The Trendelenburg Test or Brodie–Trendelenburg test is a test which can be carried out as part of a

physical examination In a physical examination, medical examination, or clinical examination, a medical practitioner examines a patient for any possible medical signs or symptoms of a medical condition. It generally consists of a series of questions about the pati ...

to determine the competency of the

valves A valve is a device or natural object that regulates, directs or controls the flow of a fluid (gases, liquids, fluidized solids, or slurries) by opening, closing, or partially obstructing various passageways. Valves are technically fitting ...

in the

superficial Superficial may refer to: *Superficial anatomy, is the study of the external features of the body *Superficiality, the discourses in philosophy regarding social relation *Superficial charm, the tendency to be smooth, engaging, charming, slick and ...

and

deep vein A deep vein is a vein that is deep in the body. This contrasts with superficial veins that are close to the body's surface. Deep veins are almost always beside an artery with the same name (e.g. the femoral vein is beside the femoral artery). ...

s of the legs in patients with

varicose veins Varicose veins, also known as varicoses, are a medical condition in which superficial veins become enlarged and twisted. These veins typically develop in the legs, just under the skin. Varicose veins usually cause few symptoms. However, some indiv ...

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Procedure

With the patient in the supine position, the leg is flexed at the hip and raised above heart level. The veins will empty due to gravity or with the assistance of the examiner's hand squeezing blood towards the heart. A tourniquet is then applied around the upper thigh to compress the superficial veins but not too tight as to occlude the deeper veins. The leg is then lowered by asking the patient to stand. Normally the superficial saphenous vein will fill from below within 30–35 seconds as blood from the capillary beds reaches the veins; if the superficial veins fill more rapidly with the tourniquet in place there is valvular incompetence below the level of the tourniquet in the "deep" or "communicating" veins. After 20 seconds, if there has been no rapid filling, the tourniquet is released. If there is sudden filling at this point, it indicates that the deep and communicating veins are competent but the superficial veins are incompetent. The test is reported in two parts, the initial standing up of the patient (positive or negative based on rapid filling) and the second phase once the tourniquet is removed (positive or negative based upon rapid filling). For example, a possible outcome of the test would be negative-positive meaning that the initial phase of the test was negative indicating competence in the deep and communicating veins and the second phase of the test was positive meaning that there is superficial vein incompetence. The test can be repeated with the tourniquet at different levels to further pinpoint the level of valvular incompetence: * above the knee - to assess the mid-thigh perforators * below the knee - to assess incompetence between the short saphenous vein and the

popliteal vein The popliteal vein is a vein of the lower limb. It is formed from the anterior tibial vein and the posterior tibial vein. It travels medial to the popliteal artery, and becomes the femoral vein. It drains blood from the leg. It can be assess ...

. Superficial veins of the leg normally empty into deep veins, however retrograde filling occurs when valves are incompetent, leading to varicose veins. The test is named for Friedrich Trendelenburg, who described it in 1891.

References

External links

* {{Cardiovascular system symptoms and signs Physical examination Veins Symptoms and signs: Vascular

Procedure

See also

References

External links