Pulmonary embolism; Source of Thrombosis, Femoral versus Deep Leg Veins - USMLE Forums
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Old 03-25-2013
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Question Pulmonary embolism; Source of Thrombosis, Femoral versus Deep Leg Veins

what would you answer if the origin of embolus is asked ......?

while majority of text books say deep leg veins (including FA) ....but goljan specifically says femoral vein ....what should i chose if both comes in a question ...and goljan even gives a good explanation on his audio why femoral vein should be ......what do you say guys ?
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Old 03-25-2013
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i would say deep leg veins

whenever theres an embolus calf muscles are dissected and deep veins checked for thrombus-routine of forensic pathologist

even so femorel vein has bigger caliber and chance of thrombus breaking off from its wall is more
deep leg veins remain the most common sites of origin of pulmonary emboli
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Look ate wikipedia under embolism it is stated

Assuming a normal circulation, a thrombus or other embolus formed in a systemic vein will always impact in the lungs, after passing through the right side of the heart. This forms a pulmonary embolism that can be a complication of deep-vein thrombosis. Note that, contrary to popular belief, the most common site of origin of pulmonary emboli are the femoral veins, not the deep veins of the calf. Deep veins of the calf are the most common site of thrombi, not emboli origin.

so FA is wrong ??
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What I have learned from Goljan is:

Most often thrombi develop in deep veins of calf. When this thrombus extends into femoral vein it has fairly greater chance to dislodge and cause Pulmonary emblous.

Please correct me if I'm wrong.
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Quote:
Originally Posted by mutant View Post
What I have learned from Goljan is:

Most often thrombi develop in deep veins of calf. When this thrombus extends into femoral vein it has fairly greater chance to dislodge and cause Pulmonary emblous.

Please correct me if I'm wrong.
yeah but the origin of pulmonary EMBOLI not Thrombus is femoral vein .... so thrombus origin is deep calf veins while embolus origin is femoral right but FA states deep leg veins are the site of embolus and that makes it all wrong .....and it is stated in the majority of the text books i have read while goljan was the first to point out
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By the way femoral vein is a deep vein. Others being iliac, popliteal, and tibial veins.
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Quote:
Originally Posted by mutant View Post
By the way femoral vein is a deep vein. Others being iliac, popliteal, and tibial veins.
but we are being specific here ....so is popliteal and many other veins
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I think they will not confuse you in exam. They will write it clearly.
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i was thinking of a possibility if they gave deep leg veins and femoral ....what might i should choose
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Femoral vein is a deep leg vein. So they can not give both options. They can either mention deep leg veins or they are going to write name of individual deep leg veins. Sorry about my english!
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yeah you are right .....i have a habbit of going into these minute details and make myself paranoid maybe my med school has made me to act one
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