CHRONIC VENOUS INSUFFICIENCY:- Effective venous return depends on 4 factors
- Central pump
- Pressure gradient
- Abdominal increased pressure causes decrease gradient
- Peripheral Venous Pump
- Hydrostatic Pressure
- On long flight, edema occurs due to sustained hydrostatic pressure
- Type
- C.F
- Symptoms
- Pain, aching, throbbing, muscle cramps
- Signs (6 stages)
- Telangiencesia
- Protruding varicose vein
- Venous Stasis Ulcer
- Hyperpigmentation
- Lipodermatoclearosis
- Scar
- Advanced form: Present in 6 %
- Calssification (CEAP)
- Clinical Classification
- Etiology
- Anatomy
- Physiology
- Classification of edema
- Venous Edema
- Lhyphadema
- Lipedema
- Ulcer Characteristics
- Venous
- Arterial
- Neuropathic
- Managemnet
- COnservative
- Graduated compression
- NOTE: TED HOSE ARE NOT USED (around 18 mmhg)
- 20-30 for mild venous stasis is typically needed
- weight loss
- exercise
- leg elevation
- References: Chronic Venous Disease NEJM 2006
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