an early sign of cancerPathophysiologyVirchow’s triadStasis of bloodVessel wall damageIncreased blood coagulabilityComplications for DVTChronic venous insufficiencyPulmonary embolism
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PVD: VENOUS DISORDERS: VENOUS THROMBOSIS RISK FACTORSFactors associated with Venous ThrombosisImmobilization: MI, CHF, Stroke, Post-op patientsSurgery: orthopedic, thoracic, abdominal, genitourinaryCancer: pancreatic, lung, ovary, testes, urinary tract, breast, stomachTrauma: fractures of the spine, pelvis femur, tibia, spinal cord injuryPregnancy and deliveryHormone therapy: oral contraceptives, hormone replacement therapyCoagulation disorders
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PVD: VENOUS DISORDERS: VENOUS THROMBUS MANIFESTATIONSSuperficial venous thrombosisDeep Venous ThrombosisLocalized pain and tenderness over the affected areaUsually asymptomaticRedness and warmth along the course of the veinDull aching pain in the affected extremity, especially when walkingPalpable cordlike structure along the affected veinPossible tenderness, warmth, erythema along affected veinSwelling and redness of surrounding tissueCyanosis of affected extremityEdema of affected extremity
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DIAGNOSTICSVenous Duplex UltrasoundMRIPlethysmographyAscending contrast venograpy – expensive and uncomfortable but provides most accurate diagnosis
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MEDICAL MANAGEMENTPrevention of clot growth and emboli developmentAnticoagulationHeparin – IV or SCCoumadin - poLow molecular weight heparinLovenox (more common)FragminEnsure there are no contraindications to anticoagulant therapiesSevere traumaBleeding disordersSevere hepatic or renal diseaseRecent hemorrhagic CVA
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SURGICAL MANAGEMENTThrombectomy BypassVena cava filter insertionGreenfield filter
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PVD: VENOUS DISORDERS: VARICOSE VEINSDefinitionTortuous veins with incompetent valve of the vein in the lower extremitiesTypically seen in lower extremities but can manifest in the rectum or esophagusRiskCommon in women over 35 with increased risk of venous stasis in pregnancyFamily historyProfessions of prolonged standingCultural: higher incidence in whites than blacksDiagnostic testingDoppler test, Trendelenburg test. TreatmentsCompression hoseCosmetic surgery (elective)Walking, leg elevation also helps to prevent venous stasis
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PVD: VENOUS DISORDERS: VARICOSE VEINS MANIFESTATIONSManifestations of Varicose VeinsSevere aching pain in the legLeg fatigue, heavinessItching of the affected leg (stasis dermatitis)Feelings of warmth in the legThin discolored skin above the anklesVisibly dilated veinsStasis ulcers
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  • Fall '19
  • Arterial Disorders,  Outline,  Describe procedures,  Arteriosclerosis

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