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Senior Rotations > Plastics > Flashcards

Plastics Flashcards

1
Q

stop aspirin 2 weeks prior to

A

anticoagulant causes hematoma

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2
Q

stop smoking 2 weeks prior to

A

vasoconstrictor

ischemia

necrosis

stops wound healing

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3
Q

chlorhexidine gluconate

A

not for eyes or ears toxic

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4
Q

4 dyes for skin marking

A

methylene blue

indigo carmine

gentian violet

Bonny’s blue

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5
Q

epi to local

A

prolong effect

hemostasis/vasoconstrictor

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6
Q

goals of postop dressing

A

immobilize

even pressure

drainage

comfort

protect

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7
Q

pressure dressing

A

eliminate dead space

prevent seroma/hematoma

prevent 3rd spacing

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8
Q

stent/tie-over dressing

A

pressure dressing when bandage doesn’t fit

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9
Q

2 closed-wound suction devices

A

hemovac

jackson pratt

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10
Q

why use closed-wound suction drains

A

prevent seroma/hematoma

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11
Q

2 local anesthetics

A

xylocaine/lidocaine/marcaine/bupivicaine

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12
Q

2 topical anesthetics

A

tetracaine eyes

cocaine nose

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13
Q

4 drugs for sedation with local

A

diazepam

fentanyl

meperidine (demerol)

midazolam

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14
Q

allograft

A

tissue from same species

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15
Q

autograft

A

tissue from self

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16
Q

xenograft

A

tissue from different species

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17
Q

isograft

A

tissue from genetically identical person

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18
Q

homograft

A

tissue from same species

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19
Q

heterograft

A

tissue from different species

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20
Q

dermatome

A

STSG graft procurement

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21
Q

4 knife dermatomes

A

ferris smith

watson

weck

Desilva

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22
Q

drum dermatome

A

Reese

Padgett

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23
Q

why use dermatape/dermacement

A

reese

adhere drum to skin

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24
Q

motor driven dermatome

A

brown

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25
Q

what is a skin mesher

A

uniform slits in graft to make it larger

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26
Q

loupes

A

magnifying lenses to improve cosmetics

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27
Q

wood’s lamp

A

UV to determine vascularity of skin graft

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28
Q

sodium florescin with woods lamp

A

makes blood vessels purple

IV

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29
Q

why use a colorless prepping agent for grafting procedures?

A

see true skin color

access vascularity of donor graft

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30
Q

why are donor sites prepped separately but concurrently for grafting?

A

CHECK

prevent cross contamination

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31
Q

how are free grafts preserved

A

cool saline

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32
Q

what is used to access the vascular perfusion of grafts

A

wood’s lamp

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33
Q

what is a composite skin graft

A

epidermis

dermis

fat

other structures

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34
Q

how does a composite skin graft become vascularized?

A

ingrowth of vessels from recipient site

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35
Q

what is a STSG, Thiersch

A

from free knife

superficial defects

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36
Q

what is a FTSG, Wolfe

A

exact size/shape for face neck hands

joints

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37
Q

pros of STSG

A

cover large area

donor site reusable in 2-3 weeks

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38
Q

cons of STSG

A

contraction

fragile

poor look

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39
Q

pros of FTSG

A

minimal contracture

looks better

stronger

over areas of flexion

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40
Q

cons of FTSG

A

donor site can’t be used again

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41
Q

how does the donor site of STSG heal

A

regenerate epithelium from dermal elements

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42
Q

how does the donor site of FTSG heal

A

primary closure with a STSG over

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43
Q

why use topical thrombin, epi, or phenylephrine on donor site of skin graft

A

hemostasis

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44
Q

what is a composite graft

A

skin separated from blood supply

fat

hair follicles

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45
Q

example of a composite graft

A

hair transplant

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46
Q

omental graft

A

from omentum in abdominal cavity

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47
Q

why use an omental graft

A

soft tissue defects in face, neck, scalp

control infection/inflammation

vascular support for burns

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48
Q

pedicle flaps

A

attachment of elevated tissue w/vascular bundle

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49
Q

when is a pedicle flap used

A

reconstruct deformities of soft tissue loss

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50
Q

arterialized tissue flap

A

FTSG

skin graft with vascular bundle and subQ

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51
Q

myocutaneous flap

A

muscle with fascia, subQ, sin

vascular pedicle and nerves accompany

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52
Q

applications of myocutaneous flaps

A

soft tissue defects in lower extremities

pressure sores

after head/neck surgery or mastectomy

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53
Q

tissue expander

A

streches tissue

filled during an office visit

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54
Q

free flap

A

tissue moved from one area of the body to another with its own blood supply

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55
Q

why is a free flap autogenous

A

comes from the patient

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56
Q

why is microsurgery required when working with free flaps

A

vascular work

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57
Q

what is rhinoplasty

A

reshaping the nose

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58
Q

why is rhinoplasty performed

A

improve appearance of external nose

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59
Q

what is septoplasty, SMR,

A

straighten nasal septurm

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60
Q

goal of septoplasty

A

separate nasal cavities for a clear airway

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61
Q

blepharoplasty

A

excision of redundant skin/orbital fat

correct deformity of upper/lower eyelids

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62
Q

rhytidectomy

A

facelift

removal/redraping excess skin in the face

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63
Q

why perform rhytidectomy

A

tighten sagging skin

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64
Q

anesthesia for rhytidectomy

A

hypotensive for hemostasis

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65
Q

incision for rhytidectomy

A

CHECK

above and in front of the ear and behind pinna

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66
Q

what is mentoplasty

A

altering size or shape of the chin

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67
Q

why perform mentoplasty

A

functional bite disorder

aesthetics

micrognathia-underdeveloped jaw

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68
Q

what is otoplasty

A

repairing external ear

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69
Q

why perform otoplasty

A

burns

traumatic avulsion

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70
Q

what is dermabrasion

A

mechanical or chemical peeling of the skin

71
Q

why perform dermabrasion

A

smooth skin damaged by acne scars

remove tattoos/wrinkles

72
Q

3 methods of dermabrasion

A

mechanical

chemical

CO2 laser

73
Q

scar revision with Z-plasty

A

z-shaped incision in same direction as skin line

less noticeable

74
Q

what is a keloid

A

growth of extra scar tissue

75
Q

what is liposuction

A

vacuuming fat

76
Q

where is liposuction performed

A

abdomen

back

face

hips thighs knees

breasts

77
Q

what is tumescent solution

A

local anesthetic with Wydase, epi, and saline

no GA, hemostasis, liquefy fat

78
Q

max tissue removed by liposuction

A

1500-2000ml

2500-3000ml with tumescence

79
Q

what is abdominoplasty

A

tummy tuck

80
Q

goal of abdominoplasty

A

thinning fat, tightening muscles, remove fat and excess skin

81
Q

indications for abdominoplasty

A

discomfort

unable to wash

82
Q

how is the umbilicus preserved in abdominoplasty

A

vascularized stalk

repositioned after dissection

83
Q

augmentation mammoplasty

A

inserting implants under breast tissue or psoas muscle

84
Q

indications for breast augmentation

A

aesthetics

85
Q

3 incisions for breast augmentation

A

periareolar

inframammary

transaxillary

86
Q

what are breast implants filled with

A

saline or silicone

87
Q

complications with breast implants

A

capsular contraction

skin necrosis

hematoma

88
Q

what is reduction mammoplasty

A

remove excess breast tissue

89
Q

indications for breast reduction in females/males

A

macromastia with back pain, intertrigo (skin infection), grooving in shoulders from bra

gynecomastia-large male breast

90
Q

indication for breast reconstruction

A

post mastectomy

91
Q

3 ways breast reconstruction can be done

A

available tissue + implant

tissue expanders

autogenous flaps

92
Q

how are tissue expanders used with breast reconstruction

A

create skin by stretching

93
Q

what solution is placed in expander

A

saline

94
Q

complication due to seroma with tissue expander

A

rotation or malposition of expander

95
Q

why use myocutaneous flap for breast reconstruction

A

significant tissue deficiency

when abdominal flap can’t be used

96
Q

2 myocutaneous flaps for breast reconstruction

A

latissimus dorsi: lateral, donor side up

transverse rectus abdominis: supine

97
Q

2 modifications for TRAM in breast reconstruction

A

pedicle-vascular bundle

free-from another part

98
Q

2 ways a nipple can be reconstructed

A

autogenous tissue

tattooing

99
Q

3 common causes of burns

A

thermal

chemical

electrical

100
Q

4 classifications of burns according to depth

A

1st degree

2nd degree

3rd degree

4th degree

101
Q

1st degree

A

outer epidermis

redness

heals rapidly

102
Q

2nd degree

A

epidermis and dermis

blisters, redness

103
Q

how does a 2nd degree burn heal

A

reepithelialization, thickened scars

104
Q

3rd degree

A

skin, dermis, subQ

dry, pearly white, charred, no sensation

eschar

105
Q

how does a 3rd degree burn heal

A

skin grafts

106
Q

4th degree

A

bones, tendon, muscle, nerves

107
Q

what is eschar

A

dry dark scab of dead skin

108
Q

2 methods of burn %

A

lund-browler: kids

rule of 9s: adults

109
Q

IV fluid for burn patients

A

fluid and electrolyte balance to maintain plasma

110
Q

warm environment for burn patients

A

skin loses ability to thermoregulate

keep core temp stable

111
Q

why is cleaning of burns important

A

reduces growth media of pathogens/prevent infection

112
Q

excisional debridement

A

tangenital excision

escharectomy

113
Q

tangenital excision

A

remove burned tissue until dermal tissue is reached

for deep partial thickness

114
Q

escharectomy

A

remove full thickness eschar to fascia

115
Q

why are tangenital excision and escharectomy performed

A

remove devitalized tissue so healing may occur with reduced chance of infection

prevents extensive tissue loss

116
Q

escharotomy

A

incision into eschar to improve circulation to lower extremities

117
Q

fasciotomy

A

incision into fascia to relieve compression

118
Q

biologic dressing use

A

skin over burned area to prevent infection and regulate fluids

119
Q

biologic dressing vs. autografting

A

extensive burns where there isn’t enough tissue for autograft

prevent infection and fluid loss

120
Q

cultured epithelial autografts

A

biologically engineered tissue through injection of isolated cells, polymer scaffolds, encapsulated systems, polymer matrices with cells

121
Q

why change dressings frequently for burn patients

A

control infection

122
Q

silver on burn dressings

A

silver sulfadiazine: less painful removal, antimicrobial

mafenide acetate: reduce bacteria

silver nitrate

123
Q

principles of maxillofacial surgery

A

restore anatomy

stabilize fracture

anatomic reduction

healing for function

124
Q

3 classifications of LeFort fractures

A

transverse maxillary: nasal floor, septum, teeth

pyramidial: nasal cavity, hard palate, eye
craniofacial: zygomas, nose

125
Q

symptoms of maxillary fracture

A

malocclusion

middle face deformity

126
Q

inermaxillary fixation (arch bars) in maxillary fractures

A

immobilization for healing

127
Q

purpose of treatment for mandibular fractures

A

restore dental occlusion

128
Q

immobilization of the mandible

A

arch bars, plates, screws

129
Q

blow-out fracture

A

depressed orbital floor fracture

intact infraorbital rim

130
Q

symptoms of blow-out fracture

A

orbital contents herniate

inferior rectus/oblique become incarcerated

131
Q

treat blow-out fracture

A

caldwell luc anterostomy

132
Q

orthognathic surgery

A

rearrangement of the maxilla/mandible

133
Q

why is elective orthognathic surgery performed

A

fix defects of maxilla/mandible

134
Q

LeFort procedure differences

A

LeFort 1&2: closed reduction with intermaxillary fixation

LeFort 2&3: open reduction and intermaxillary fixation

135
Q

cleft lip

A

deficiency in tissue on one or both sides of the upper lip

136
Q

chelioplasty

A

reconstruct lip by moving tissue to approximate lip

137
Q

why perform chelioplasty

A

feeding

infant/parent bonding

138
Q

rule of 10s in cleft lip

A

10 weeks old

10lbs

hemoglobin 10g/dl

139
Q

logan’s bow postop chelioplasty

A

relieve tension

140
Q

cleft palate

A

separation of the palate in midline

141
Q

functions of the palate

A

soft: speech
hard: prevent escape of air through nose during speech, liquid food out through nose

142
Q

palatoplasty

A

adjacent tissue to close defect

143
Q

when is palatoplasty performed

A

6 months

144
Q

why use a pharyngeal flap in palatoplasty

A

when abnormal speech remains

145
Q

mouth gag in palatoplasty

A

Dingman

146
Q

if both cleft lip and palate what is repaired first

A

palatoplasty to preserve speech

147
Q

syndactyly

A

webbing of hands or feet

148
Q

how to treat syndactyly

A

separate and skin graft (full thickness)

after 1yr. old

149
Q

polydactyly

A

extra fingers or toes

150
Q

how to treat polydactyly

A

excision

151
Q

microtia

A

underdeveloped pinna/absent ears

152
Q

how to treat microtia

A

otoplasty

153
Q

bony anatomy of the hand

A

14 phalanges (bones of the digits), 5 digits, 5 metacarpals (hand), 8 carpals (wrist)

154
Q

how are the phalanges numbered

A

distal, middle, proximal

CHECK

155
Q

8 carpals

A

scaphoid, lunate, triquetrum, pisiform

trapezium, trapezoid, capitate, hamate

156
Q

dorsal/volar hand

A

dorsal: back
volar: palm

157
Q

why is a tourniquet used in hand surgery

A

bloodless field

158
Q

where is a tourniquet placed

A

as proximal as possible with cotton underneath

159
Q

exsanguinate arm prior to tourniquet

A

3 in. esmarch wrapped distal to proximal

160
Q

avulsion

A

body part forcibly detached

loss of joint movement

161
Q

laceration

A

a jagged cut

loss of joint movement

162
Q

repair avulsion/laceration tendon injury

A

primary flexor or extensor repair

suture tendon ends together

163
Q

suture for tendon repair

A

3-0, 4-0 double-armed nonabsorbable

164
Q

when is a free tendon graft used

A

large gap

failed primary repair

165
Q

repair severed nerve

A

direct approximation of ends or graft

166
Q

suture for nerve repair

A

nylon nonabsorbable 7-0, 10-0

167
Q

implant arthroplasty

A

excise diseased joint cartilage

insert implant spacer

168
Q

why perform implant arthroplasty

A

traumatic/rheumatoid arthritis

169
Q

Dupuytren’s contracture

A

progressive disease of palmar fascia

cord pulls finger down

170
Q

treat Dupuytren’s contracture

A

palmar fasciotomy/ectomy

171
Q

carpal tunnel

A

volar/palm side with median nerve, tendons through

transverse carpal ligament and 3 bones

172
Q

carpal tunnel syndrome

A

compression of median nerve

swelling, numbness, pain,

173
Q

treat carpal tunnel

A

release transverse carpal ligament

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