Study of veins
Last reviewed: 17.10.2021
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Investigation of veins allows to reveal disturbances of circulation in them, connected, for example with obstruction as a result of thrombosis, phlebitis or compression from the outside, with valve insufficiency in varicose veins. Evaluation of the veins is important for examination and palpation. When blood flow is disturbed in a large vein, collateral circulation rapidly develops. These collaterals can be seen under the skin, depending on the site of the primary obstruction.
Inspection
The veins become visible on the anterior thoracic wall with occlusion of the superior vena cava, in the lower part of the abdomen - with the defeat of the inferior vena cava. The direction of the blood flow can be established with pressure on the venous anastomosis and subsequently in the picture of the restoration of blood flow.
The detection of deep vein thrombosis of the lower legs is of great importance due to the high risk of thromboembolism in the lungs and pulmonary infarction. Clinically, it often goes unnoticed, which is confirmed by special studies using radioactive fibrinogen and postmortem examination of veins. The tendency to venous stasis and thrombosis occurs in sedentary individuals, especially with prolonged stay in bed after surgery or myocardial infarction, as well as after childbirth. The manifestations of deep venous thrombosis in hospitalized patients can sometimes be even a slight deterioration in overall well-being, an increase in the rhythm of the heart and an unexpected increase in temperature. On examination, an increase in the calf or swelling on the affected side can be detected. The leg on the affected side is warm to the touch. If thrombosis spreads to the femoral or iliac vein, this can cause a significant deterioration in overall well-being, tension of the tissues upon palpation of these veins. Deep vein thrombosis can resemble manifestations of symptoms of a hematoma or a partial rupture of the gastrocnemius muscle.
Varicose veins of the shins are often accompanied by discomfort and increased fatigue of the legs during movement, decreasing at rest with an elevated position of the shin.
When examined, large varicose enlargements are clearly visible, complications in the form of eczema of the skin, which precedes the development of ulcers, are possible. Varicose enlargements are identified during examination and palpation in a patient who is standing.
Often, the defeat of the veins (especially deep), accompanied by their thrombosis, proceeds little. It can be useful to measure the circumference of the shins at the same level on the left and right. An increase in the volume of the tibia on the one hand may be a sign that indicates the phlebitis of the deep veins of the shins with a violation of blood flow in them and swelling of the tissues.