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Adv. Vas. Son.
Test 1 Venous Anatomy and Hemodynamics
| Question | Answer |
|---|---|
| What makes up the Venous lower extremity system? | Deep system carries 85% of limb blood volume, Superficial system, Perforators & communicators, Calf muscle veins (Often considered deep veins) -Gastrocnemius veins (deep)/Soleal veins (sinuses) (deep) |
| Deep vein facts. | Have an adjacent artery w/ same name (except IVC), Deep veins are paired in calf |
| Is bifid femoral vein uncommon? | No it's not uncommon, FV duplicity in thigh, 30% in some reports, Follow vein to see if it's a tributary vs. bifid. If it courses away= tributary |
| Posterior Tibial veins facts. | Paired and lie along the PT artery, they are posterior to tibial |
| Peroneal facts. | Paired and lie along the peroneal artery, Medial to the fibula |
| Anterior Tibial Veins facts. | Paired and lie along the At artery Anterior to the interosseous membrane and Lateral to the tibia |
| What is the tibioperoneal trunk formed by? | Formed by the confluence of the posterior tibial and peroneal veins. It then joins the distal popliteal vein @ the confluence @ the anteriortibial trunk |
| What do the gastrocs drain? | The gastrocnemius muscles and the popliteal vein |
| The Soleal veins or soleal sinuses lie in the deeper soleal muscle and drain into what? | Posterior tibial or peroneal veins |
| Is the Soleal sinus a common place for clots? | Yes because blood pools there |
| What are the calf muscle veins? | Gastrocnemius and Soleal veins |
| Superficial system: GSV facts | Joins deep system at the CFV, and Carries approx. 15% of venous blood volume in leg, No adjacent artery |
| Saphenous veins are contained within fascial envelopes called the Eygptian eye | GSV in the thigh in fascia, and SSV in posterior calf in fascial envelope |
| SSV facts | Posterior aspect of the calf, Typical confluence is at the Pop vein. In 20-30% of the population, SSV will enter above the Pop vein (Giacomini vein) No adjacent artery |
| What is the vein of Giacomini? | Connects the SSV with the GSV |
| Perforator veins facts. | Course from superficial to deep, pass through deep fascial plane, Perforating veins have valves to prevent flow from moving from deep to superficial |
| Blood flow to tissue in the upper and lower extremities is governed by? | Contractility of the heart, Intraluminal blood pressure, Peripheral resistance in the distal end of the arterial "tree", the capillary bed |
| More blood entering the arterial system means what? | More blood volume for the venous system to return |
| Capillary bed perfusion is dependent on a what? | Pressure gradient |
| What is a pressure gradient? | Exists across all capillary beds w/ high pressure occurring in the arterial side and low pressure in the venous side. This allows blood to perfuse through tissue. |
| What happens if venous pressure in the venules are equal to or higher than the pressure in the arterioles? | We in trouble b/c as little or no perfusion will occur in the capillary bed |
| Hydrostatic pressure affect on lower veins when a person is stationary affects: | ↑ tranmural venous pressure distally, ↑ venous distention, ↑ venous pooling, ↓ in capillary perfusion, ↓ venous return, ↓ in cardiac output Hypotension |
| Flow patterns & venous resistance: Cardiac influence: | Venous pressure & flow are affected by Cardiac activity, This effect is most pronounces in the thoracic vessels, Cardiac influence is usually not apparent or is reduced in the lower extremities |
| Pulsatility at the level of the CFV and below is evident when the PT has what? | CHF will occur bilaterally |
| Flow patterns in the upper extremities- Central veins: | Cardiac pulsatility is usually apparent and pronounces, Respiratory variation occurs, but flow during inspiration increases due to the changes in thoracic pressure |
| What happened to the diaphragm with inspiration? | It moves downward and increases the intra-abdominal pressure. The IVC is compressed and venous outflow is temporarily reduced or stopped. Flow resumes during exhalation |
| What is a primary venous return mechanism? | Calf veno motor pump |
| What does the calf veno motor pump do? | Muscle contraction squeezes blood upward and valves prevent return |
| The efficiency of the calf veno motor pump is dependent on: | Ability of the calf skeletal muscles to contract, Competency of the venous valves, and Patency of outflow veins |
| What is PRIMARY venous insufficiency/incompetence? | Congenital absence or defect of valves |
| What is SECONDARY venous insufficiency/incompetence? | Post-phlebitic: Valves damaged by venous thrombosis, &/or chronic outflow obstruction |
| What is retrograde venous flow? | Antegrade popliteal venous flow during calf compression, then retrograde flow (reflux) w/cessation of compression |
| During muscle contraction what might happen to blood if the distal valves are incomptent? | Blood may be forced downward |
| What might cause perforators to dilate and become incompetent? | Increased deep vein intraluminal pressure |
| When perforating veins are incompetent what may happen? | Intraluminal pressure may increase in the superficial venous system, this may contribute to varicose vein formation |
| What are venous insufficiency symptoms? | Stasis dermatitis, Chronic ↑ in capillary pressure, Higher incidence of superficial venous thrombophelbitis in PTs w/ insufficiency, Venous ulcers |
Created by:
EmilyGriffin
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