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Plastic ORL > Plastic > Flashcards

Plastic Flashcards

0
Q

Nasofrontal angle

A

Line tangent to glabella through nasion and intersecting with a line tangent to dorsum
115-135 deg

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1
Q

Boundaries of forehead

A

Hairline to glabella

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2
Q

Trichion

A

Anterior hairline in the midline

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3
Q

Glabella

A

Most prominent point of the forehead on profile

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4
Q

Nasion

A

Deepest depression at the root of the nose. Corresponds to nasofrontal suture

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5
Q

Radix

A

Region root of nose

Superior orbital ridge to lateral nasal wall

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6
Q

Rhinion

A

Soft tissue correlate of osseocartilagenous junction

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7
Q

Sellion

A

Osseocartlagenous junction at nasal dorsum

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8
Q

Supratip

A

Point cephalic to tip

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9
Q

Tip

A

Most anterior projection of nose in profile

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10
Q

Subnasale

A

Junction of columella and upper lip

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11
Q

Labrale superius

A

Vermilion border of upper lip

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12
Q

Stomion

A

Central portion of interlabial gap

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13
Q

Labrale inferius

A

Vermillion border of lower lip

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14
Q

Mentolabial sulcus

A

Most posterior point between lower lip and chin

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15
Q

Pogonion

A

Most anterior soft tissue point of the chin

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16
Q

Menton

A

Most inferior soft tissue point on chin

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17
Q

Cervical point

A

Innermost point between the submental area and neck

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18
Q

width of eye

A

1/5 of facial width

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19
Q

normal intercanthal distance

A
  1. 5-37.5mm for women

26. 5-38.7mm for men

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20
Q

average palpebral opening

A

10-12mm in height 28-30mm in width

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21
Q

upper lid crease

A

11mm from the lash line

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22
Q

nasolabial angle

A

angle is formed between the intersection of a line tangent to labrale superius and subnasal and a line tangent to the most anterior point of the columella

95 to 110 deg women
90 to 95 deg men

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23
Q

nasofacial angle

A

incline of the nasal dorsun in relation to facial plane

30-40 deg ideally 36 deg

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24
Q

nasomental angle

A

angle between tangent line from nasion to tip intersecting with a line from tip to pogonion
120-132 deg

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25
Q

simons tip projection

A

1:1 with upper lip

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26
Q

goodes method tip projection

A

55 to 60 deg

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27
Q

alar to tip lobular complex

A

1:1

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28
Q

gonzales ulloa zero meridian

A

ideal chin position

Tangential line from nasion to pogonion and perpendicular frankfurt horizontal plane

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29
Q

Cervical point

A

Innermost point between the submentum and neck

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30
Q

Long axis of ear is parallel to long axis of nasal dorsum

A

15 degrees from the vertical plane

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31
Q

Ear protrudes from theskull

A

At an angle of 20-30 deg/ 15-25mm

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32
Q

Hyperdynamic facial lines

A

Long term facial animation

Forehead creases, crows feet and glabellar lines

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33
Q

fitzpatrick classification

A

I white always burns never tans
II white usually burns tans with difficulty
III white sometimes burns sometimes tans
IV white rarely burns tans with ease
V brown very rarely burns tans very easily
VI black never burns always tans

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34
Q

Seborrheic keratoses

A

Verrocous surface slightly raised soft friable brownish black
Benign inherited with no malignant potential

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35
Q

Lesser trelat sign

A

Colonic adenoca

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36
Q

Dermatosis papulosa nigra

A

Small smooth pigmented hyperkeratotic papules

Variant of sebboreheic keratoses

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37
Q

Verruca vulgaris

A 
HPV
Common warts (filiform) - HPV 2 and 3
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38
Q

Molluscum contagiosum virus family (EM2)

A

Small discrete skin colored dome shaped papillomas with umbilicated centers

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39
Q

Actinic keratoses

A

precancerous lesion
sun exposed area fourth decade of life
5Fu imiquimod retinoid cream
photodynamic therapy dermabrasion and chemical peels

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40
Q 
most common malignancy in humans
more common in men
40-60 yrs old
UVB
nasal tip and ala most common
A

basal cell CA

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41
Q

ideal scar

A

flat level of the skin
good color match
narrow parallel to RSTL at the edge of subunits

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42
Q

indicationa for scar revision

A 
widened
perpendicular to RSTL
webbed
pin cushioned
long and linear and misaligned with RSTL
hypertrophied
interrupting aesthetic units of the face
adjacent to but not lying within a favorable site
causing distortion of facial features
scar revision after 60-90 days
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43
Q

excision

A

fusiform shape with 30 degree angled ends positioned within RSTL

44
Q

serial excision

A

wide scars
birthmarks
skin grafts

45
Q

tissue exapnder

A

base of an expander should br approximately 2.5 to 3 times as large as the area to be constructed

46
Q

tissue expanders

A

epidermis is thickened melanin production increases mitotic activity increases dermis thins collagen synthesis is enhanced hair follicle
number remains unchanged hair
density decreases muscle thins blood vessels proliferate

47
Q

Irregularization is needed

A

GBLC and W plasty

48
Q

Irregularization and lengthening

A

Z plasty

49
Q

Z plasty

A

60 deg- 75%
45 deg- 50%
30 deg- 25%

50
Q

Dermabrasion

A

6-8 week intervals
Preservation if reticular dermis
Re epithialization accomplished after 5 to 7 days post treatment erythema 2to 3 mos

51
Q

Intralesional steroids

A

Lessen pin cushion edema

Can cause hypopigmentation and telangiectasia

52
Q

Silicone sheeting

A

8 to 12 hours per day use it for 6 to 12 months

53
Q

Pivotal flaps

A

Rotation
Transposition
Interpolated

54
Q

Rotation flap

A

Width of the pedicle twice as large ad width of defect

55
Q

Transposition flaps

A 
Linear axis
Random blood supply
Compound or axial
Mose useful local flap
Length of random flap must not exceed three times the width
56
Q

Interpolated flap

A

Pivotal flap with linear configuration

Must pass over and under intervening tissue

57
Q

Advancement flap

A

Linear flap

Depends on elasticity

58
Q

V to Y advancement flap

A

A structure or region requires lengthening or release from contracted state

59
Q

y to v advancement flap

A

Reduce redundancy

60
Q

Hinge flaps

A 
Trap door
Turn in 
Turn down
Full thickness nasal defect
With a second flap
Close mature sino nasal and salivary fistulas
61
Q

Nasa subunits

A 
Dorsum
Sidewall
Alae
Facets
Tip
Collumella
62
Q

Melolabial interpolated flap

A

Does not violate aesthetically important faciAl sulcus

63
Q

Paramedian forehead flap

A

Surface defect of collumella dorsum nasal sidewall

64
Q

Auricular cartilagr

A

Replace lower lateral cartilage

65
Q

Septal cartilage

A

Replace upper lateral cartilage

66
Q

Ipsilateral septal mucosal flap

A

Septal branch of labial artery

67
Q

Contralateral septal mucosal flap

A

Anterior ethmoid artery

68
Q

Composite turn out flap

A

Full thickness central nasal defects

69
Q

Paramedian forehead flap

A

Supratrochlear artery
1.7 to 2 cm lateral and midline corresponds to the vertical tangent of the medial aspect of the brow
Proximal 1/4 remains thick
Pedicle detachment after 3 weeks

70
Q

Aesthetic unit upper lip

A

Philltrum

Two lateral segments

71
Q

Lip reconstruction

A

Those that use remaining lip tissue
Those that borrow tissue from opposite lip
Those that use adjacent cheek tissue
Those that use distant flaps

72
Q

Less than 1/2 defect of lip

A

Primary closure

73
Q

One half to two thirds defect of lip

A

Karpazandic flap

74
Q

Lip defects with oral commisure

A

Estlander

75
Q

Lip defects without oral commisure

A

Abbe flap

76
Q

Abbe flap

A

Labial artery
Full thickness flap pedicled at the vermillion border
Pedicle is severed after 2-3 weeks

77
Q

Closure of the lip in 4 layers

A

Mucosa
Muscle
Deep dermal
Skin

78
Q

Recon of cheek defect

A

Rhomboid flap

120 and 60 degree angle

79
Q

Bilobed flap

A

For cheek defect
1st lobe 20%smaller than the defect
2nd lobe 20% smaller than the 1st lobe

80
Q

Medial cheek defects

A

Rotational flap border along the lower lid

81
Q

Large inferiorly based rotation flap for cheek defects

A

Dissected beneath the SMAS and platysma

82
Q

Small and medium sized skin defects cheek

A

V to Y advancement

83
Q

Medial and lateral cheek defect

A

Superiorly based transposition flap

84
Q

Reconstruction of forehead defect

A

Preservation of frontalis muscle function
Preservation of sensation of the forehead skin
Placement of scars within aesthetic borders

85
Q

Aesthetic units of forehead

A

Lateral temple
Paramedian
Median

86
Q

Goals for reconstruction of forehead defects

A 
Maintenance of eyebrow symmetry 
Maintenance of natural appearing temporal and frontal hairlines
Hiding of scars along the hairline
Creation of transverse scars
Avoidance of diagonal scars
87
Q

Ideal location in forehead defect to heal by secondary intention

A

Well away from the brow, lateral third

88
Q

SMAS

A

submuscular fibromuscular extension of the pladtyma muscle arises superiorly from the zygoma and is continuous with the inferior cheek with the platysma

89
Q

Facial nerve

A

Deep to SMAS

90
Q

Sub SMAS

A

Ameliorate melolabial fold

91
Q

Extended supra SMAS

A

improve midface

92
Q

Subperiosteal advantage

A 
Extensive release of periosteum away from the zygoma and maxilla for better elevation of upper lip
No pre auricular scar
Does not impair vascular supply
Lifts orbicularis oculi
Lifting of oral commisure
93
Q

Transorbital acces

A

Ectropion

94
Q

Subperiosteal disadvantages

A

Increase horizontal width
Risk to temporal and buccAl branch
Greater postoperative edema

95
Q

Supra SMAS advantage

A

Does not reposition zygomatic musculature
Avoid risk to temporal and buccal branch
Less post operative edema

96
Q

Supra SMAS disadvantage

A

Long preauricular cutaneous flap
Reduces skin vascularity of the face
Risk to zygomatic branch of nerve VII
Does not lift orbicularis oculi

97
Q

Subcutaneous facelift with plication of the SMAS

A

most common
Safest from facial nerve paralysis
Shorter long term improvement of the jowl and no correction of midface

98
Q

SMAS rhytidectomy

A

SMAS flap is dissected from the parotid

99
Q

Strip SMASectomy

A

Excising a strip of SMAS advancing the mobile SMAS posterosuperiorly to the junction of the SMAS
Advantage of simplicity but no effect on midfacr

100
Q

Subperiosteal rhytidectomy

A

Superior displacement of muscles

101
Q

Transtemporal subperiosteal advantages

A

No pre auricular incision

Concomitant lateral brow lift

102
Q

Transtemporal subperiosteal disadvantages

A

Risk to temporal and buccal bramch
Requires endoscope
Poor access to periosteal dissection of maxilla

103
Q

Transorbital subperioosteal supraperiosteal advantages

A

Direct access for dissection and suspension of midface

More vertical vector for suspension of midface tissues

104
Q

Transorbital subperioosteal supraperiosteal disadvantages

A

Risk to buccal bramch
Risk to infraorbital nerve
Risk of lower lid retraction

105
Q

Transoral subperiosteal advantages

A

Direct access for dissection of mid face

Ease in elevating periosteum of maxilla

106
Q

Transoral subperiosteal disadvantages

A

Risk to buccal branch
Does not provide suspension for midface
Greater risk of infection risk to infraorbital nerve

107
Q

Goals of rhytidectomy

A

Preserve motor and sensory function
Modify cervical fat if excessive
Tighten the SMAS and platysma
Redrape cervical and facial skin and trim excess

108
Q

Classic rhytidectomy incision

A

Above the auricle curving upward and forward to end 1 to 2 cm above the level of the eyebrow

Plastic ORL (2 decks)

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