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Color Doppler ultrasound in the veins of the extremities
1. The anatomy and examination of the veins of the lower limbs and upper extremity (1) The anatomy of the veins of the lower extremities
a. the superficial vein system: the dorsal vein of the foot: the lateral vein of the small saphenous vein and the medial continuous great saphenous vein. The great saphenous vein: the longest body vein (76cm) runs in the medial part of the calf and thigh and ends in the femoral vein. The small saphenous vein: between the lateral malleolus and the calf behind the gastrocnemius muscle, and ends in the popliteal vein.
b. Communicating vein:
There are many shallow and deep veins between the lower extremities of the lower extremities. The blood flow direction is opposite when deep vein thrombosis occurs. Between the great saphenous vein and the lesser saphenous vein.
c. Venous valves: function: prevent blood flow. Most of them are before the venous confluence. The number of valves: femoral vein 1, superficial femoral vein 1-5, superficial femoral vein 0-3. Great saphenous vein --9-10. Popliteal vein - 2-4. Valve shape: double valve type, free end up.
2. The anatomy of the upper limb veins: the dorsal radial vein of the hand, the front of the forearm and the elbow fossa, the lateral of the biceps brachii, the intermuscular ditches of the deltoid, and the axillary vein. The main vein is the dorsal ulnar vein of the hand, the ulnar side of the forearm, the medial side of the biceps brachii, and the inferior middle arm of the upper arm into the brachial vein. Median cubital vein: the anastomotic branch between the head vein and the basilar vein at the elbow socket. The sides of the companion vein and the same name vein are mostly two, relatively fine. The blood of the upper limb is mostly reflued by the superficial vein.
3. Inspection method
Position: standing position, sitting position, head high, low lying position.
High frequency linear array, 5.0-10.0MHz. 3.0-5.0MHz can be used in fat, thick leg and iliac vein. The artery can be displayed first with the artery of the same name. The pressure of the probe should be light, especially the superficial vein.
However, when the crosscutting examination is done, the pressure of the probe is very important to determine whether the blood vessel is compressible.
Ultrasonographic image of normal limbs vein
Two dimensional ultrasound: thin tube wall, good continuity, smooth endometrium, with moderate echo. The translucent in the cavity is good. Accompanied by the same name artery around, before and after, cross and so on. The deep vein is slightly wider than the arterial diameter of the same name.
a, The diameter of the tube changes with the time of breathing movement, posture change, probe pressure and muscle extrusion. The veins near the heart change with the heart beat. Venous valve
b, It can only show a large portion of the valve.
The venous valve is thin, soft, double valve symmetrical, flexible in opening and closing. The part of the vein valve base attached to the vein wall is larger than that of the venous sinus.
When the blood flows to the heart, the valve opens and attaches to the inner wall. When standing or suffocating, the valve is closed, the tip of the valve is centripetal, and the tip is closed in the center of the lumen to prevent blood flow backwards.
c, The two-dimensional ultrasound of the vein is normal without echo.
When the blood flow is slow or stagnant, it can be cloudy. (RBC superposition to form a string or a cluster)