Nails Flashcards
How long is the contact time with phenol to destroy the nail matrix?
4 minutes
What is the most common cause of erythronychia
onychopapilloma
What virus is most likely to be associated with a nail involved SCC?
HPV 16
What is the advantage of Bupivacaine over Lidocaine.
longer duration
What is the cuticle?
It is the stratum corneum of the proximal nail fold.
Where do you inject for a thecal block of the finger.
At the palmar digital crease
What is the advantage of Ropivacaine over Bupivacaine?
- has inherent vasoconstriction.
- quick onset but long acting as well
- Less cardiotoxicity
80% of the nail plate is made by what?
Proximal nail matrix
What is another chemical to destroy the nail matrix that may show faster healing than phenol
90% TCA + 10% NaOH
What width of a pigmented band do you need to have more concern.
> 3mm
Besides onychopapilloma and glomus tumor what two other growths may cause erythronychia?
warts
Bowens disease.
In regards to pigmented bands of nails. What is the difference between activation and proliferation.
Activation is when there are a normal number of melanocytes in the nail matrix, but they over produce pigment. Proliferation is when there is an increase in melanocytes and it could be either a benign (nevi lentigo) or malignant process (melanoma)
What % of nail plate melanomas are amelanotic?
25%
What are the most common sites of nail plate melanoma.
Thumb/ big toe or index finger.
What is the most common nail malignancy.
SCC
where are most of the melanocytes found in the nail unit.
Distal nail matrix
which finger nerve block has the advantage of only one injection?
thecal nerve block in the digital palmar crease. Push needle down to bone and inject as you are withdrawing.
What are the three main anesthetics in nail surgery.
Lidocaine
Bupivacaine
Ropivacaine
Which has a better rate of cure for destroying the nail matrix surgery or phenol
Phenol 88%
How is erythronychia formed?
There is a focal loss of ventral nail plate. Vascular bed Swelling occurs in the cavity sometimes with splinter hemorrhages. the nail may disintegrate distally.
If you have painful erythronychia what should you think of?
glomus tumor.
What is the maximum time to have a tourniquet on in nail surgery.
20 minutes.
what percent of phenol is used to destroy nail matrix
88%
Are nail melanoma more common in dark pigmented races?
Yes
where do you inject for a wing block?
start in the proximal nail fold and work out to the lateral nail folds to the tip.
Where do you inject for a digital block.
between the web spaces.
