Plastic, Oral, Maxillofacial on 9/16 Flashcards

1
Q

Adip/o

A

fat

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2
Q

caus/o

A

burn

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3
Q

cauter/o

A

heat
burn

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4
Q

derm/o

A

skin

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5
Q

Dermat/o

A

skin

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6
Q

diaphor/o

A

sweat

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7
Q

eryther/o

A

red

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8
Q

erythemat/o

A

red

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9
Q

hydr/o

A

water

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10
Q

kerat/o

A

hard or horny tissue
cornea

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11
Q

leuk/o

A

white

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12
Q

lip/o

A

fat
lipid

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13
Q

melan/o

A

black

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14
Q

myc/o

A

fungus

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15
Q

onych/o

A

nail

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16
Q

phyt/o

A

plant

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17
Q

pil/o

A

hair

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18
Q

py/o

A

pus

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19
Q

seb/o

A

sebum

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20
Q

sebace/o

A

sebum

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21
Q

squam/o

A

squamous

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22
Q

steat/o

A

fat

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23
Q

trich/o

A

hair

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24
Q

ungu/o

A

nail

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25
Q

xer/o

A

dry

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26
Q

What makes up the integumentary system?

A

skin, hair, nail, and exocrine glands

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27
Q

What is he most visible and largest organ?

A

skin

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28
Q

What are 6 functions of the skin?

A

protection: barrier to outside
senses: pain, temp
Regulates: own body temp
Prevents loss of body fluids
Excretes through sweat glands
Absorption

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29
Q

What are the 3 main layers of skin?

A

Epidermis
dermis
hypodermis

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30
Q

What does the dermis layer of skin do for us?

A

provides strength and elasticity
callagen fibers
vascular layer
AKA true skin

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31
Q

What does the epidermis layer of skin do for us?

A

AKA false skin
continually replaces itself
non vascular

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32
Q

What does the hypodermis layer of skin do for us?

A

attaches skin to tissue
thick and fatty
AKA subcutaneous tissue

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33
Q

What are the purpose and goals of reconstructive skin procedures?

A

restore normal function/ appearance
correct congenital deformities/ disfigurements
scars or trauma
slef body immage

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34
Q

What is done to prep the skin for a face procedure? And what solution is used?

A

eyebrow/ lashes left alone
colorless prep solution used
hibiclense & betadine used
Hibiclense NOT near eyes and ears

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35
Q

What kind of draping used for plastic surgeries?

A

creative to expose several areas
universal drape

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36
Q

What kind of sutures are used in most plastic procedures?

A

fine sutures swagged to needles
2-0 to 8-0 depending on tissue
8-0 to 11-0 during microsurgeries (nerve & vessel)

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37
Q

What kind of anesthesia is used?

A

frequently local on WIWO
general on children or confused

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38
Q

What are the common anesthesia meds used?

A

xylocaine/lidocaine (1% or 2%)
bupivacaine/sensorcaine/
Marcaine (0.25%, 0.5%, 0.75%)
epinephrine as a local

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39
Q

What kind of visual equipment is used?

A

fiberoptic headlamp
lighted retractors
loupes- magnifying glasses
microscopes

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40
Q

What is an ESU?

A

electrosurgical unit used for coagulating and cutting tissue

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41
Q

What is a smoke evacuator?

A

used in conjunction with the ESU helps remove the smoke made

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42
Q

What is a pneumatic tourniquet? what are the steps to putting one on?

A

stops blood flow to extremity

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43
Q

What is a doppler used for?

A

identify sufficient blood flow through grafts

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44
Q

What is a nerve stimulator?

A

identifies nerves
used in craniofacial and hand reconstruction
facelift- facial and trigeminal nerve (cranial 5)

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45
Q

What powered instruments are used in plastic, oral, maxillofacial surgeries?

A

drills
z-serter for inserting small pins, plates, and screws

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46
Q

What is the liposuction vacuum machine and curettes used for?

A

removing excess subcutaneous fat

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47
Q

When handling plastics instruments what should be looked for on the forceps? scissors?

A

malocclusion- miss aligned teeth
burrs- uneven cuts

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48
Q

What are two reasons for doing implants and prostheses?

A

replace diseased, injured, or missing body parts
augment body parts
(mammoplasty-breast or mentoplasty- chin)

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49
Q

What does alloplastic mean?

A

material made from environmental materials

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50
Q

What kind of alloplastic materials are used?

A

dacron
silicone
silastic
mesh
teflon
stainless steel

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51
Q

Pressure dressing are frequently used when?

A

(FTSG) full thickness skin graft
aka stent dressing

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52
Q

What is the vacuum assisted closure device?

A

VAC
assists drainage with negative pressure
post-op dressing
used for pressure ulcers, flaps, and skin grafts to eliminate dead space

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53
Q

What is another name for neoplasm?

A

skin lesion

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54
Q

What is a skin lesion?

A

abnormal growth
benign or cancerous
anywhere on body
excised for cosmetic/ health

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55
Q

What is Basal cell carcinoma?

A

BCC
malignant tumor (most common)
head and neck
sun exposure
locally aggressive but rarely metastasizes

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56
Q

How is a lesion assessed?

A

Asymmetry
Border
Color
Diameter
Evolution

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57
Q

What is squamous cell carcinoma?

A

SCC
older people exposed to sun
rapid growing that can metastasize through lymph and blood

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58
Q

What is a malignant melanoma?

A

tumor of pigment cells
common on fair skin
can remain small or grow fast
tx- wide local excision
Prognosis determined by depth of tissue invasion
genetic predisposition

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59
Q

What is a pressure ulcer?

A

prolonged compression of soft tissue over bony prominences

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60
Q

Where are common sites of pressure ulcers?

A

sacrum
ischium
trochanter (hip)
malleolus (ankle)
heel

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61
Q

How many pressure ulcer stages are there?

A

4

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62
Q

Describe a stage 1 pressure ulcer

A

a reddend painful area that does not turn white when pressed on

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63
Q

Describe a stage 2 pressure ulcer

A

the skin is blistering or causing an open sore

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64
Q

Describe a stage 3 pressure ulcer

A

the skin develops an open or sunken hole called a crater or ulcer
need debridement

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65
Q

Describe a stage 4 pressure ulcer

A

sore deepens and may involve, muscle, bone, or tissue
need debridement and grafts

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66
Q

What are the classifications of burns?

A

first degree
second degree
third degree
fourth degree

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67
Q

Explain a second-degree burn

A

deep partial thickness burn damage into dermis
heals by regeneration if some dermis viable
blisters, severe pain, moist red pink appearance
EX bad sunburn

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68
Q

Explain a third degree burn

A

Full thickness burn epidermis and dermis destroyed
Eschar develops
lack of sensation
skin infection possible

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69
Q

Explain a fourth degree burn

A

char burns
damage to blood vessels, nerves, muscles, and tendons
extensive reconstruction

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70
Q

What is the rule of nines?

A

tool to estimate percentage of skin burned

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71
Q

What are the sections and the percentages for the rule of nines?

A

9% head and neck, and each arm
(27)
18% posterior trunk, anterior trunk, each lower leg (72)
1% for perineum

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72
Q

What is debridement ?

A

removal of foreign material, necrotic, or damaged tissue from a wound

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73
Q

What is being removed in a burn? (Specific term?

A

Eschar- dark tissue covering or shedding from wound

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74
Q

When is debridement of a burn performed? on what kind of thickness burns?

A

partial or full thickness
before healing or skin graft

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75
Q

What tool is used to excise the nonviable tissue

A

weck knife or
dermatome

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76
Q

How is homeostasis achieved in a burn?

A

electrocautery and topical thrombin

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77
Q

What are ways neoplasms are removed?

A

sharp dissection
electrosurgery
cryosurgery
laser surgery
radiation surgery
Mohs micrographic surgery

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78
Q

What is Mohs micrographic surgery?

A

procedure to treat skin cancer
cut away layers of skin, examine each layer until margins are clear

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79
Q

What is scar revision?

A

rearranging or reshaping a hypertrophic or keloid scar to improve appearance

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80
Q

What are 4 methods of scar revision?

A

excision
Z-plasty
W-plasty
Y-V-plasty

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81
Q

What is the simplest method of scar revision

A

excision and resuture it

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82
Q

What is the most common scar revision method?

A

Z-plasty

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83
Q

What is Z-plasty?

A

placing a Z shaped incision into scar and suturing it. The jagged edges help make healing better

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84
Q

What process can be used to improve the appearance of a large scar?

A

temporary sterile tissue expander
injection of NSS into port stretches the skin
scar is then excised & normal skin is reapproximated

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85
Q

What are the 3 types of skin grafts?

A

autograft
homograft
heterograft

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86
Q

What is an autograft skin graft?

A

=self
transfer one part of body to another

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87
Q

What are some example of autografts used?

A

cortical bone
cancellous bone
ribs
cartilage
tendons
fat
dermis
collagen

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88
Q

What is a homograft skin graft?

A

=another person
cadaver skin donation or skin bank
acellular dermal graft (alloderm)
placenta

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89
Q

What is another name for autograft skin graft?

A

autogenous graft

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90
Q

What is another name for a homograft skin graft?

A

allograft

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91
Q

What are some types of allografts used?

A

bone
cartilage
(ortho & nuero)

92
Q

Where does a heterograft skin graft come from? What are 3 examples of donors?

A

= another species
porcine (pig) skin for burns
reduces fluid loss
protects wound from infection
Biobrane- synthetic
bovine cow

93
Q

What is another name for heterograft skin graft?

A

Xenograft

94
Q

What are 3 types of autografting techniques?

A

split-thickness graft (stsg)
full-thickness graft (ftsg)
composite graft

95
Q

What layer or layers of skin are removed in a STSG? How much is removed (thickness)?

A

epidermis and portion of dermis
.010–.035 in (.3-1 mm)

96
Q

What is the most frequently used graft?

A

Split-thickness skin graft (STSG)

97
Q

What are some advantages for the donor site of a STSG?

A

heals rapidly by regeneration
can be reused 2 weeks later

98
Q

What layer or layers of skin are removed in a FTSG? How much is removed (thickness)?

A

all of epidermis and dermis
more than 1mm

99
Q

What parts of the body are FTSG preferred to be done on?

A

face
neck
hands
elbows
axilla
knees
feet

100
Q

For what reason would a FTSG be done instead of a STSG?

A

causes less contraction
used on areas of flexion like knee and elbow

101
Q

What kind of graft will the donor receive if the recipient is getting a FTSG?

A

a FTSG will be taken from one site and a STSK will be taken from another site

102
Q

What are some disadvantages for the donor in FTSG?

A

primarily closed- will not heal on its own
site cannot be reused

103
Q

What layer or layers are removed in a composite graft?

A

skin and underlaying tissue
including subcutaneous fat or cartilage

104
Q

What are examples of composite grafts?

A

hair transport- plugs of skin, fat, and hair follicles
conchal composite grafts- postauricular (ear) skin & cartilage for nose & eyelid reconstruction

105
Q

What is a tissue flap?

A

tissue detached from one area of body and transferred to recipient site with blood supply

106
Q

What are two types of tissue flaps?

A

pedicle
free

107
Q

What is a pedicle flap? What are 2 examples of?

A

tissue remains attached during transfer
when blood supply reestablishes some the flap can be detached
preserves skin sensation
loose tip of finger and mole cover up on lip

108
Q

What is a free tissue flap?

A

tissue, including vascular bundle detached from donor site and transferred to recipient site
-anastomosis of arteries and veins done

109
Q

When is a free tissue flap performed?

A

when a STSG & FTSG will not provide coverage

110
Q

Where is a free tissue flap usually taken from

A

abdominis rectus

111
Q

What are two examples of free tissue flaps?

A

toe to thumb- tissue transplant
jejunal tissue transfer to reconstruct pharynx & larynx for resection of tumor

112
Q

What are tissue flaps used to cover?

A

areas with extensive tissue loss like exposed bone, tendons, and nerves

113
Q

Some examples of tissue flaps are?

A

tissue expansion flap
musculocutaneous or myocutaneous
muscle
neurosensory
omental

114
Q

What is a tissue expansion flap? What are 2 examples?

A

flap intended for later transplant/ implant
breast reconstruction
removal of a scar

115
Q

What is a musculocutaneous or myocutaneous tissue flap?

A

flap that includes muscle, fascia, subcutaneous tissue, and skin

116
Q

What are 2 examples of musculocutaneous/ myocutaneous tissue flaps?

A

TRAM flap- transverse rectus abdominis
Latissimus dorsi flap (back side)
both for post mastectomy

117
Q

What is a muscle tissue flap?

A

muscle tissue and proximal blood supply

118
Q

What is an example of muscle tissue flap?

A

gluteus maximus flap rotated to cover an ulcerated area of STSG needed to cover the muscle

119
Q

What is a neurosensory tissue flap?

A

flap that involves sensory nerves to provide sensation to hands and feet

120
Q

What is an example of a neurosensory tissue flap?

A

toe to hand surgery
anastomosis
figure of eight suturing to attach tendons

121
Q

What is an omental tissue flap?

A

tissue mobilized to cover defects exposing vital organs

122
Q

What is an example of an omental tissue flap?

A

cover chest wall following radiation necrosis

123
Q

What is a dermatome?

A

a machine used to take STSG

124
Q

What is the tech responsible for when dermatome is on the table?

A

inserting blade
attaching the guard
-surgeon will set depth-

125
Q

What are three types of dermatomes?

A

oscillating-blade
knife
drum

126
Q

What is an oscillating dermatome? What is used to power?

A

blade moves back and forth
electric or nitrogen powered

127
Q

Where area is an oscillating dermatome used? rarely used?

A

firm underlying support areas
abdominal wall

128
Q

What is used as a lubricant for a oscillating dermatome?

A

mineral oil

129
Q

What are 3 examples (Brands)of oscillating dermatomes

A

Zimmer
Brown
Padgett

130
Q

What is a knife dermatome

A

handheld knife
(reminds me of the barber knife used to shave a guy)

131
Q

What are 3 types of knife dermatomes?

A

Weck
ferris-smith
humby- watson

132
Q

What is the weck dermatome? What kind of graft is obtained?

A

knife dermatome
straight razor blade with sterile blades and interchangeable guards to determine depth of graft
obtain small STSG

133
Q

What is a ferris-smith dermatome? What kind of graft is obtained?

A

knife dermatome
sterile straight razor
free hand grafts

134
Q

What is a humby or watson dermatome?

A

knife dermatome
adjustable roller
controls thickness of graft

135
Q

What is a drum dermatome?

A

bulk and hand held
round blade inside round metal drum

136
Q

What are 2 examples of a drum dermatome?

A

Padgett-hood
Reese

137
Q

What is a skin graft mesher?

A

cuts small slits in STSG
enlarges graft for larger coverage

138
Q

What are advantages of a meshed skin graft?

A

facilitates drainage
prevents fluid accumulation
epithelial tissue able to grow

139
Q

What are 4 considerations when doing skin grafts?

A

prepping
care of graft
graft healing
pressure or stent dressing

140
Q

What kind of prep should be used on skin grafts?

A

colorless antiseptic agents
hibiclens or betadine

141
Q

How are donor and recipient sites prepped for a skin graft?

A

prepped and draped separately
donor site prepped first

142
Q

What is the most important thing to care for skin grafts?

A

do not allow to dry keep moist with NSS on 4x4

143
Q

When caring for a STSG graft, what is done for dressing it?

A

thrombin spray/ pressure for homeostasis
donor site covered with fine medicated mesh
5x9 xeroform gauze
baciguent (bacitracin) and 4x4’s

144
Q

When caring for a FTSG, what is done for dressing it?

A

recipient may get stent dressing
use 4-0 or 5-0 nylon to secure

145
Q

When caring for a small graft on the face, what kind of dressing?

A

stent dressing over a rosebud (ball) of xeroform

146
Q

What do stent and pressure dressings do on a skin graft?

A

exert even pressure
eliminate potential shearing forces
eliminate dead space
prevent edema or hemotoma

147
Q

What is a craniomaxillofacial surgery?

A

reconstruction and repair of the facial bones and oral cavity

148
Q

What two imaging studies are done to assess facial fractures?

A

panoramic radiographic
CT scan

149
Q

What is visible/ seen in a panoramic radiographic image?

A

alveolar process
mandible
posterior maxillary sinuses
zygomas

150
Q

When is a CT scan used for a facial fracture?

A

complex fractures
reconstruction procedure

151
Q

What are the most common reasons for facial FX’s?

A

intentional violence
MVA

152
Q

What is used to prep a facial surgery?

A

Betadine
entire face
NOT chloraprep

153
Q

How is the head draped for a facial surgery?

A

Half drape
2 towels (wrapped like a turban)
3/4 drape for body

154
Q

What is a maxillomandibular fixation?

A

surgery to preserve patients bite pattern

155
Q

What is used to close and fixate the maxilla and mandible in a fixation?

A

Arch bars

156
Q

What are arch bars used for? Special instructions?

A

thin metal wire strips (like braces)
wire cutters with patient in case of airway emergency
protocol to tighten clockwise

157
Q

What is an ORIF midface fracture? What are they identified as? How many types?

A

open reduction and internal fixation
due to a trauma usually
LeForte
3

158
Q

What is a LeFort 1 fracture? What separates? What else can be affected?

A

mustache area
most common
hard palate and alveolar process separate from maxilla
nasal septum, lateral maxilla sinus, & palatine bones

159
Q

What is a LeFort 2 fracture?

A

mustache and nose
(pyramid shape)

160
Q

What is a LeFort 3 fracture? Where are the fx’s at?

A

mustache, nose, and cheeks
fx’s of zygoma, maxilla, nasal

161
Q

What are orbital-craniofacial deformities?

A

abnormalities to the cranial, facial, and orbital
congenital or severe disfigurements

162
Q

What kind of discipline (doctors) are involved in orbital- craniofacial deformities?

A

dental
neurological
opthalmic
plastics

163
Q

What is an orif frontal nasal sinus fx?

A

can be life threatening
can result in CSF leak or herniation of brain
bi-coronal incisions
FX’s exposed and repaired

164
Q

What is an ORIF orbital floor FX?

A

result of increased orbital pressure by impact on the globe
AKA blowout

165
Q

What are fx complications in a ORIF orbital floor Fx?

A

extrusion of globe into nasal sinus
entrapment of eye muscle

166
Q

How is an ORIF orbital floor fx repaired?

A

sub ciliary or transconjunctival incision
orbit exposed- retractors moistened with saline
Fx reduced and repaired
incision closed

167
Q

What happens immediately after a ORIF orbital floor fx?

A

double vision due to corneal shield and antibiotic ointment

168
Q

What is a zygomatic fx? What instruments are used?

A

small temporal incision
dingman elevator

169
Q

ORIF mandibular fx

A
170
Q

What happens in a nasal fx reduction?

A

closed reduction of nasal bone and cartilage
topical or local anesthesia

171
Q

What is a cheiloplasty procedure?

A

closure of a cleft lip
congenital defect
surgery at 3 months
use fine absorbable suture

172
Q

What is a palatoplasty procedure?

A

closure of a cleft palate
soft, hard, or both
after 6 months of age

173
Q

What is an otoplasty procedure?

A

procedure to change the shape, size, or position of the ear

174
Q

What are some reasons for otoplasty surgery?

A

congenital deformity (big, small, not complete)
reconstruct microtia (small ear)
2nd set may be needed)
traumatic injury (burn)

175
Q

What is a mentoplasty procedure?

A

procedure to reshape the chin

176
Q

What is a mentoplasty procedure augmented with?

A

bone, cartilage grafts, or artificial chin implants

177
Q

What is Micrognathia?

A

underdevelopment of the jaw

178
Q

What is a blepharoplasty procedure What is another name?

A

procedure to repair droopy eyes
remove excess skin between eyes
dermachalasis

179
Q

What kind of incision is most common in a blepharoplasty procedure? What kind of anesthesia?

A

an elliptical incision
MAC

180
Q

What is a rhytidectomy procedure?

A

AKA facelift
removal of skin in lower third of the face

181
Q

What kind of anesthesia is used in a rhytidectomy surgery?

A

local, MAC, or general

182
Q

Where are the two incisions made in a rhytidectomy surgery?

A

hairline and behind the ear
indiscernible

183
Q

What nerve needs to be protected in a rhytidectomy procedure?

A

Facial nerve (CNVII)
use nerve stimulator

184
Q

Why are brow lifts preformed?

A

correction of ptosis of eyebrows, forehead, and wrinkles

185
Q

What is a submalar augmentation?

A

fix deficiency in cheeks
trauma or atrophy
implants possible

186
Q

What is a rhinoplasty procedure?

A

improve nose by altering shape or size

187
Q

How is a rhinoplasty procedure performed?

A

rasping or cutting of bone
excising cartilage
shorten septum

188
Q

What is a dermabrasion procedure?

A

sanding or planing of skin
removes epidermis and some dermis
Wear shields and mask

188
Q

What is a hair transplant procedure?

A

hair follicles moved to balding areas

189
Q

What is an abdominoplasty procedure?

A

AKA tummy tuck
excision of exceess fat
tighten rectus abdominis

190
Q

What is a panniculectomy?

A

removal of the large apron of fat hanging from the abdomen

191
Q

What is liposuction?

A

removal of fat for body contour
high vaccuum suction

192
Q

What does the surg tech need to prepare, prior to a liposuction procedure?

A

tumescent solution- liquifies fat and makes it easier to suction

193
Q

What is a mammoplasty procedure? What are the 2 types?

A

increase or decrease in the breast size
augmentation and reduction of

194
Q

What are three incision sites used in an augmentation mammoplasty?

A

peri areolar
axillary crease
inframammary

195
Q

What is an augmentation mammoplasty?

A

breast implant
placed under pectoralis major

196
Q

What is a reduction mammoplasty?

A

reduce breast size

197
Q

What are 3 types of breast lift techniques?

A

Crescent
Benelli -(uses cookie cutter)
Benelli-lollipop

198
Q

What are the types of reconstructive mammoplasty flaps?

A

TRAM and free flap

199
Q

What are 3 examples pedicle flaps?

A

Latissimus dorsi myocutaneous flap
TRAM flap
Free TRAM flap (lengthy)

200
Q

What is a latissimus dorsi myocutaneous flap?

A

pedicle flap
uses muscles, fat, skin, and prosthesis

201
Q

What is a TRAM flap? What does TRAM stand for?

A

(transverse rectus abdominus myocutaneous)
uses rectus muscles, fat, skin from lower abdomen
pedicle flap

202
Q

What is nipple reconstruction in a mammoplasty procedure?

A

adding a nipple after a mammoplasty surgery

203
Q

What kind of skin graft is taken for a nipple reconstruction? Where from?

A

Full-thickness
inner thigh or labial fold

204
Q

What are the 4 main parts of the hand?

A

ulna
carpus
metacarpals
phalanges

205
Q

How do you position and drape a patient for a hand surgery?

A

hand drape with cuff on arm board
stockinette to cover the arm

206
Q

What are reasons to perform hand surgery?

A

congenital deformities
disease
trauma
-restore function of hand

207
Q

What are some injuries treated in a hand surgery

A

nerve repair
fractures
tendon repair
blood vessel reanastamosis
amputated digits or limbs

208
Q

What happens in a tendon repair?

A

sutured, grafted , or implanted
hunter rods may be used
palmaris longus commonly used (longest)

209
Q

What kind of fractures are repaired? What is used?

A

ORIF or CR
(open reduction internal fixation or closed reduction)
use image intensifier, c-serter, or synthes mini drill and K wires

210
Q

What happens in a severed nerve procedure?

A

digital nerves sutured or grafted
micro instruments used

211
Q

What is the order of anastomosis in reattaching a limb or digit?

A

bones
tendons
vessels
nerves

212
Q

What are three types of hand congenital deformities?

A

Radial Dysplasia
Syndactyly
Polydactyly

213
Q

What is radial Dysplasia?

A

aka clubhand
radius fails to form properly
(%5 different procedures possible)

214
Q

What is Syndactyly?

A

webbed or fused digits of hand or feet
Use FTSG
1yo and older

215
Q

What is Polydactyly?

A

extra digits on hand or feet
5th finger duplication most common
excised during infancy

216
Q

What causes joint deformities?

A

trauma
RA- rheumatoid arthritis
DJD- deformitive joint disorder

217
Q

What is arthroplasty?

A

resurfacing of joint using silastic implant as a spacer
relieves pain

218
Q

What 3 carpals are usually involved in an arthroplasty?

A

lunate, trapezium, and scaphoid

219
Q

What is arthrodesis?

A

fusion of a joint
immobilization

220
Q

What are fascial tissue contractures?

A

releasing or excising of constricted structures

221
Q

What are 3 fascial tissue contractures?

A

Dupuytren’s contracture
DE Quervain disease
Carpal tunnel release

222
Q

What is Dupuytren’s contracture?

A

progressive disease involving palmer fascia of hand
aka palmer fasciectomy

223
Q

What is De Quervain disease?

A

pain on flexion & addduction of thumb
excise stenosing sheath at distal radius

224
Q

What is carpal tunnel disease?

A

transverse carpal ligament compresses median nerve at volar surface of wrist

225
Q

Burn patients are susceptible to what?

A

dehydration
septicemia
pneumonia

226
Q
A