LBM 5 Swollen leg accompanied with redness and pain

STEP 1
a) Varicose : is delated venose with tortuous hardened channel of blood
vessel on the lower leg.

STEP 2
1. Explain the anatomy and fisiology of vein and the rule of vein
valves!
2. What are the etiology of varicose vein?
3. What are the classification of varicose vein?
4. What is the patofisiology of varicose vein?
5. Why the predilection of varicose vein almost in the leg?
6. Why the varicose showed after the second pregnancy?
7. Why the patient had a profuse bleeding on the affected limb?
8. Why the skin was brownish in color and hard when palpated?
9. Why the people complain swelling redness and pain in the
right leg?
10. What is the relationship between obese and varicose vein?
11. What is the relationship between the physical examination in
this scenario with varicose vein?
12. What are the risk factor of varicose vein?
13. How to prevent the varicose vein?
14. What is the treatment of the varicose vein?
15. What are the complication of varicose vein?

STEP 3
1. Explain the anatomy and fisiology of vein and the rule of vein
valves!
 Characteristic: Thin, collaps, have valve and not elastic
 Function:
 Membantu dalam pemompaan darah ke atas, tidak kembali
lagi ke bawah
 Superficial: terlihat dari luar, dekat permukaan kulit
(Contoh: v.saphena magna, v. Saphen parva)  punya katup
Profundal: cenderung tidak terlihat
 Ketika bernafas, tekanannya negatif
VCS, VCI,
Yang mempengaruhi aliran balik vena: Gravitasi, tekanan,
sedotan jantung, saraf, pompa thoracal abdominal, inspirasi.
2. What are the etiology of varicose vein?
Endogen: hormone (in the woman pragnancy, example:
estrogen  volume darah meningkat, angiotensinogen),
genetic, insuficiensy of valve, thrombus (karena plak, emboli
udara)
Eksogen:
Kurang aktivitas, sering berdiri (pompa vena tidak bekerja),
penggunaan sepatu hak tinggi, work hard.
3. What are the classification of varicose vein?
Pembagian (menurut etiologi)
 Primer : karena kelemahan struktur vena
,akibatnyapelebaran pembuluh vena
 Sekunder: oleh gangguan patologis vena, bisa didapat
kongenital, menyebabkan dilatasi, kerusakan vena dalam
akan menyebabkan gangguan aliran darah menuju
jantung.
Derajat:
 C 0 : tidak ada kerusakan vena
 C 1 : Telangioektasis, diameter = 1- 2 mm (vena
superfisial)
 C 2 : Varises vena , diameter > 2 mm
 C 3 : Edem tanpa kelainan kulit
  C 4 : Perubahan kulit (lipodermatosklerosis)
 C 5 : ulkus sembuh
 C 6 : ulkus aktif
CO- C3 : Kronis
C4-C6: Insufiency of vein
Pelebaran arteri: aneurisma
Pelebaran AORTA:
Berdasarkan Pf:
1. Keluhan samar- samar (bengkak, nyeri)
2. Pelebaran vena ,
Berdasarkan letak: Ven superfisial dan pofundal, diameter
berapa?
4. What is the patofisiology of varicose vein?
 Adanya tekanan: berkontraksi, tekanan naik
 Ada kerusakan katup:
* Primer (akibat katupnya, bukan karena pelebaran)
* Sekunder (ada dilatasi, mengakibatkan katupnya
merengang, tidak rapat)
 Kelemahan otot (pengaruh obese, tekanan hidrostatis,
volume darah, memperburuk penyangga vena; lemaknya
numpuk di sekitar fasia, jd pembuluh darah sulit kembali)
5. Why the predilection of varicose vein almost in the leg?

6. Why the varicose showed after the second pregnancy?

7. Why the patient had a profuse bleeding on the affected limb?
8. Why the skin was brownish in color and hard when palpated?
9. Why the people complain swelling redness and pain in the
right leg?
10. What is the relationship between obese and varicose vein?
 11. What is the relationship between the physical examination in
this scenario with varicose vein?
12. What are the risk factor of varicose vein?
13. How to prevent the varicose vein?
14. What is the treatment of the varicose vein?
15. What are the complication of varicose vein?
16. What are the DDs of varicose vein?
17. What is the different between artery dilatation and aorta
dilatation?
18. Why the varicose vein can be happen in right leg?

STEP 4

varicose