Venous Ulcer Case Study
Venous Ulcers Homework
1. True/false: The medium and large veins in the leg have bicuspid valves to prevent retrograde venous blood flow, but the perforating veins do not have valves.
False
2. What causes the ulcers to form in patients with venous insufficiency? [The question is what causes ulcers to form, not what causes venous insufficiency (people can have venous insufficiency and varicose veins for years without ulceration)]
Ulceration is caused by hypoxia, which is a decrease in the amount of oxygen reaching the tissues. Limiting the amount of oxygen can cause ulceration from minor trauma from the decreased capability of the body to respond to cellular demand. Ulceration can also be caused by the increased vascular permeability causing fibrin to adhere to the capillary walls. The barrier can also cause hypoxia. The increase in blood flow from venous htn triggers an inflammatory …show more content…
The patient S. Doo presents to your clinic for evaluation of a lower leg wound. He has been a detective with a special task force in Albany since the 80’s. He walks all day without any difficulty except that he complains of a heavy, aching, tired feeling in his legs at the end of the day, which resolves with elevation. His wound is located on his right leg, right above the medial malleolus and measures 5 x 4 x 0.1 cm. The wound bed is 100% beefy red granulation tissue, glossy, and draining a moderate amount. This is a moderate odor when the dressings are removed, which is more of a normal wound odor after cleansing. His leg appears moderately swollen around the calf area. The periwound is macerated, warm, and there is a brown tinge to the skin around the ankle. You are unable to palpate a dorsalis pedis artery but his posterior tibial artery can be heard with the hand-held doppler. His past medical history includes: HTN, obesity (he likes his snacks), fx ankle, shoulder reconstruction, + smoker,
1. True/false: The medium and large veins in the leg have bicuspid valves to prevent retrograde venous blood flow, but the perforating veins do not have valves.
False
2. What causes the ulcers to form in patients with venous insufficiency? [The question is what causes ulcers to form, not what causes venous insufficiency (people can have venous insufficiency and varicose veins for years without ulceration)]
Ulceration is caused by hypoxia, which is a decrease in the amount of oxygen reaching the tissues. Limiting the amount of oxygen can cause ulceration from minor trauma from the decreased capability of the body to respond to cellular demand. Ulceration can also be caused by the increased vascular permeability causing fibrin to adhere to the capillary walls. The barrier can also cause hypoxia. The increase in blood flow from venous htn triggers an inflammatory …show more content…
The patient S. Doo presents to your clinic for evaluation of a lower leg wound. He has been a detective with a special task force in Albany since the 80’s. He walks all day without any difficulty except that he complains of a heavy, aching, tired feeling in his legs at the end of the day, which resolves with elevation. His wound is located on his right leg, right above the medial malleolus and measures 5 x 4 x 0.1 cm. The wound bed is 100% beefy red granulation tissue, glossy, and draining a moderate amount. This is a moderate odor when the dressings are removed, which is more of a normal wound odor after cleansing. His leg appears moderately swollen around the calf area. The periwound is macerated, warm, and there is a brown tinge to the skin around the ankle. You are unable to palpate a dorsalis pedis artery but his posterior tibial artery can be heard with the hand-held doppler. His past medical history includes: HTN, obesity (he likes his snacks), fx ankle, shoulder reconstruction, + smoker,