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Board Review > OMS > Flashcards

OMS Flashcards

1
Q

What percentage of disc recapture occurs following arthroscopy?

A

0-10%

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2
Q

What is the most common long term complication of costochondral grafts?

A

asymmetric growth

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3
Q

What form of TMJ noise has the best prognosis?

A

Early opening & late reciprocal click

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4
Q

How is pain felt when you have a disc perforation?

A

Capsular nociceptors

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5
Q

If done incorrectly, a high condylotomy may cause damage to what nerve?

A

Auriculotemporal nerve

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6
Q

A diagnostic aid for Rheumatoid Arthritis is?

A

ANA

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7
Q

Why is there an increased incidence of TMJ ankylosis in children vs. adults?

A

thin cortical bone

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8
Q

Tricyclic antidepressants work by:

A

Blocking reuptake of norepinephrine

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9
Q

Which STD can cause arthritis?

A

gonorrhea

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10
Q

There is damage to the articular cartilage in the TMJ, what is the cause of pain?

A

Prostaglandin E2, leukotriene B4

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11
Q

How does damaged articular cartilage heal?

A

by forming fibrocartilage

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12
Q

What happens to the synovial fluid in the TMJ in a patient with RA?

A

Decreased viscosity

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13
Q

What type of occlusal splint will cause more loading on the TMJ?

A

anterior primary contact

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14
Q

What is the thickness of the superior tarsal plate?

A

1mm thick, 10mm in height, 25mm length

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15
Q

What is the position of the upper eyelid, at primary gaze, in relation to limbus?

A

2-3mm inferior

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16
Q

Where do you make the lateral orbital osteotomy for a Lefort III?

A

Frontozygomatic suture extending into the inferior orbital fissure

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17
Q

What is the most common site for A-V malformation following Lefort I osteotomy?

A

Descending palatine artery

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18
Q

What area of the maxilla is most resistant to RPE?

A

midpalatal

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19
Q

What causes immediate relapse following BSSRO?

A

Proximal segment distraction during fixation

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20
Q

Patients with VME have?

A

Decreased masticatory force (by EMG measurement)

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21
Q

What is the complication of placing the medial cut of a BSSO too high?

A

The medial pole of the condyle remains with the distal segment

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22
Q

SARPE should be considered in which patient?

A

Adults (>18 years) with greater than 5mm of transverse deficiency

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23
Q

What is the most common “bad split” during a BSSO?

A

Buccal plate fracture

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24
Q

Where does the mentallis muscle insert?

A

Dermis of skin

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25
Q

Best age for hard tissue manipulation in cleft patients is?

A

9-11

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26
Q

What palatal muscle is not involved in speech?

A

Tensor veli palatine

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27
Q

What is the function of the hamulus?

A

Pully point for the tensor veli palatini

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28
Q

Patients with congenital micrognathia may also have defects in which bones?

A

Malleus & Incus (1st pharyngeal arch)

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29
Q

What muscle acts to close the eustacian tube?

A

No muscle acts to close the tube, it is closed by relaxation of the levator veli palatine and the tensor veli palatine, which both actually aid in opening the tube

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30
Q

Describe how you would use a tongue flap to close an alveolar cleft defect?

A

anteriorly based

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31
Q

Parents without clefts have a child with a cleft, what is the chance that they will have another cleft child?

A

4%
2 children: 9% for 3rd
1 parent: 4-6% child
1 parent and 1 child: 17%

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32
Q

What is the ideal time for lip adhesion?

A

6-8 weeks, completed by 3 months, brings palatal segments together, not muscles

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33
Q

What palatal muscle is most responsible for speech?

A

Levator veli palatini

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34
Q

What is the etiology of hemifacial microsomia?

A

Intrauterine damage of the stapedial artery

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35
Q

What is the most important muscle to close for VP competence?

A

Levator veli palatine

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36
Q

What is the average preferred distance of the upper brow to the pupil center?

A

25mm

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37
Q

What is Romberg’s syndrome?

A

Progressive hemifacial atrophy, coup de gras defect

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38
Q

What is the relationship of the malar eminence to the lateral canthus?

A

10 mm lateral and 15-20 mm inferior

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39
Q

What is the normal dimension for the palpebral fissure?

A

8-12mm women, 7-10mm men

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40
Q

Likely causes of 100 degree neck-chin angle?

A

normal (105-120)

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41
Q

What is the relationship of the medial and lateral canthus?

A

Lateral is 4mm superior to medial

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42
Q

Which muscle is not affected by brow lift?

A

rizorius

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43
Q

What muscle insert into the Nasolabial fold?

A

levator labii superirois aleque nasi

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44
Q

What is the blood supply to a genioploasty segment?

A

periosteum

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45
Q

Ramsey Hunt syndrome is?

A

Involves auditory canal & nerve, caused by Herpes zoster virus, causes facial paralysis due to CN VII involvement, deafness, vertigo and pain. Triad of ipsilateral facial paralysis, ear pain, and vesicles in the auditory canal and auricle

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46
Q

The least predictable area of soft tissue change with mandibular movements is?

A

lower lip

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47
Q

The least predictable area of soft tissue change with mandibular movements is?

A

Supraorbital nerve –has a deep division that is not easily identified

48
Q

The open sky approach in the bleph, the following structure is exposed?

A

Septum

49
Q

The ability to distract the lower lid more than ___ mm indicates the need for a lower eyelid shortening procedure?

A

8mm

50
Q

What 2 anatomic factors are implicated for their movement having an effect on the soft tissues after Lefort I osteotomies?

A

ANS and upper incisor

51
Q

How do you treat VPI with poor elevation of soft palate?

A

Superior based flap

52
Q

Mueller’s muscle is under what type of control?

A

Sympathetic

53
Q

What is the location of the nasal portion of the Lefort II osteotomy?

A

Inferior to the nasofrontal suture

54
Q

What is the vascular supply to the inferior turbinate?

A

Spenopalatine artery (internal max)

55
Q

After a Lefort I osteotomy, a patient has a strange aura and diplopia, what is the cause?

A

Cavernous sinus thrombosis

56
Q

What is the correct pressure setting of CPAP for a patient with OSA?

A

7-15

57
Q

What artery does not contribute to the frontal flap to the nose?

A

Superficial Temporal (Supratrochlear, supraorbital, dorsal nasal do)

58
Q

What separates the fat pads in the lower lid?

A

Inferior oblique separates medal & central pads

59
Q

What is the pathway of dissection for an open rhinoplasty?

A

Over perichondrium, under Periosteum

60
Q

What is the relationship of the lateral nasal cartilage to the nasal bones?

A

Cartilage fits under the bones

61
Q

What is the minimum that is required on the lower lateral cartilages for tip support?

A

5-7mm (at the dome)

62
Q

Where do you place bone grafts for Lefort III?

A

Tuberosity, Zygomatic/temporal, orbital

63
Q

What muscle opens the Eustachian tube?

A

Tensor veli palatine

64
Q

What is the length of the nares, when compared to the columella?

A

2:3

65
Q

Where does the maxillary sinus exit in the nose?

A

middle meatus

66
Q

What is the pollybeak deformity?

A

Convexity of nasal supratip, relative to rest of nose
Complication following rhinoplasty – inadequate reduction of the superior septal angle, a transfixation incision that is not adequately reconstructed and/or postoperative scarring in the supratip region
Also called Parrot’s beak deformity

67
Q

Distraction osteogenesis Advantage over BSSO or difference is:

A

higher rate of condylar resorption and nerve injury w/ BSSO

68
Q

Which type of BSSO movement would cause most condylar resorption?

A

High mandibular plane advancement

69
Q

When would DO be more beneficial over BSSO?

A

Short posterior face height

70
Q

Wilkes classification, what characteristics of stage IV?

A

Bony remodeling

71
Q

What do you do to minimize relapse of B point after mand OGS surgery?

A

2 superior border and one inferior border screw

72
Q

What is Bolton analysis?

A

The overall ratio known to be 91.3%
The Anterior analysis measures the sum of Mesio-distal width of front 6 mandibular teeth and compares them to maxillary teeth. The anterior ratio is known to be 77.2%

73
Q

Physical findings in chondromatosis of the TMJ.

A

loose radiodense bodies within the joint. These loose bodies are formed by metaplastic synovial tissues (joint mice)

74
Q

Muscle not important in velopharyngeal competence

A

Superior pharyngeal constrictor.

75
Q

Path of Hypoglossal nerve in relation to hyoglossus and mylohoid muscle?

A

Lateral to hyoglossus, medial to mylohyoid

76
Q

Innervation of Deltoid, Bicep, Tricep

A

Deltoid C4-5
Bicep C5-6
Tricep C6-7

77
Q

Which of the following is an accessory TMJ ligament?

A

Sphenomandibular and stylomandibular

78
Q

Mueller’s muscle but called it the superior tarsus muscle innervation

A

innervated form the cervical sympathetics and will still have a superior lid crease if it’s out because the crease is caused by the levator

79
Q

Deficit in frontalis vs Deficit procerus and corrugator

A

Deficit in frontalis: brows drop

Deficit procerus and corrugator: brow raises

80
Q

Least helpful to evaluate disc position:

A

tomogram

81
Q

ee increased what in inflammed TMJ

A

prostaglandins e2, leukotrienes b4

82
Q

When do palatal shelves fuse-related to tongue dropping down

A

8 week is when tongue drops and the palatal shelves are completley fuses at week 12

83
Q

Innervation of posterior and anterior digastric

A

anterior belly - mandibular division (V3) of the trigeminal (CN V) via the mylohyoid nerve;
posterior belly - facial nerve (CN VII)

84
Q

Muscles that open jaw.

A

Lateral pterygoid, digastric, mylohyoid, geniohyoid

85
Q

a delta vs c nerve

A 
A Delta: sharp Pain (mechanical and thermal), mylenated, large (1-5micrometers)
fast conduction (5-40m/s)

C-fiber: dull pain (mechanical, thermal, and chemical), unmylenated, small (0.2-
1.5micrometers), slow (0.5-2 m/s)

86
Q

Innervation of Palatoglossus

A

vagus

87
Q

What happens to the bone of the condyle when it gets eroded through. How does it repair and would MMF help ?

A

bony thickening and marginal osteophyte formation in the mandibular condyle –MMF does not help

88
Q

What joins maxillary vein to form retromandibular vein:

A

superficial temporal vein

89
Q

Characteristics of Cluster headache: onset:

A

severe, unilateral orbital, supraorbital, temporal pain lasting 15-180 minutes accompanied by ipsilateral lacrimation, rhinorrhea, eyelid edema, miosis, 1 to 8 attacks per day.

90
Q

What RDI is indication for treatment in child with craniofacial anomaly?

A

10

91
Q

After birth what part of the mandible shows the least growth?

A

symphysis

92
Q

Muscle of facial expression that does not attach to bone?

A

rizorius

93
Q

What percentage of lingual nerves rise above the level of the alveolar crest at the area of the thrid molar?

A

14%

94
Q

Alveolar bone comes from what brachial arch? And is it ecto or endomesenchyme?

A

1st arch and ectomesenchyme

95
Q

How long does cememtum take to repair in weeks?

A

4-6

96
Q

SARPE area most likely to cause orbital and sphenoid bone fractures?

A

Pterygomaxillary junction

97
Q

Lefort unrepaired causes elongation of the midface due to what muscle?

A

medial pterygoid

98
Q

What nerve provides sensory to cutaneous nasal tip?

A

Anterior ethmoidal

99
Q

How does the mandible /maxilla form?

A

First arch with mesoderm

100
Q

After lefort surgery, notice a septal deviation with alar aspect of nose disformed, what do you do?

A

Put the septum back in the clinic or in the OR.

101
Q

difference between myofascial pain and myositis

A

Myofacial pain: repepetive strain: unilateral, dull, aching pain; limited mouth opening, pts often complain of frequent
headache and earache; soft end-feel; pain increases with function. LOCALIZED, REPRODUCIBLE TENDERNESS with trigger points. Sensation of acute malocclusion
(not verifiable clinically). Complaints of frequent temporal headaches

Myositis: injury or infection: swelling and inflammation secondary to direct trauma or infection; trismus. Localized CONTINUOS PAIN IN MUSCLE WITH DIFFUSE TENDERNESS AND SWELLING OF THE ENTIRE LENGTH OF THE AFFECTED MUSCLE

102
Q

Epker modification with BSSO

A

dissection carried out, only as needed, avoiding excessive stripping of the masseter and medial pterygoid muscles. This causes less swelling and postoperative discomfort as well as preservation of blood supply

103
Q

how many seconds are considered an apnic event

A

10 seconds

104
Q

During arthrocentesis develop Retro-discal bleeding

A

retrude the condyle

105
Q

Palatal cleft affects which dimensions of growth

A

transverse, A-P and vertical

106
Q

multiple alveolar cleft repair failures results in recurrent oronasal fistula, best closed with what flap?

A

anterior tongue

107
Q

Supraorbital rim position

A

5-8 mm in front of cornea

108
Q

What makes stable brow lift

A

Trancutaneous bone screws at each parasag. Location – removed after 1 week

109
Q

In Endoscopic brow lift, which muscles cut?

A

Procerus and corrugator

110
Q

Best way to prevent skin dimpling following submental SAL

A

keep cannula toward platysma

111
Q

Where is temporal branch of VII?

A

contined within its undersurface

112
Q

Why is there a risk of going subplatysmal

A

because many people have a natural midline dehiscence

113
Q

What is the action of the hypoglossal nerve:

A

n 12-motor to all tongue muscles except palatalglossus (9, 10)

114
Q

What med do you give TMJ patient with GI disease that can’t take nsaids?

A

choline magnesium trisalicylate or salsalate

115
Q

columellar double break is formed by:

A

olumellar double break marks the transition between the intermediate crus of the lower lateral cartilage and the medial crus

116
Q

Submentoplasty contraindications

A 
retrogenia/micrognathia, cherubic face
low and anterior hyoid bone (ideal high and posterior hyoid bone)
ptotic submandibular glands
loss of cervical skin elasticity
platysmal banding/laxity
little to no cervical subcutaneous fat
117
Q

Glogau classification of wrinkles

A
  • Category I: young, with “no wrinkles” and minimal photoaging and are best managed with cosmoceutical agents and superficial resurfacing procedures such as light chemical peels and microdermabrasion
  • Category II patients: in their thirties, with early to moderate signs of photoaging and characterized by wrinkles in motion
  • Category III patients: moderate to advanced photoaging with static wrinkles requiring more significant ablative resurfacing techniques
  • Category IV patients are the oldest, with more severe photoaging changes and wrinkles significant enough to justify deep resurfacing and other surgical techniques

Board Review (3 decks)

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