Professional Documents
Culture Documents
INSUFFICIENCY
ANATOMY
PHYSIOLOGY
DEFINITION
AETIOLOGY
RISK FACTOR
PATHOGENESIS
PATHOPHYSIOLOGY
MANIFESTATIONS
• VENOUS DILATATION
• OEDEMA
• SKIN CHANGES
• VENOUS ULCER FORMATION
HISTORY TAKING
PHYSICAL EXAMINATION
TESTS
MANAGEMENT
ANATOMY
• The two major superficial veins are the great
and small saphenous veins
EDEMA &
DERMATOSCLEROTIC
CHANGES
Venous dilatation
Oedema
Skin changes
Venous ulcer formation
Venous dilatation
1)Telengiectasia
• a confluence of dilated
intradermal venules less
than 1 mm in caliber
• Spider vein, hype webs,
and thread vein
2)Reticular vein
• Dilated bluish subdermal
tortuous veins 1-3 mm in
diameter
3)Varicosities
• Visible, dilated, tortuous superficial veins
formed by main tributaries of saphenous vein
• 3mm or more in caliber
• Medial thigh and calf varicosities suggest long
saphenous incompetence
Atrophic blanche
Lipodermatosclerosis
Hyperpigmentation
Hyperpigmentation is usually
a brown discolouration
(because of haemosiderin
deposition) of the skin
• Eczema is an
erythematous
dermatitis which
may progress to
blistering, weeping
or scaling eruption
of the skin
• not to be confused
with contact
dermatitis
Lipodermatosclerosis
localised chronic inflammation and
fibrosis of the skin and subcutaneous
tissues of the leg
sign of severe chronic venous
disease.
Acute Lipodermatosclerosis
Episodes of painful inflammation
above the ankle, resembling cellulitis.
The affected area is red, warm , and
scaly.
Some thickening of the skin can be
felt but this is not sharply
demarcated as in chronic
lipodermatosclerosis.
Chronic lipodermatosclerosis
5.Drug History
• Is the patient on any anticoagulant drugs ? ( DVT )
6.Social History
• It is important to ask the patient regarding their functional status and employment such
as patient’s job,income , how the vein problem affecting their daily lives as this is
important for us ( the physician ) to decide the best treatment plan
1. Brodie–
Trendelenburg Test @
Tourniquet Test
2. Perthes Test
Brodie–Trendelenburg Test @
Tourniquet Test
• Only performed in patients with varicose vein
• Purpose: To figure out if the cause of VV is due to
(a) Perforator valve insufficiency
(b) Superficial valve insufficiency