13 Face Flashcards
What is the ideal nasofrontal angle
125-135 deg
What is the ideal nasolabial angle
90-120 deg
What is the ideal nasofacial angle
36-40 deg
What is the ideal alar-to-lobular ratio
1:1
How does the ideal supratip break differ b/w men and women
more pronounced in women
What is the single most imp aesthetic quality of the nasal tip and base
symmetry
What is the ideal configuration of the alar margin
S-shaped, exposing 2-3 mm of the caudal columella on lateral view
In a female, where should max brow elevation occur
at a line tangent and vertical to the lateral limbus of the eye
What is the ideal brow position in a woman
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
What is the ideal brow position in a man
at the level of the supraorbital rim with a less pronounced arch
What is the ideal ratio of the length of the lower lip to the upper lip
2:1
What are the physical signs of aponeurosis disinsertion
Thin upper lid skin and high lid fold with good levator fnc (>10 mm)
Define mild, moderate, and marked ptosis
Mild: 1-2 mm
Mod: 2-3 mm
Marked: >4 mm
How is lower lid laxity defined
If > 10 mm or > 25% of the skin can be gathered w/o distortion of the rim
What is the significance of a “negative vector” profile?
Describes pts w/ protuberant eyes and hypoplastic malar eminence – fat should not be removed from these pts during blepharoplasty
What measurement can be used to determine deficiency in the malar area
The distance from the malar prominence to the nasolabial groove on lateral projection (ideally > 5 mm)
What is Hering’s law?
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
What are 2 angles used to determine chin projection
Legan angle (nl 12 deg +/- 4) Merrifield Z angle (nl 80 deg +/- 5) (uses the Frankfort horizontal)
Where should the chin lie in relation to a vertical line dropped from the lips
In men, chin should meet the line. In women, the chin should lie 2-3 mm posterior
What is the difference b/w microgenia and micrognathia?
Microgenia is a small mandible with nl occlusion. Micrognathia is an underdeveloped mandible w/ class II occlusion
What is retrognathia
Nl sized mandible with class II occlusion
What is the nl position of the lower lip in relation to the upper lip and chin
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
What is the nl angle b/w the ear and the head
25-30 deg
What is the nl incline of the vertical axis of the auricle
20 deg
What is the nl superior limit of the auricle
The level of the brow
Skin that rarely burns and tans more than average is what Fitzpatrick’s class
IV
How do adnexal carcinomas arising from hair follicles classically present
A tuft of white hair emerges from the central portion of the tumor
The pneumonic AEIOU is useful for which type of tumor
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
On PE, the nose and maxillary alveolar process are found to be free floating. What type of fx has occurred
LeFort II
What is the bowstring sign
An obvious give that occurs with lateral tension on the lower lid, indicating disruption of the medial canthal tendon
What is the nl intercanthal width
30-35 mm in caucasians or roughly the width of the alar base
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?
Type II
What is the most sensitive test to detect optic nerve injury after facial trauma
Pupillary rxn to light
6 yo boy with a slapped cheek rash on face
5th dz (erythema infectiosum)
What PE findings are classic for measles
Rash, conjunctivitis, and Koplik’s spots
“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?
Kawasaki dz or mucocutaneous LN syndrome
