32 PathophysiologyGenerally blood flow from the superficial veins to the deep veins To the large veins to the heart Venous blood flow work against gravity This is assisted by unidirectional intraluminal valves in the veins
33 Cont…Activity causes intermittent compression of the veins by muscles Pressure increases in the vein valves Incompetent valves Valve failure
34 Cont….Veins become swollon and enlarged Become hard & tortuous Feeling of heaviness & pressure
35 Clinical manifestations Aching ,heavy legsAppearance of spider veinsAnkle swellingBrownish blue shiny skin discolourationRedness, dryness, itching of the affected area
36 Cont… Cramps while standing Bleeding during minor injuries Hard swollon areaWhitened irregular scar like patches in the ankles.
37 Diagnostic evaluation History collectionPhysical examinationTourniquet testDoppler ultrasoundMRI
38 TREATMENT Conservative Elevation of legs Regular exercises Compression stockingsAnti inflammatory medications
39 Cont….Active Stripping - Removal of all or part of the saphenous vein . Endovascular laser surgery – uses a laser to destroy the veins. Radiofrequency ablation – heat to destroy the affected veins.
40 Cont…Ligation – it is usually involved in an incision at the groin .here they tied saphenous vein to the femoral vein just at the entrance of the incision.