Flaps Flashcards

1
Q

What is a flap?

A

Tissue that is either transferred or transplanted with intact circulation.

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2
Q

How are muscle flaps classified by Mathes and Nahai?

A

Type I: single vascular pedicle.
Type II: dominant vascular pedicle(s) and minor vascular pedicle(s).
Type III: two dominant pedicles.
Type IV: segmental vascular pedicles.
Type V: dominant vascular pedicle and secondary segmental vascular pedicles.

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3
Q

What is the vascular supply and classification of the sartorius muscle?

A

Superficial femoral artery and vein, type IV—segmental.

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4
Q

What type of ultrasonography will most reliably image and locate vascular perforators preoperatively?

A

Duplex ultrasonography.

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5
Q

What is most likely to improve the survival of the distal portion of a random pattern cutaneous flap?

A

Surgical delay prior to flap elevation.

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6
Q

What is the vascular supply of the gastrocnemius muscle?

A

Sural vessels.

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7
Q

The lateral arm flap is supplied by what artery?

A

Posterior radial collateral artery.

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8
Q

The arterial pedicle to the radial forearm flap arises between what two muscles?

A

Brachioradialis and flexor carpi radialis.

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9
Q

What are the indications of leech therapy?

A

Venous congestion.

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10
Q

What method of flap monitoring is most reliable?

A

Clinical observation.

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11
Q

What flap receives its motor innervation from the obturator nerve?

A

Gracilis.

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12
Q

What is the dominant vascular supply of the gracilis flap?

A

Ascending branch of the medial circumflex artery.

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13
Q

The rectus femoris receives its blood supply from what source?

A

Lateral circumflex femoral artery.

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14
Q

What organism is associated with medicinal leeches?

A

Aeromonas hydrophila (gram-negative rod).

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15
Q

What artery provides the primary blood supply to a groin flap?

A

Superficial circumflex iliac artery.

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16
Q

The gluteal thigh flap is supplied by what vessel?

A

Inferior gluteal artery.

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17
Q

The periosteal perforators of the peroneal artery will be found bordering what aspect of the fibula.

A

Posteromedial.

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18
Q

The parascapular flap is based on what vessel?

A

Circumflex scapular artery.

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19
Q

Which nerve provides sensation to the lateral arm flap?

A

Posterior brachial cutaneous nerve (C5–C6).

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20
Q

The venous outflow of the reverse radial forearm flap depends on what vessel?

A

Radial venae comitantes.

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21
Q

The fibula flap is based on what vessel?

A

Peroneal vessels.

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22
Q

The fibula and radial forearm osteocutaneous flap can provide up to what length of bone?

A

25 and 10 cm, respectively.

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23
Q

What is the dominant vascular supply to the vastus lateralis muscle?

A

Descending branch of the lateral femoral circumflex artery.

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24
Q

Which muscles comprise the borders of the triangular space?

A

Triceps (lateral), teres major (inferior border), and teres minor (superior).

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25
Q

What vessel traverses the triangular space?

A

Circumflex scapular artery.

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26
Q

The gracilis muscle is immediately posterior to what muscle?

A

Adductor longus muscle.

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27
Q

Name the three subtypes of fasciocutaneous flaps according to Cormack-Lamberty.

A

Type A: Multiple perforators
Type B: Solitary perforator Type C: Segmental perforator

28
Q

Name the three subtypes of fasciocutaneous flaps according to Nahai-Mathes.

A

Type A: Direct cutaneous perforator
Type B: Septocutaneous perforator Type C: Musculocutaneous perforator

29
Q

Describe the arc of rotation of a flap.

A

The range of reach of the flap when transposed at its point of rotation (usually the vascular pedicle).

30
Q

What is the vascular supply of the temporoparietal fascia flap?

A

Superficial temporal artery and vein.

31
Q

The saphenous artery originates from what artery?

A

Genicular.

32
Q

What is the secondary vascular supply of the gracilis flap?

A

Superficial

33
Q

The paramedian forehead flap is based on what vessel?

A

Supratrochlear.

34
Q

What is the source of free radicals in the ischemic flap?

A

Xanthine oxidase.

35
Q

What is the blood supply of the deltopectoral flap?

A

First, second, and third perforating branches of the internal mammary artery.

36
Q

The posterior thigh flap involves transfer of what three muscles?

A

Biceps femoris, semimembranosus, and semitendinosus muscles.

37
Q

What are the main functions of the gluteus maximus muscle?

A

Extension of the hip joint and adductor of the thigh.

38
Q

The deep inferior epigastric artery arises from what artery?

A

External iliac

39
Q

What is the dominant pedicle to the latissimus dorsi muscle?

A

Thoracodorsal.

40
Q

Where does the gluteus maximus muscle insert?

A

Greater trochanter of the femur.

41
Q

What is the blood supply to the trapezius flap?

A

Transverse cervical artery.

42
Q

What is an angiosome?

A

Composite area of tissue supplied by the same source artery.

43
Q

Which gastrocnemius muscle has a longer reach?

A

Medial head.

44
Q

What is the blood supply to the soleus muscle?

A

Popliteal.

45
Q

The radial forearm neurosensory flap is innervated by what nerve(s)?

A

Lateral and medial antebrachial cutaneous nerves.

46
Q

The great toe flap and second toe flap are based on what vessel?

A

First dorsal metacarpal artery and venae comitantes.

47
Q

what is the blood supply of the external oblique?

A

Lateral cutaneous branches of the inferior eight posterior intercostal arteries.

48
Q

What are the muscles that define the boundaries of the quadrangular (quadrilateral) space?

A

Long head of the triceps (medial), teres major (inferior), and teres minor (inferior), humerus (lateral).

49
Q

What structures traverse the quadrangular (quadrilateral) space?

A

Posterior circumflex humeral vessels and axillary nerve.

50
Q

Which is more lateral, the quadrangular space or the triangular space?

A

The quadrangular space is more lateral (makes sense since the humerus is one of its borders).

51
Q

What are the two dominant pedicles of the omental flap?

A

The right and left gastroepiploic artery and vein

52
Q

Can the anterolateral thigh flap be neurotized?

A

Yes, from the lateral femoral cutaneous nerve.

53
Q

What is the origin and insertion of the gracilis muscle?

A

The pubic symphysis and the medial tibial condyle.

54
Q

The forehead flap is based on what vessel?

A

Superficial temporal artery and vein.

55
Q

The random pattern flap is based on what blood supply?

A

Subdermal

56
Q

What is the appropriate length-to-width design ratio of a random pattern flap?

A

2 to 1.5.

57
Q

What is the blood supply of the nasolabial flap?

A

Angular artery (from facial artery).

58
Q

What is the dominant vascular pedicle to the pectoralis major flap?

A

Pectoral branch of the thoracoacromial artery and venae comitantes.

59
Q

What is the origin of the pectoralis major muscle?

A

The medial half of the clavicle, the anterior surface of the sternum, the cartilaginous portions of the upper seven ribs, and the aponeurosis of the external oblique muscle.

60
Q

The vascular pedicle to the anterolateral thigh flap traverses what muscles?

A

Vastus lateralis and rectus femoris muscles.

61
Q

What is the function of the rectus femoris muscle?

A

Hip flexion and knee extension.

62
Q

What is the blood supply of the abductor digiti minimi flap?

A

Deep palmar artery (from ulnar artery) and venae comitantes.

63
Q

The reverse sural flap depends on what blood supply?

A

The median superficial sural artery.

64
Q

What is the origin of the tensor fascia lata flap?

A

Anterior 5 cm of the outer portion of the iliac crest and ASIS.

65
Q

What is the blood supply of the tensor fascia lata flap?

A

Ascending branch of the lateral circumflex femoral artery.

66
Q

What is the course of the radial collateral artery to the lateral arm flap?

A

Courses through the lateral intermuscular septum between the brachialis and lateral head of the triceps muscle.

67
Q

What is the innervation of the trapezius muscle?

A

Spinal accessory nerve (XI).