Flaps Flashcards
What is a flap?
Tissue that is either transferred or transplanted with intact circulation.
How are muscle flaps classified by Mathes and Nahai?
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.
What is the vascular supply and classification of the sartorius muscle?
Superficial femoral artery and vein, type IV—segmental.
What type of ultrasonography will most reliably image and locate vascular perforators preoperatively?
Duplex ultrasonography.
What is most likely to improve the survival of the distal portion of a random pattern cutaneous flap?
Surgical delay prior to flap elevation.
What is the vascular supply of the gastrocnemius muscle?
Sural vessels.
The lateral arm flap is supplied by what artery?
Posterior radial collateral artery.
The arterial pedicle to the radial forearm flap arises between what two muscles?
Brachioradialis and flexor carpi radialis.
What are the indications of leech therapy?
Venous congestion.
What method of flap monitoring is most reliable?
Clinical observation.
What flap receives its motor innervation from the obturator nerve?
Gracilis.
What is the dominant vascular supply of the gracilis flap?
Ascending branch of the medial circumflex artery.
The rectus femoris receives its blood supply from what source?
Lateral circumflex femoral artery.
What organism is associated with medicinal leeches?
Aeromonas hydrophila (gram-negative rod).
What artery provides the primary blood supply to a groin flap?
Superficial circumflex iliac artery.
The gluteal thigh flap is supplied by what vessel?
Inferior gluteal artery.
The periosteal perforators of the peroneal artery will be found bordering what aspect of the fibula.
Posteromedial.
The parascapular flap is based on what vessel?
Circumflex scapular artery.
Which nerve provides sensation to the lateral arm flap?
Posterior brachial cutaneous nerve (C5–C6).
The venous outflow of the reverse radial forearm flap depends on what vessel?
Radial venae comitantes.
The fibula flap is based on what vessel?
Peroneal vessels.
The fibula and radial forearm osteocutaneous flap can provide up to what length of bone?
25 and 10 cm, respectively.
What is the dominant vascular supply to the vastus lateralis muscle?
Descending branch of the lateral femoral circumflex artery.
Which muscles comprise the borders of the triangular space?
Triceps (lateral), teres major (inferior border), and teres minor (superior).
What vessel traverses the triangular space?
Circumflex scapular artery.
The gracilis muscle is immediately posterior to what muscle?
Adductor longus muscle.
Name the three subtypes of fasciocutaneous flaps according to Cormack-Lamberty.
Type A: Multiple perforators
Type B: Solitary perforator Type C: Segmental perforator
Name the three subtypes of fasciocutaneous flaps according to Nahai-Mathes.
Type A: Direct cutaneous perforator
Type B: Septocutaneous perforator Type C: Musculocutaneous perforator
Describe the arc of rotation of a flap.
The range of reach of the flap when transposed at its point of rotation (usually the vascular pedicle).
What is the vascular supply of the temporoparietal fascia flap?
Superficial temporal artery and vein.
The saphenous artery originates from what artery?
Genicular.
What is the secondary vascular supply of the gracilis flap?
Superficial
The paramedian forehead flap is based on what vessel?
Supratrochlear.
What is the source of free radicals in the ischemic flap?
Xanthine oxidase.
What is the blood supply of the deltopectoral flap?
First, second, and third perforating branches of the internal mammary artery.
The posterior thigh flap involves transfer of what three muscles?
Biceps femoris, semimembranosus, and semitendinosus muscles.
What are the main functions of the gluteus maximus muscle?
Extension of the hip joint and adductor of the thigh.
The deep inferior epigastric artery arises from what artery?
External iliac
What is the dominant pedicle to the latissimus dorsi muscle?
Thoracodorsal.
Where does the gluteus maximus muscle insert?
Greater trochanter of the femur.
What is the blood supply to the trapezius flap?
Transverse cervical artery.
What is an angiosome?
Composite area of tissue supplied by the same source artery.
Which gastrocnemius muscle has a longer reach?
Medial head.
What is the blood supply to the soleus muscle?
Popliteal.
The radial forearm neurosensory flap is innervated by what nerve(s)?
Lateral and medial antebrachial cutaneous nerves.
The great toe flap and second toe flap are based on what vessel?
First dorsal metacarpal artery and venae comitantes.
what is the blood supply of the external oblique?
Lateral cutaneous branches of the inferior eight posterior intercostal arteries.
What are the muscles that define the boundaries of the quadrangular (quadrilateral) space?
Long head of the triceps (medial), teres major (inferior), and teres minor (inferior), humerus (lateral).
What structures traverse the quadrangular (quadrilateral) space?
Posterior circumflex humeral vessels and axillary nerve.
Which is more lateral, the quadrangular space or the triangular space?
The quadrangular space is more lateral (makes sense since the humerus is one of its borders).
What are the two dominant pedicles of the omental flap?
The right and left gastroepiploic artery and vein
Can the anterolateral thigh flap be neurotized?
Yes, from the lateral femoral cutaneous nerve.
What is the origin and insertion of the gracilis muscle?
The pubic symphysis and the medial tibial condyle.
The forehead flap is based on what vessel?
Superficial temporal artery and vein.
The random pattern flap is based on what blood supply?
Subdermal
What is the appropriate length-to-width design ratio of a random pattern flap?
2 to 1.5.
What is the blood supply of the nasolabial flap?
Angular artery (from facial artery).
What is the dominant vascular pedicle to the pectoralis major flap?
Pectoral branch of the thoracoacromial artery and venae comitantes.
What is the origin of the pectoralis major muscle?
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.
The vascular pedicle to the anterolateral thigh flap traverses what muscles?
Vastus lateralis and rectus femoris muscles.
What is the function of the rectus femoris muscle?
Hip flexion and knee extension.
What is the blood supply of the abductor digiti minimi flap?
Deep palmar artery (from ulnar artery) and venae comitantes.
The reverse sural flap depends on what blood supply?
The median superficial sural artery.
What is the origin of the tensor fascia lata flap?
Anterior 5 cm of the outer portion of the iliac crest and ASIS.
What is the blood supply of the tensor fascia lata flap?
Ascending branch of the lateral circumflex femoral artery.
What is the course of the radial collateral artery to the lateral arm flap?
Courses through the lateral intermuscular septum between the brachialis and lateral head of the triceps muscle.
What is the innervation of the trapezius muscle?
Spinal accessory nerve (XI).
