Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

FRCS Plast > Flaps > Flashcards

Flaps Flashcards

0
Q

Ponten flap Classification

A

1981
Fasciocutaneous flaps
A multiple vessels at base of flap (ponten)
B single axial vessel (lower limb)
C multiple perforating vessels from intermuscular septum (RFF)
D type C with bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

Mathes and Nahai muscle classification

A

Type 1 Single dominant pedicle (TFL)
Type 2 Dominant and minor pedicles (Gracilis)
Type 3 Two dominant pedicles(Glut max)
Type 4 Multiple segmental pedicles (Sartorius)
Type 5 Single dominant and multiple minor pedicles which can support muscle (LD)

1981

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Delay concept

A

Surgical interruption of part of the flap’s blood supply at a preliminary stage with intention to improve survival of the flap.

Pearl 1981:
Open choke vessels
Increase axiality of blood flow in random pattern flaps
Sympathectomy at borders -> vasodilation
Improve tolerance to ischaemia
Reduced hyperadrenergic state and vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Deltopectoral flap

A

Fasciocutaneous type C
Cutaneous axial pattern, Bakamjian 1965

Perforators from internal thoracic artery (3rd/4th IC space)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pectoralis minor flap

A

Terzis 1980s

Type III

Pedicle: Pectoral branch of thoracoacromial artery from subclavian
NS: medial and lateral pectoral nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Trapezius flap

A

McCraw 1977

Type II

Pedicle: TCA (transverse cervical artery) from thyrocervical trunk.
Ascending branch to lateral flap, desc branch to vertical flap.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Lat Dorsi

A

Tansini 1906

Type V

Pedicle: Dominant: thoracodorsal artery off subscapular (after circumflex scapular a)
Also branches to Serratus anterior
Minor: posterior intercostals, lumbar artery perforators (LAP)

8cm length, 3mm artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Serratus anterior

A

Type IV (segmental)

Upper/middle: subscapular, posterior scapular, superior thoracic
Distal: thoracic branch of thoracodorsal artery (only distal 3 of 5 slips can be used)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Scapular flap

A

dos Santos 1980, Nassif 1982, Hamilton 1982, Gilbert 1982

Adipocutaneous, fasciocutaneous or osteocutaneous.

Pedicle: circumflex scapular a - horizontal scapular branch and longitudinal parascapular bracnch

6cm length, 2mm artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Omentum flap

A

1826? Jobet and Lambel
Kiricuta 1950s
1972 Harry Buncke and Donald McLean for scalp defect

Right omental a via gastroepiploic a., 2-3mm. 4-5cm length.
Upper laparotomy - identify greater curvature of stomach to find right & left gastroepiploic arteries. Ligate left and middle omental vessels.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Groin flap

A

McGregor and Jackson 1972

Fasciocutaneous flap

A: Superficial circumflex iliac artery (from femoral) = 3cm below where femoral a meets inguinal ligament
N: IC branch T12 and lat femoral cut nerve
Skin paddle - just medial to femoral v, to superolateral to vertebral column (35-40cm), 10-12cm width

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Parascapular flap

A

Nassif 1982

Fasciocutaneous

Pedicle: circumflex scapular a (see scapular flap)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Gluteal flap

A

Ger 1972

Type III muscle or musculocutaneous

Dominant: superior and inferior gluteal arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Rectus abdominis

A

Robins 1979

Type III

Dominant: DIE
Minor: superior epigastric
8-10cm pedicle, 4mm artery

Pennington 1980 - TRAM
Allen 1994 - DIEP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Pectoralis major flap

A

Ariyan 1979
Type V
Dominant: pectoral branch of thoracoacromial (from subclavian)
Minor: lat thoracic, superior thoracic, intercostal perforators, internal thoracic perforators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Posterior interosseous flap

A

Penteado 1986

FC flap B

Desc branch of common interosseous division of ulnar a (10% direct from ulnar a)

1/3 from line between lateral epicondyle and DRUJ (pronated)
Enters post compartment betw supinator and APL, runs in septum betw EDM and ECU, with 7-14 perforators, anastomoses with perforating branch of ant IO at wrist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Deltoid flap

A

Type I

Pedicle: cutaneous branch of posterior circumflex humeral artery (from 3rd part of axillary a)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Temporal flaps

A
  • STF ( STA = terminal branch of ECA, bifurcates 2-4cm above zygomatic arch into frontal and parietal branches, and middle temporal a (deep branch) immed above zygomatic arch)
  • DTF (superficial to temporalis, suppl by middle temporal a, branch of STA)
  • temporalis muscle (suppl by deep temporal arteries (branches of maxillary), type 3)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Forehead flap

A

Sushruta Samhita 7th century

FC flap A

Supratrochlear and supraorbital arteries plus VCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Converse scalping flap

A

1942

Contralateral superficial temporal arteries

Coronal incision plus skin paddle on contralateral forehead

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Washio flap

A

1969

STA and communication with postauricular a
Raise subgaleal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Bilobed flap

A

Esser 1918

Local random pattern flap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Abbé flap and Estlander flap

A

Abbé flap - Sabattini 1838
For upper lip recon

Estlander flap for commissural defect

28
Q

Karapandzic flap and Webster flap

A

Karapandzic 1974

Lower lip defect >1/3

Webster flap = transverse cheek advancement, excise large Burrow’s triangles

29
Q

Tongue flap

A

Guerrero-santios

Use undersurface of tongue for lower lip, divide at 10 days.
Need mouth block to prevent biting.
Use anteriorly based lateral flaps for upper lip.

Risk of dry mucosa.

30
Q

Gillies fan flap, McGregor modification

A

Gillies 1920? 1957 - result in microstomia, similar to Estlander flap

McGregor 1983 - rectangular, vertical element becomes lip border. Rotates around commissure.

Nakajima flap - based on facial artery rather than labial a

31
Q

Quaba and Maruyama flaps

A

Maruyama flap - incorporates dorsal MC artery and perforator as reverse flow

Quaba flap - thinner, leaves dorsal MC artery behind

32
Q

Foucher flap

A

Holevich 1963 “racquet flap” included branches of sup radial nerve, based over 2nd MC
Then Foucher refinement (tunnelled flap) in 1979

Uses skin over dorsal index P1, based on 1st dorsal MC artery

33
Q

Atasoy-Kleinert flap

A

Tranquilli-Laeli 1935, then reported by Atasoy in 1970

VY advancement of pulp

34
Q

Kutler flap

A

1947

Bilateral advancement flaps for fingertips

35
Q

Venkataswami flap

A

1980

Oblique advancement flap for palmar/oblique fingertips

36
Q

Cross finger flap

A

Cronin 1951

Reverse cross finger flap - Atasoy

37
Q

Hueston flap

A

Rotation-advancement (hatchet) flap on volar finger for fingertip recon - includes 1 NVB at base

Soquet modification - used both NVBs

38
Q

Moberg flap

A

1964 Volar thumb advancement

Also O’Brien - rectangular flap (proximal skin divided) raised on both NVBs and advanced

39
Q

Littler flap

A

Neurovascular island pedicle flap - uses ulnar border ring (or little) finger

40
Q

TFL flap

A

1978 Nahai, and Hill.

One of earliest described free flaps

Type 1

Lat circumflex artery(lat/asc branches) (6cm below ASIS) + lat cutaneous n of thigh

Now used as pedicled flap for pressure sores

41
Q

ALT

A

Song 1984 (popularised by Koshima)

Type C

Descending branch of lat fem circumflex

42
Q

Vastus lateralis

A

Type 2

Proximal 1/3: lateral circumflex femoral and transverse descending branch or “great artery” from profunda femoris
Middle 1/3: perforators from profunda femoris
Distal 1/3: 1st collateral of popliteal artery

Usually raised on proximal vessel, to reconstruct around hip, or distal 1/3 can be distally based to cover knee

43
Q

Lateral arm flap

A

Song 1982

Fasciocutaneous, osteocutaneous, fascial

Posterior branch of radial collateral artery (from profunda brachii)

8cm pedicle, 2mm artery

44
Q

Posterior thigh

A

FC flap
Desc branch of inferior gluteal artery, skin overlying biceps femoris
Can be raised with post cutaneous n of thight (in midline)

45
Q

Saphenous artery flap

A

McCraw 1977

Type 2 muscle flap?

Used for knee+ prox 2/3 of tibia

Saphenous a (with saphenous nerve), plus perforator from post tibial a, and perforators from medial head of gastroc.

46
Q

Gastrocnemius flap

A

Type 1

Medial and lateral sural arteries from popliteal
Protect sural n.
medial head is longer

47
Q

Soleus flap

A

Type 2

Used for middle 1/3 of lower leg, can used medial hemisoleus.
Post tibial and peroneal arteries

48
Q

Medial plantar

A

Distal branch of post tibial - check that medial plantar artery is present!

Found at proximal border of Adb hallucis, just distal to tarsal tunnel, need to divide muscle
- deep branch runs adjacent to tarsal bones, superficial branch runs between Abd hallucis and FDB
Sensate via medial plantar nerve

49
Q

Reverse sural artery flap

A

Sural nerve and artery pierce deep fascia at mid-calf

Pivot point 3 finger breadths proximal to lat malleolus. Proximal limit is where 2 heads of gastroc meet.

Can also be raised antegrade.

50
Q

DCIA flap

A

Mialhe 1975 and Taylor 1979

Can take iliac crest (not ASIS) and internal oblique (if ascending branch preserved, 1cm superior to ASIS)

A: DCIA arises from ext iliac at level of inguinal ligament, courses within fascial sheath behind inguinal lig

8cm pedicle, 4mm artery

51
Q

Fibular flap

A

Taylor 1975

A: nutrient artery of fibula, from peroneal, from posterior tibio-peroneal trunk.
Minor pedicle from peroneal artery (medial and post aspect of fibula)

6cm pedicle, 3mm artery

52
Q

Dorsalis pedis

A

McCraw 1975

Axial FC flap +- tendon, bone, sensation(deep and superficial peroneal nerves)
Entire dorsum of foot, 1st web space, and medial 3 toes and MTs

53
Q

Bilobed flap

A

Esser 1918

2 transposition flap, tertiary defect must loe in line with RSTLs

54
Q

SGAP

A

Allen 1995

Type 3

A: sup gluteal

8cm pedicle, 3mm artery

55
Q

EDB flap

A

Muscle flap, no skin paddle

Lateral tarsal artery, with branch from DP. Can trace back to origin from ant tibial a
Origin - ant surface of calcaneus and inferior ext retinaculum, insertion onto P1s and long toe extensors

56
Q

Posterior interosseous flap

A

Penteado 1986

PIA- descending branch of common interosseous division of ulnar artery (or from ulnar a in 10%)
For 1st web space, thumb, dorsal hand to PIPJ level, palm and wrist coverage

57
Q

Becker flap

A

Becker 1988/1992

Used as propellor flap - pivot point 2cm proximal to pisiform

Ulnodorsal artery from ulnar artery - middle branch supplies skin via ascending and descending branches

58
Q

Radial forearm flap

A

Yang 1981, Song 1982

Type C

Proximal branch near origin
Middle branch 7-8cm proximal to radial styloid.
Distal branch 2cm proximal to styloid (runs beneath PQ for osseous component)
Perforators lie within septum betw BR and FCR

15cm pedicle, 3mm artery

77
Q

Gracilis muscle/musculocutaneous flap

A

Harii 1976/8
Pickrell 1956

Type 2

Pedicle - branch off med fem circumflex (smaller A1 from profunda femoris, A3 from superficial femoral a), VC x2 into profunda femoral v
Nerve - single motor - ant branch of obturator n

8cm pedicle, 3mm artery

FRCS Plast (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions