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Plastics Flashcards

0
Q

Name common benign lacrimal gland tumor

A

Pleomorphic adenoma

Aka benign mixed tumor

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1
Q

What % of pple have a common caniliculus?

A

90%

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2
Q

Whats the most common type of melanoma on the face?

A

Lentigo maligna

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3
Q

whats kassabach merrit syndrome?

A

thrombocytopenia in capillary hemangioma 2/2 plt sequestration

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4
Q

whats a hemangiopericytoma?

A

round encapsulated within cone needs to be excised completely can be benign or malignant and can look like cav hemangioma

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5
Q

lacrimal gland tumors: 50% inflammatory (painful) and 50% tumors- what are the 2 types of epithelial tumors?

A

adenoid cystic ca

benign mixed cell tumor

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6
Q

how do you treat benign mixed tumor of lac gland?

A

complete excision including capsule. Why not incisional biopsy? bc it has malignant potential

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7
Q

what are the causes of inflammation of the lacrimal gland?

A

sarcoid- painful
IOI- painful
Lymphoma- NOT painful

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8
Q

whats the most important consideration in chosing a ptosis surgery?

A

amount of levator fxn

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9
Q

whats a fasanaella?

A

remove mullers and top 1/3 of tarsus

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10
Q

in both TAO, and CC fistula there are angry conj vessels How do the 2 presentations differ?

A

CC fistula the mad vessels go right up to limbus. In TAO theres a clear zone w no angry vesses between muscle and K

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11
Q

what are the symptoms of IOI?

A

Deep pain, EOM restriction, chemosis, pain w eom,

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12
Q

whats the first part of the orbit to be affected by IOI?

A

Lacrimal gland

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13
Q

whats the next step in rx if steroids fail for IOI?

A

Radiation

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14
Q

how does sarcoid usually present in the orbit? uni or bilateral?

A

bilateral lacrimal gland swelling

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15
Q

whats the cause of a CC fistula?

A

basal skull fracture

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16
Q

whats a dural cavernous fistula, who gets it, whats the cause?

A

1) menigeal artery commun w cav sinus
2) old pple
3) htn, atherosclerosis

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17
Q

does a varix present w proptosis or enophthalmos?

A

both!

proptois upon valsalva and enophthalmos upon rest

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18
Q

how do you treat optic n glioma?

A

complete excision

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19
Q

what does a meningioma arise from?

A

arachnoid villi

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20
Q

meningioma is described as “fusiform tumor” what does that mean?

A

fusiform = tapered on the ends (as opposed to gliom which is not)

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21
Q

what does a sphenoid wing meningoma look like on ct?

A

hyperostosis of the surrounding bone

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22
Q

how do you treat sphenoid wing meningioma?

A

observe till visually significant. If so, then debulk tumor. Complete excision is impossible

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23
Q

how do you treat a optic nerve meningioma that is visually significat?

A

radiation

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24
Q

whats “fibrous dysplasia”

A

benign condiition of hyperostotic bone in face. Need to debulk.

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25
Q

how does neuroblastoma present besides horners?

A

abrupt eccymotic protosis

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26
Q

whas a CDCR?

A

Connect carucle into middle meatus w pyrex tube. it completely bipasses the canalicular system

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27
Q

if youre doing a DCR and find abnormal tissue what do you do?

A

frozen section of the specimen

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28
Q

what do you connect in a dcr?

A

lacrimal sac to middle meatus (bypass lower portion of lacrimal system that drains into inferior meatus)

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29
Q

2-8-12-15mm

A

punctum- canaliculus-lac sac- NL duct

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30
Q

2-8-12-15mm

A

punctum- canaliculus-lac sac- NL duct

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31
Q

whats the bick procuedure whats it used for?

A

LL ectropion- cut full thickness flap out of lateral lower lid and close primarily- may cause “rounding” of canthal angle if heals like shit

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32
Q

whats the medial spindle procedure whats it used for?

A

medial LL ectropion or LL punctum turned out- excise conj and retractors medially in a diamond configuration (ie posterior lamella) and close

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33
Q

where do the frontal, ethmoidal, and maxillary sinuses drain?

A

middle meatus

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34
Q

Bones of orbital roof

A

Frontal

Lesser wing of sphenoid

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35
Q

Lateral orbital wall bones

A

Zygomtic

Greater wing of sphenoid

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36
Q

where are glands of Krause and where are wolfring?

A

Krause- superior fornix
wolfring- NON-MARGINAL tarsal border
Julie Krause has to be superior to everyone else

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37
Q

ASPERGILLUS CELLULITIS CAUSES WHAT LAB ABNORMAILTY

A

Hgh IgE

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38
Q

what % of pple with hyperthyroid get TAO?

A

30%

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39
Q

whats more common primary meningioma (ie arising from the ON) or secondary orbital meningioma?

A

secondary orbital meningioma

40
Q

what does ON meningioma arise from

what does secondary orbital meningioma arise from?

A

1) arachnoid villi

2) intracrainial site like sphenoid or clinoid

41
Q

Developing lymphoma in which part of the eye confirs the greatest risk of systemic non-hodgkins lymphoma?

A

eyelid

42
Q

what causes involutional LL entropion?

A

disinsertion of retractors

horizontal laxity

43
Q

Whats a synonym of blue nevus

A

nevus of ota

44
Q

whats the cell of origin in kaposis sarcoma?

A

endothelial! (lymphatic endothelium forming vascular channels)

45
Q

What 2 structures does the IO separate?

A

medial and central fat pads of LL

46
Q

Where does CN7 run in the upper face?

A

IN the SMAS

47
Q

where does cn7 run in the lower face

A

deep to smas

48
Q

name layers of face

A 
epidermis
dermis
subQ fat
smas
deep facial facia
49
Q

where does levator aponeurosis insert?

A

into pretarsal orbicularis and skin (makes the crease)

50
Q

why Asian eyelid the way it is?

A

bc septum fuses w levator aponuerosis lower down allows fat to have lower positioning

51
Q

whats a normal LF?

A

12-15mm

52
Q

whats a normal mrd1

A

4mm

53
Q

where does superior septum arise from and where does it insert?

A

superior periosteum

fuses w levator aponeurosis above tarsus

54
Q

where does inf septum arise from and where does it insert?

A

inferior periosteum

fuses w capsulopalpebral fascia below inferior tarsus

55
Q

where does levator originate from

A

lesser wing of sphenoid

56
Q

what does whitnall ligament do?

A

transitions from levator muscle to aponeurosis

57
Q

where does the anterior portion of levator aponeurosis insert? where does posterior insert?

A

anterior- pretarsal skin and orbicularis

posterior- anterior surface of lower half of tarsus (dehiscence=ptosis but LF remains normal bc ant portion still ok)

58
Q

what does the lateral horn of the levator do?

A

divided lacrimal gland

59
Q

where does mullers insert?

A

sup border of tarsus

60
Q

where does medial canthal tendon insert?

A

ant and post lacrimal crest

61
Q

wheres the peripheral arcade?

A

above tarsus

62
Q

wheres marginal arcade?

A

2mm above lid margin

63
Q

where does medial face lymph drain into?

A

submandibular

64
Q

where does lateral face lymph drain into?

A

pre-auricular

65
Q

whats the triad of blepahrophimosis and inher?

A

AD

  1. telecanthus
  2. epicanthi inversus
  3. ptosis
66
Q

in what systemic dz can you see congenital eyelid eversion?

A

ichthyosis

67
Q

wheres epicanthus inversus

A

inferior/lower lid

68
Q

wheres epicathus tarsalis?

A

tarsalis= top (upper lid)

69
Q

wheres epicanthus palpebralis?

A

equal upper and lower

70
Q

where epicanthus supraciliaris?

A

eyebrow

71
Q

whats epiblepharon

A

Asian kid w eyelashes up

72
Q

when eyelid coloboma is isolated finding where is it usually located?

A

upper eyelid

73
Q

when lid coloboma is in the lower lid, its ass w?

A

goldenhaar

74
Q

whats the soft yellow things josh has below his lid?

A

syringoma (benign eccrine gland papule)

75
Q

when do eccrine hidrocystomas enlarge?

A

warm weather/sweating

76
Q

if defect is 33% or less

A

direct closure

77
Q

if defect is 33-50%

A

semicircular flap

78
Q

if defect >50%

A

cutler beard

modified hughs

79
Q

how to correct mild ptosis

A

fasanella

80
Q

how to correct ptosis if LF is 4-8mm

A

levator resection

81
Q

if levator fxn is <4mm how to correct?

A

sling

82
Q

how to correct aponurotic ptosis

A

levator advancement

83
Q

whats blepharochalasis

A

rare inflammatory dz in young females lids become thin

84
Q

when does the lacrimal gland start working?

A

6 wks

85
Q

if you have to remove puncta 2/2 sebaceous cell do you do dcr at same time?

A

no. observe bc don’t want to spread the cancer. do dcr at later time

86
Q

How long before surgery should each of these drugs be stopped
NSAID
Coumadin
ASA

A

NSAID- 3 days
Coumadin- 4 days
ASA 5 days
(reverse alphabetical order)

87
Q

most common INFECTIOUS cause of dacryoadenitis

A

EBV

Mumps = #2 and will be bilateral!

88
Q

whats a “direct” fracture?- think baseball bat to face

A

naso-orbital-ethmoid fracture
epistaxis
rounding of medial canthal angle
telecanthus

89
Q

whats Lefort 1?

A

?

90
Q

whats lefort 2?

A

?

91
Q

whats lefort 3?

A

?

92
Q

Most common cause of pre-septal 2/2 a scratch?

A

s. aureus

93
Q

whats the weakest part of the maxilla?

A

posterior-medial

94
Q

whats a stye?

A 
external hordeolum 
(infection of zeiss gland)
95
Q

whats an internal hordeolum?

A

infection of meibom gland oricifes

96
Q

when a kid w congenital ptosis looks down, why is there lagophthalmos and lid is high?

A

bc lid is fatty and doesn’t go all the way down

97
Q

whats another name for apaneurotic ptosis?

A

involutional ptosis

98
Q

how much ptosis can you repair w a fasanella

A

2

if theres more ptosis than 2, you have to touch the levator

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