Chapter 19

Question 1

Dx procedures for plastics

Answer 1

before + after pics
visual exam
xray, CT, MRI

Question 2

pharmacologic agents for plastics

Answer 2

tumescent solution
cocaine

Question 3

forms of tumescent solution

Answer 3

saline: hydro dissection
epinepherine: hemostasis
lidocaine: anesthetic
wydase: fat liquifier

Question 4

characterisitcs of cocaine used for plastics

Answer 4

4% controlled substance
vasoconstrictor
anesthetic
used in rhinoplasty

Question 5

instrumentation and equipment for plastics

Answer 5

plastic set
nasal set
dermis

Question 6

what comes in a plastic set

Answer 6

lipo set
breast augmentation set
breast + abdominoplasty set
minor ortho
- hand sets

Question 7

what comes in a nasal set

Answer 7

rhinoplsty set

Question 8

what comes in a dermis set

Answer 8

dermatome
mesh graft device

Question 9

what is dermatome

Answer 9

cuts thin slices of skin for split thickness skin graft

Question 10

what are the types of dermatome

Answer 10

handheld: small graft
drum: large flat graft
oscillating

Question 11

process of doing dermatome

Answer 11

• chlorhexidine gluconate applied
• skin tension
• dermatone cuts to desired thick

Question 12

what is a mesh graft device

Answer 12

expands the size of skin graft so it can cover more area

Question 13

characteristics of autograft

Answer 13

split thickness
remove epi+ half of dermis
used for large surface areas

Question 14

characteristics full thickness skin graft (FTSG)

Answer 14

removes epi+ dermis
used for small or large deep surface areas

Question 15

characteristics of homograft

Answer 15

same species
used in dressings/ face transplants

Question 16

what are the determining factors for skin grafts

Answer 16

location of defect
condition of possible donor sites
cause of the defect

Question 17

characteristics of free flap flap grafts

Answer 17

free flap
- comes from another location
- must micro anastomose
-no sensation

Question 18

characteristics of pedicle flap flap grafts

Answer 18

remain attached to its blood supply
tunnel under the existing skin

Question 19

pathology of burns

Answer 19

heat
cold
radiation
chemicals
electrical

Question 20

surgical procedures for burns may include:

Answer 20

- debridement of necrotic
- skin grafts
- restoring function
- cosmetic

Question 21

how many degrees of burn

Answer 21

4
4th one is burning bone

Question 22

first degree burn characteristics

Answer 22

epidermis
no blister
heals within 1 week
no scarring

Question 23

second degree burn characteristics

Answer 23

partial thickness
extremely painful blisters
superficial or deep
debridement + grafting maybe

Question 24

third degree burn characteristics

Answer 24

full thickness
permanent tissue damage
skin grafting needed

Question 25

fourth degree burn characteristics

Answer 25

(char burns) surgery necessary grafting or amputation prone to infection extensive reconstruction

Question 26

5 criteria of the abbreviated burn severity index

Answer 26

age of patient sex of patient presence of inhilation injury depth of burn (degree) percentage of body surface burned

Question 27

two BSA methods

Answer 27

lund browder - chart variables according to age rule of nines

Question 28

rule of nines categories

Answer 28

head and neck- 9% anterior trunk- 18% posterior trunk- 18% upper extremity- 9% lower extremity- 18% perineum- 1%

Question 29

what is systemic response

Answer 29

more than 30% total body surface burned

Question 30

characteristics of full thickenss skin graft

Answer 30

small but deep defects try to maintain blood supply + nerves dirty+ clean setups free and pedicle flaps

Question 31

steps of full thickness skin graft

Answer 31

excise elsion (send to path) donor site: excise skin graft and cut to size undermine skin at donor site close donor site recipient site: suture graft in place bolster dressings in place

Question 32

what to use for split thickness skin graft

Answer 32

use topical thrombin or epi for hemostasis on donor site pressure dressings

Question 33

steps for a split thickness skin graft

Answer 33

donor site: lubricate and stretch skin cut and mesh graft hemostasis cover recipient site: suture into place bolster dressings applied

Question 34

what lubricant do you use for skin grafting

Answer 34

mineral oil

Question 35

scar revision techniquess

Answer 35

w plasty m plasty y-v plasty z plasty

Question 36

Cause of dermatologchalasis

Answer 36

Sun exposure and age Collagen fibers lost

Question 37

Blephroplasty

Answer 37

Surgical repair of eyelid

Question 38

Considerations with blephrolasty

Answer 38

Bilateral Done local Avoid corneal abrasion Prolene to close for color

Question 39

Procedure steps for blephrolasty

Answer 39

Mark tissue Incision with 15 blade Hempstead is Excise fat Close

Question 40

What instrument do you excise fat with on blephrollasty

Answer 40

Westcott Bishop Harmon Caliper

Question 41

What instrument do you use to close blephroplasty

Answer 41

Castroveijo needle

Question 42

What is an endo brow lift

Answer 42

Reduce forehead wrinkles

Question 43

Steps of endo brow lift

Answer 43

- Tumescent solution injected - 3-5 incisions made behind hairline - endoscope introduced - periosteum dissected - muscle elimination - periosteum fixation - closure

Question 44

Two forms of periosteum fixation

Answer 44

Temporary Permanent

Question 45

Pathology for malar deficiencies and asymmetries

Answer 45

When severe asymmetry Cosmetic Trauma Previous plastic procedures

Question 46

Steps to malar implants

Answer 46

- Gingobuccola sulcus incision - periosteum in used - pocket created - implant inserted - irrigated - fixated with bolsters - wound closed

Question 47

Another name for malar implants

Answer 47

Submalar augmentation

Question 48

what is a mandbular dificiencies and asymmetry

Answer 48

improves the shape of the chin

Question 49

what is a mentoplasty

Answer 49

synthetic implant placement - incision made under the jaw - extends the chin

Question 50

what is ear microtia

Answer 50

congenital absence of part or all of ear - grade 1-4

Question 51

waht implant is used for ear microtia

Answer 51

6=9th costal cartilage graft or synthetic implants

Question 52

what is a rhinoplasty often odne in conjunction with

Answer 52

septoplasty mentoplasty

Question 53

two types of implants for rhinolpasty

Answer 53

synthetic autograft - ear or rib

Question 54

instruments/ equipment for rhinoplsty

Answer 54

nose set ENT prep stand headlamp packing splint

Question 55

procedure steps for rhinoplsty

Answer 55

trim hair incision at base of nose - 15 on 7 repair closure splint

Question 56

what instruments do you use for rhinoplasty repair

Answer 56

chisel or rasp boies elevator implants/ grafts

Question 57

what is a rhytidectomy, what is it commonly done with

Answer 57

face lift laser resurfacing blephroplasty lipo

Question 58

procedure steps for rhytidectomy

Answer 58

incision - 15 on 3 undermine skin from platysma smas dissected recessed + stitched stretch skin+ remove redundant tissu duplicate contralaterally close

Question 59

pathology for a cleft lip and palate

Answer 59

cheiloschisis: cleft lip palatoschisis: cleft palate

Question 60

how many people have cleft lip and palate

Answer 60

one in every 500 - 20% genetic - 80% maternal substances + age

Question 61

characteristics of cheiloplasty/ palatoplasty

Answer 61

class ii procedure hard palate fixation device

Question 62

how long can cheiloplasty/ palatoplasty be delayed

Answer 62

3-18 months

Question 63

post op requirments of cheiloplasty/ palatoplasty

Answer 63

speech therapy and orthodont care

Question 64

cheiloplasty steps

Answer 64

map it out excise both sides of cleft - 15 blade + adsons close mucous membrane of lip close obicularis oris muscle create cupids bow