Veins and arteries There are significant pathogenetic and clinical symptoms that differ from chronic venous insufficiency (CVI) and deep vein thrombosis (DVT). As a provider, it is important to distinguish between pathogenic processes and clinical presentation to provide an accurate diagnosis and treatment plan. This article will review the pathophysiology of CVI and DVT, including the differentiation of thrombosis. The influence of behavioral factors on pathophysiology, diagnosis and treatment will also be examined. Pathophysiology An understanding of the pathophysiology and function of veins and arteries can help clinicians recognize disease processes such as CVI and DVT. According to Huether and McCance (2012), veins are made up of a thin layer of endothelium and fibrous tissue that has less retraction than arteries. Changes in the endothelium of the vein wall will lead to an “exposed subendothelial wall that potentiates prothrombogenic and proinflammatory cytokines” (Huether & McCance, 2012). These cellular changes can lead to opportunities for vasoconstriction, platelet adhesion, and inflammatory processes (Huether & McCance, 2012). Furthermore, the function of blood flow to the heart can be altered when pathogenic changes occur at the cellular level and changes in muscle contraction occur. Veins have valves that return circulating blood to the heart. Muscle activity will support blood return by contracting the skeletal muscles of the extremities to promote blood return (Huether & McCance, 2012). Therefore, individuals who have conditions that alter the vascular endothelium such as hypertension or who are inactive are at risk for inefficient blood flow to the heart or… factors. Diagnosis of DVT involves a physical evaluation, a Doppler, and tests laboratory (D-dimer) (Huether & McCance, 2012). Treatment should include anticoagulant therapy or insertion of a superior vena cava (Huether & McCance, 2012). When behavioral factors such as inactivity, obesity, and smoking are present, considerations should include risk for the presence of other cardiovascular disease processes. Summary When caring for patients exhibiting signs of venous disease, it is important to evaluate and identify progression of venous disease. Additionally, a detailed history and physical examination will need to include coexisting behavioral factors that can be modified to help prevent further progression of venous disease. Finally, it is essential to provide education regarding preventative strategies and signs of thrombus formation.