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Oto Board Pearls of Wisdom - Section II Diagnostic and Assessment Procedures > 13 Face > Flashcards

13 Face Flashcards

1
Q

What is the ideal nasofrontal angle

A

125-135 deg

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2
Q

What is the ideal nasolabial angle

A

90-120 deg

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3
Q

What is the ideal nasofacial angle

A

36-40 deg

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4
Q

What is the ideal alar-to-lobular ratio

A

1:1

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5
Q

How does the ideal supratip break differ b/w men and women

A

more pronounced in women

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6
Q

What is the single most imp aesthetic quality of the nasal tip and base

A

symmetry

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7
Q

What is the ideal configuration of the alar margin

A

S-shaped, exposing 2-3 mm of the caudal columella on lateral view

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8
Q

In a female, where should max brow elevation occur

A

at a line tangent and vertical to the lateral limbus of the eye

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9
Q

What is the ideal brow position in a woman

A

medial segment club shaped and inferior to the lateral segment; peak of the arch above the orbital rim at the lateral limbus; lid margin to brow distance > 2 cm

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10
Q

What is the ideal brow position in a man

A

at the level of the supraorbital rim with a less pronounced arch

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11
Q

What is the ideal ratio of the length of the lower lip to the upper lip

A

2:1

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12
Q

What are the physical signs of aponeurosis disinsertion

A

Thin upper lid skin and high lid fold with good levator fnc (>10 mm)

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13
Q

Define mild, moderate, and marked ptosis

A

Mild: 1-2 mm
Mod: 2-3 mm
Marked: >4 mm

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14
Q

How is lower lid laxity defined

A

If > 10 mm or > 25% of the skin can be gathered w/o distortion of the rim

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15
Q

What is the significance of a “negative vector” profile?

A

Describes pts w/ protuberant eyes and hypoplastic malar eminence – fat should not be removed from these pts during blepharoplasty

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16
Q

What measurement can be used to determine deficiency in the malar area

A

The distance from the malar prominence to the nasolabial groove on lateral projection (ideally > 5 mm)

17
Q

What is Hering’s law?

A

Unilateral ptosis with CONTRA lid retraction – if you cover the ptotic eye with a patch for 30-60 mins, the retracted eye will settle into the nl position and the ptotic eye will reveal itself

18
Q

What are 2 angles used to determine chin projection

A 
Legan angle (nl 12 deg +/- 4)
Merrifield Z angle (nl 80 deg +/- 5) (uses the Frankfort horizontal)
19
Q

Where should the chin lie in relation to a vertical line dropped from the lips

A

In men, chin should meet the line. In women, the chin should lie 2-3 mm posterior

20
Q

What is the difference b/w microgenia and micrognathia?

A

Microgenia is a small mandible with nl occlusion. Micrognathia is an underdeveloped mandible w/ class II occlusion

21
Q

What is retrognathia

A

Nl sized mandible with class II occlusion

22
Q

What is the nl position of the lower lip in relation to the upper lip and chin

A

The most anterior portion of the white roll should lie slightly posterior to the upper lip and lie in the same plane as the soft tissue chin point

23
Q

What is the nl angle b/w the ear and the head

A

25-30 deg

24
Q

What is the nl incline of the vertical axis of the auricle

A

20 deg

25
Q

What is the nl superior limit of the auricle

A

The level of the brow

26
Q

Skin that rarely burns and tans more than average is what Fitzpatrick’s class

A

IV

27
Q

How do adnexal carcinomas arising from hair follicles classically present

A

A tuft of white hair emerges from the central portion of the tumor

28
Q

The pneumonic AEIOU is useful for which type of tumor

A

Merkel Cell Carcinoma

  • A: asx/nontender (88% of pts)
  • E: expanding rapidly (63%)
  • I: immune suppressed (8%)
  • O: Old (over 50)
  • U: UV exposed site (81%)

89% will have 3 of these features at presentation

29
Q

On PE, the nose and maxillary alveolar process are found to be free floating. What type of fx has occurred

A

LeFort II

30
Q

What is the bowstring sign

A

An obvious give that occurs with lateral tension on the lower lid, indicating disruption of the medial canthal tendon

31
Q

What is the nl intercanthal width

A

30-35 mm in caucasians or roughly the width of the alar base

32
Q

On PE, digital pressure on the nasal tip causes prolapse of the distal nose into the pyriform aperture. Which type of NOE fx is this according to Gruss’ classification of NOE injuries?

A

Type II

33
Q

What is the most sensitive test to detect optic nerve injury after facial trauma

A

Pupillary rxn to light

34
Q

6 yo boy with a slapped cheek rash on face

A

5th dz (erythema infectiosum)

35
Q

What PE findings are classic for measles

A

Rash, conjunctivitis, and Koplik’s spots

36
Q

“A 3-year-old boy presents with a 10-day history of irritability, diarrhea, and malaise followed by a 5-day history of swollen, red lips, a polymorphous rash, fever, and peeling of the skin on his hands and feet. What is the diagnosis?

A

Kawasaki dz or mucocutaneous LN syndrome

Oto Board Pearls of Wisdom - Section II Diagnostic and Assessment Procedures (11 decks)

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