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Exam 3 > Plastics > Flashcards

Plastics Flashcards

1
Q

What are the three common types of skin cancers?

A

Melanoma
Basal
Squamous

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2
Q

Which skin cancer has the highest occurrence rate?

A

Basal at 70%

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3
Q

Which skin cancer is most aggressive?

A

Squamous

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4
Q

What is Mohs surgery?

A

Specialized excision used to tat basal and squamous. Layer by layer under microscope examination until abnormal tissue removed

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5
Q

What type of burns are there?

A

Thermal
Chemical
Electric

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6
Q

What are the degrees of burns?

A

First degree - outer layer of epidermis e.g sunburn

Second degree - all epidermis and upper part of dermis. Blisters present. No graft needed.

Third degree burn - skin, nerves, hair follicles, sweat glands, and subcutaneous tissue.

Fourth degree burn - all in third degree plus bone, muscle, tendons, blood vessels.

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7
Q

What do we do different for patients with burns regarding linen and room temp?

A

Sterile linen and increase room temp.

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8
Q

What is excharotomy?

A 
Debridement in 3rd degree burns - removal of eschar
Remove necrotic tissue
Expos fatty tissue underneath
Tissue rehydration
Skin graft
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9
Q

What is a Split thickness skin graft (STSG)?

A

Graft of epidermis and uppermost portion of dermis
Heals in approx 14 days
Site reused.

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10
Q

What is a full thickness skin graft?

A

Epidermis and dermis
Retains characteristics
Tissue does not regenerate.

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11
Q

Which skin graft instrument is used for a split thickness skin graft?

A

Brown dermatome

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12
Q

What is the humbler knife?

A

Manual adjustable roller skin graft instrument where the thickness of the graft can be controlled

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13
Q

What is the rule of nines?

A

Divide body into 11 areas of 9% each to estimate amount of skin surface burned in adult

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14
Q

What are flaps?

A

Tissue transferred from one area of body to another. Blood supply remains intact or is restored.

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15
Q

What types of flaps are there?

A

Skin
Subcutaneous tissue
Fascia, muscle
Bone

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16
Q

Reasons for flaps?

A

Replace tissue from trauma etc
Provide padding over bony prominences
Bring better blood supply to poorly vascularized areas

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17
Q

What are axial pattern flaps?

A

Specific artery and vein along axial portion of flap.

Can be longer and are used as island, pedicle, or free flaps

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18
Q

What are random pattern flaps?

A

Blood supplied by dermal and sub dermal vessels.
Limited length/width ratio
Used to rotate to fill defects

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19
Q

What are musculocutaneous flaps?

A

Skin, subcutaneous tissue, and muscle

Blood supply provided by muscles vessels, enabling survival from vascularity of muscle.

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20
Q

What are free flaps?

A

Used in extensive reconstructive procedures of head and neck following radical excisions for cancer.

May contain bone, vascular pedicle and nerves that may restore motor function and sensation

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21
Q

What are pedicle flaps?

A

Consists of skin and muscle
Very mobile although attached at one end
Can be rotated into distant defects

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22
Q

What kind of flaps may be used in reconstructive breast surgery?

A

Pedicle

Free flaps using microsurgical techniques

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23
Q

What is placed and why after breast reconstruction?

A

Drains to prevent hematoma

24
Q

What is a latissimus dorsi myocutaneous flap?

A

Flap of skin and muscle taken from latissimus dorsi muscle of back and used for breast

25
Q

What is a TRAM.

A

Transverse rectus abdominis myocutaneous flap.
Most common
Flap from abdomen which adds benefit of abdominoplasty

26
Q

When is nipple reconstruction usually done?

A

6-8 weeks postoperatively

27
Q

Where is skin obtained to make a nipple?

A 
Raising flap
Groin tissue
Buttock crease
Auricle
Conga lateral nipple

Sometimes may be tattooed on.

28
Q

When is the ideal time within an injury to perform surgery for an amputated body part?

A

4-6 hours after injury

Up to 24 hours if cooled

29
Q

How are amputated digits cooled?

A

In saline soaked gauze immersed in iced saline

30
Q

What type of maxillary fractures are there?

A

La forte 1 - below nose but involves nasal floor septum. 30-45% of mid face fractures.

La forte 2 - from nasal bone to maxilla

La forte 3 - complete separation of mid face through skull base
Unilateral or bilateral orbital fractures
Worst facial fractures

31
Q

How are mandibular fractures fixed?

A

Closed reduction - arch bars with suspension wire, stabilizes fracture

ORIF maxilla - small plate and screws

32
Q

What is important to remember in the contents of care for the pt who has sx for a mandibular fracture?

A

Have wire cutters available at all times in case of aspiration.

33
Q

How and when is cleft lip repaired?

A

Three layer closure of the skin, muscle, and mucosa.

Done at 3 months of age following the rule of 10.

34
Q

What are the rules of ten for a cleft lip?

A

10 weeks of age
10 pounds
Hemoglobin of 10g/dl

35
Q

When is a cleft plate repaired?

A

Approx 6 months of age preferable before speech

36
Q

What is congenital webbing of toes and fingers called?

A

Syndactyly

37
Q

What method is used to correct syndactyly?

A

Separate digits and use z-plasty. Breaks up linear scar.

38
Q

What type of anesthesia is usually used for repair of syndactyly?

A

General or local.

39
Q

What is the surgical term used to remove and redrape excess skin of face and neck with repositioning of underlying muscles and platysma (neck/chest muscle in front)?

A

Rhytidectomy

40
Q

What is blepharoplasty?

A

Removal of excess eyelid skin by removal or repositioning of periorbital fat, and tightening and smoothing of muscles under eye.
Can be outpt with local anesthesia

41
Q

What is the surgical term for pinning ears and why does this deformity occur?

A

Otoplasty

Results from absent or insufficiently pronounced antithelical fold of the external ear.

42
Q

What are the three types of microdermabrasion?

A

Chemical - chemical peel
Manual - nylon brush/sandpaper
Mechanical - dermabrader with rotating tip, co2 laser

43
Q

What is an abdominoplasty?

A

Tightening abdominal area and removing excess skin or fullness

44
Q

What are the three types of abdominoplasty?

A

Mini-abdominoplasty - skin is mostly full and there is no looseness. Small incision and no relocation of umbilicus required.

Full abdominoplasty - looseness present, incision hip to hip, relocate umbilicus

Endoscopic abdominoplasty - if only muscle repair needed

45
Q

What should the pt have after abdominoplasty?

A

Abdominal binder or compression garment

46
Q

When might capsulotomy be required?

A

Exaggerated scar response to implants

May need to release or remove constrictive tissue

47
Q

What are the three types of prosthesis placements?

A

Sub glandular
Sub pectoral
Biplanar/submuscular

48
Q

What method is used to correct congenital asymmetry of breasts?

A

Reduction mammoplasty

49
Q

What is mastopexy?

A

Correction of breast ptosis by moving nipple to more normal position and removing excess skin

50
Q

What is gynecomastia associated with?

A

Advanced age and marijuana use.

51
Q

How might gynecomastia be treated and what should be remembered for postoperatively?

A

Liposuction

Use of compression garment postop

52
Q

What does the radial nerve supply?

A

Back of hand

53
Q

What does the media nerve supply?

A

First three fingers and half of ring finger

54
Q

What does the ulnar nerve supply?

A

Other half of ring finger and pinky

55
Q

What nerve is affected in carpal tunnel syndrome and who does it affect more.

A

Median nerve

Women

56
Q

What is dupuytren’s contracture?

A

Ring finger pulled down by contracture of palmar fascia

Exam 3 (8 decks)

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