Varicose Veins

HISTORY

• • Age & Sex-

  • Ethnic group-

  • Occupation-

  • Symptom-

  • Past history-

  • Personal history-

  • Family history-

PHYSICAL EXAMINATION

• • INSPECTION:

    • Varicose veins-

    • Swelling-

    • Skin of the limb-

      • Colour-

        • Phlegmasia alba dolens-

        • Phlegmasia cerulea dolens-

      • Texture-

    • Morrissey's test-

  • PALPATION:

    • Brodie-Trendelenburg test- This test is performed to determine the incompetency of the sapheno-femoral valve & other communicating systems. This test can be performed in two ways. In both the methods, the patient is first placed in the recumbent position & his legs are raised to empty the veins. This may be hastened by milking the veins proximally. The sapheno-femoral junction is now compressed with the thumb of the clinician or a tourniquet is applied just below the sapheno-femoral junction & the patient is asked to stand up quickly.

• • • Gradual filling of the veins during the period indicates incompetency of the communicating veins, mostly situated on the medial side of the lower half of the leg allowing the blood to flow from the deep to the superficial veins. This is also considered as a positive Trendelenburg test and the positive tests are indications for operation. In case of short saphenous vein same test is done by pressing the sapheno-popliteal junction.

    • Tourniquet test-

    • Perthes' test-

    • Perthes' test (Modified)-

    • Schwartz test-

    • Pratt's test-

    • Morrissey's cough impulse test-

    • Fegan's method to indicate the sites of perforators-

    • Pitting oedema

• • PERCUSSION:

    • Schwartz test-

  • AUSCULTATION:

Examination of the abdomen-

Complications of Varicose veins-

• • Haemorrhage-

  • Phlebitis-

  • Ulceration-

  • Pigmentation-

  • Eczema-

  • Lipodermatosclerosis-

  • Calcification of vein-

  • Periostitis-

  • Equinus deformity-

Varicose Veins