Stretched, tortuous or distended veins, usually in lower extremities.
Varicose veins are formed due to valve incompetence secondary to an inherent weakness in the vein wall causing dilation and separation of venous valve cusps. Risk factors include: older age, parity, obesity
With the patient standing and both legs fully exposed, observe the limbs for swelling, skin discolouration and prominent veins. If veins are tortuous and dilated they are varicose. Determination of whether the veins affected are long or short saphenous vein system. Observe both legs carefully for any signs of swelling, varicose eczema or pigmentation changes. With patient standing, palpate veins and subcutaneous tissues on both legs. Check for tenderness, thickening of tissues or pitting oedema.
Check cough impulse at both popliteal and femoral saphenous junctions; a strong impulse indicates incompetence.