2. Structure of Vein
Vein is made of three layers of tissues
and fibers
• The tunica adventitia (outer layer)
gives structure and shape to vein.
• The tunica media (middle layer)
contains smooth muscle cells
• The tunica intima (inner most layer)
consists of flat epithelial cells.
3. Veins Disorder
• Some of the more common
disorders include:
• Venous thrombosis
• Chronic venous insufficiency.
• Deep vein thrombosis.
• Phlebitis
• Varicose
• Spider veins/ spider engioma
4. • Chronic venous
insufficiency (CVI) is a
condition that occurs when
the venous wall and/or
valves in the leg veins are
not working effectively.
5. Varicose Veins
• are enlarged, twisted veins
that bulges just under the skin
surface.
• Can happen anywhere in the
body, but are more common in
the legs.
• are not considered a serious
medical condition.
• But can be uncomfortable
• May lead to more serious
problems.
6.
7. Sign and Symptoms
Pain less varicose veins:
• Dark purple or blue
• Appear twisted and bulging, often appearing like cords on the legs
Painful varicose :
• An achy or heavy feeling in the legs
• Burning sensation
• Throbbing pain,
• Muscle cramping and swelling in the lower legs
• Worsened pain after sitting or standing for a long time
• Itching around one or more of the veins
• Changes in skin color around a varicose vein
•
8. Spider Veins
• Spider veins are smaller, red,
purple, and blue vessels that also
twist and turn.
• Visible through the skin,
• Affect the capillaries /the smallest
vessels
• look like a spider’s web or tree
branch.
• Typically visible on the legs and
9. Difference b/w varicose & spider veins
Varicose veins and spider veins are both types of venous
disease, but they look different.
Spider veins are:
• Smaller and thinner than varicose veins.
• Look like red or blue spider webs or branches of a tree,
• Close to the skin’s surface.
• Usually painless.
• Appear, most often behind the knee, on feet or on face.
• Varicose veins usually appear on feet and legs.
10. Pathophysiological mechanism
• Exact cause is unknown
• Weak or damaged valves can lead to varicose veins.
• Muscle contractions in the lower legs act as pumps, and elastic vein
walls help blood return to the heart.
• Tiny valves in the veins open as blood flows toward the heart, then close
to stop blood from flowing backward.
Weak or damaged valve:
• Cause the blood to;
• flow backward and pool in the veins
• Causing the veins to
• stretch or twist.
11. Risk factors
• Congenital: weakness of the vein structure
• Aging : valves in veins start to damage or weaken over time
• Gravity: put the negative effect on leg veins in standing position
• Family History: history of family members with varicose vein
• Sex: more common in female,
• Hormonal effect: during menopause and pregnancy
• Pregnancy: growing uterus place extra pressure on a person’s veins
• Long Standing
• Sitting down for long time periods
• Being over weight
12. Complications
• Ulcers.
• Blood clots.
• Superficial
thrombophlebitis
• Deep vein thrombosis
(DVT)
• Pulmonary embolism:
• Bleeding.
Prevention
• Avoid long periods of standing:
• Raising your legs when sitting or lying down
• Maintain a healthy weight:
• Quit tobacco use
• Stay active
• Try compression stockings
• Wear clothes that fit properly:
• To encourage blood flow
• Avoiding high heels and tight hosiery
• Changing your sitting or standing position
regularly
• Eating a high-fiber, low-salt diet
• Exercising
13. Diagnosis
• History:
• Physical Examination: in sitting and standing position.
• Ultrasound: To see Detailed images of the veins and check
for complications.
• Ultrasound can show blood clots and how your valves are
working.
14. Treatment
• Relive Pain:
• There isn’t a cure for varicose veins, these treatments can
reduce their appearance and relieve discomfort:
• Elevation: to improve circulation, elevate your legs above
your waist several times throughout the day.
• Elastic stockings: Supportive stockings or socks compress
your veins and reduce discomfort. The compression stops
vein stretching
• Injection therapy (sclerotherapy):
• During sclerotherapy, a solution is injected into the vein,
that causes the vein walls to stick together. Eventually, vein
turns into scar tissue and fades away.
15. Laser therapy:
In a minimally invasive procedure called
• Endogenous thermal ablation
• A catheter (a long, thin tube) and laser is used to close off a
damaged vein.
Vein surgery:
• ligation
• To stop blood from pooling/tying off the varicose vein
• Stripping
• To remove (strip) the vein to prevent varicose veins from
reappearing.
17. Nursing management
After Vein Ligation surgery
• Encourage deep breathing to promote venous return
• Check the extremities regularly for
• color, movements, sensations, temp, edema and pedal pulses.
• Bruises and discoloration are consider normal
• Keep the legs elevated at 15 degree to prevent edema
• Compression stocking, applied and removed every 8 hrs for short time
and then applied
• Improving circulation
• Relieving discomfort and pain
• Improving cosmetic appearance
• Avoiding complication such superficial thrombophlebitis, and ulceration