The valves inside the veins normally close in cycles when the blood flows through them or when pressure is applied from above. Their role is to prevent backflow (reflux) in the vein. Historically, these valves are of great importance because they were the critical clue (in 1628) that proved the circulation is designed to flow in one direction only. When valves fail to work properly the blood does flow back and forth in two directions and the vein no longer functions properly.
Varicose veins are dilated tortuous (twisting) veins with weakened walls and valves that no longer close when they should. They occur in the lower extremities and are important for the health of the skin and superficial tissues. They appear as bulges under the skin of the erect individual and disappear when the limb is elevated above the heart.
Blood clots (or phlebitis) can present as red tender lines on the legs or they can develop silently and grow extensively in the deep veins of the leg before being discovered. They are suspected by the physician when there is swelling or pain in just one leg that is not explainable by any other cause such as an injury or other event.
The diagnosis requires an ultrasound examination for positive identification. This should be done for any extremity in which unexplainable symptoms of swelling or pain occurs. Phlebitis occurs in superficial veins just under the skin or deep veins in the muscles of the legs. Superficial phlebitis is easily seen as an area of inflammation that is tender and red and swollen and feels usually like an oblong lump near the skin. It often occurs in legs that have varicose veins. This kind of phlebitis is easier to diagnose and less serious than the phlebitis that develops in the deep veins where it has a high tendency to extend up and down the leg and give rise to pieces that break off and travel to the lungs.
Blood clots are more likely to occur in older persons, patients at bed rest, individuals with cancer or with surgical procedures on the hip or knee. They have also been identified in people who travel long air flights or car trips, especially if there is a problem in the leg before the flight begins.
Treatment is individualized in the Vascular Center of Wichita Falls to the simplest yest most effective method appropriate to the diagnosed problem. These treatments can be done with near immediate return to customary activity for most cases.
The cause of spider veins is unknown. They are so common that nearly everyone knows someone in the family who has had them. They are more prevalent in women but occur in men as well. They can appear locally after trauma or after superficial surgery, even after vein surgery. There is not much one can do to prevent them. The advice to avoid crossing the legs or wearing constricting clothing or garters to prevent them has no established basis. The hope that support stockings and dietary supplements are of help is unsubstantiated.
An ulcer (non-healing sore) in the skin refers to a place where the normal skin covering has been wiped away and the subcutaneous tissue under the skin shows through. In the leg between the knee and the foot the most common cause of ulcers is leaking venous valves causing high pressure and abnormal circulation in the tiny vessels of the skin. Ulcers represent a late stage of lower extremity vein disease (such as varicose veins or blood clots) when the abnormal circulation from longstanding reflux in the superficial or other veins causes the skin to become thickened and inflamed and it actually breaks down into an open sore.
Lymphatics collect tissue fluid throughout the body including the extremities and return it to the large veins near the heart. The lymph represents fluid that originates as the circulation passes through the tissues. The lymph passes through filtering sites called lymph nodes along the way back to the heart.