Rhinoplasty Flashcards
What are the two clinically significant muscles affecting the nose mentioned in the passage?
A) Levator labii alaeque nasi and transverse nasalis
B) Depressor septi nasi and orbicularis oris
C) Levator labii alaeque nasi and depressor septi nasi
D) Nasalis and orbicularis oculi
C) Levator labii alaeque nasi and depressor septi nasi
What is the role of the levator labii alaeque nasi in relation to the external nasal valve?
A) Shortening the upper lip
B) Assisting in keeping the external nasal valve open
C) Decreasing tip projection
D) Interdigitation with the orbicularis oris
B) Assisting in keeping the external nasal valve open
How does the contraction of lip elevators affect the nasal airway patency?
A) It shortens the upper lip
B) It distracts the upper lateral cartilages, opening the internal valve
C) It causes alar flaring
D) It decreases tip projection
B) It distracts the upper lateral cartilages, opening the internal valve
What are the three types of depressor septi muscles identified in the cadaver study?
A) Type I, Type II, and Type III
B) Type A, Type B, and Type C
C) Visible, Identifiable, and Rudimentary
D) Levator, Depressor, and Orbicularis
Back: A) Type I, Type II, and Type III
How does transection of the depressor septi muscles benefit rhinoplasty patients with a drooping nasal tip and shortened upper lip?
A) Shortens the upper lip
B) Maintains tip rotation/projection on animation
C) Causes alar flaring
D) Decreases tip projection
Back: B) Maintains tip rotation/projection on animation
What is the primary goal achieved by transection of the depressor septi muscles in rhinoplasty patients?
A) Enhancement of the tip-lip relationship
B) Shortening of the upper lip
C) Decrease in tip rotation
D) Alar flaring
A) Enhancement of the tip-lip relationship
: How long is the follow-up period mentioned for patients who underwent transection of the depressor septi muscles in rhinoplasty?
A) Up to 6 months
B) Up to 1 year
C) Up to 2 years
D) Up to 5 years
C) Up to 2 years
What is the consequence of impaired alar flaring in the levator labii alaeque nasi muscle?
A) Shortening of the upper lip
B) Functional nasal obstruction with facial paralysis
C) Decrease in tip projection on animation
D) Opening of the internal valve
B) Functional nasal obstruction with facial paralysis
What effect does the depressor septi nasi have when clinically significant?
A) Shortening the upper lip
B) Decreasing tip projection on animation
C) Alar flaring
D) Opening the external nasal valve
B) Decreasing tip projection on animation
In the cadaver study, what characterizes Type II depressor septi muscles?
A) Little or no interdigitation with the orbicularis oris
- B) Full interdigitation with the orbicularis oris
- C) Visibility and identifiability
- D) No muscle or only rudimentary muscle visible
A) Little or no interdigitation with the orbicularis oris
What is the primary method of identifying rhinoplasty patients who may benefit from transection of depressor septi muscles?
A) Radiographic imaging
- B) Smiling during a preoperative examination
- C) Nasal endoscopy
- D) Palpation of nasal cartilages
B) Smiling during a preoperative examination
What aesthetic results are mentioned as achieved by transection of the depressor septi muscles in rhinoplasty?
- A) Alar flaring
- B) Decrease in tip rotation
- C) Shortening of the upper lip
- D) Well-maintained tip rotation/projection on animation
D) Well-maintained tip rotation/projection on animation
What is the concern associated with the transcolumellar incision in rhinoplasty?
- A) Impaired alar flaring
- B) Functional nasal obstruction
- C) Compromised blood supply to the nasal tip
- D) Decreased tip projection
C) Compromised blood supply to the nasal tip
What are the contributions to the blood supply of the nose mentioned in the passage?
- A) Internal carotid artery only
- B) External carotid artery only
- C) Both internal and external carotid arteries
- D) Vertebral artery
C) Both internal and external carotid arteries
Which arteries primarily supply the proximal portion of the nose?
- A) Facial artery
- B) Ophthalmic artery
- C) Superior labial and angular vessels
- D) Dorsal nasal artery
: B) Ophthalmic artery and its branches
What vessels primarily supply the nasal tip area?
- A) Superior labial and angular vessels
- B) Facial artery and dorsal nasal artery
- C) Lateral nasal branch and columellar branches
- D) Ophthalmic artery and its branches
C. Lateral nasal branch and columellar branches
What does the angiographic study in cadaver heads confirm about the lateral nasal vessels?
- A) They arise superficially at the nasal tip
- B) They consistently identify the alar groove
- C) They provide collateral supply to the nasal tip
- D) They are absent in 10% of cases
C) They provide collateral supply to the nasal tip
What is the clinical relevance of the study mentioned in the passage?
- A) Excessive defatting is recommended for nasal tip procedures
- B) The nasal tip can be safely defatted without risk
- C) Collateral blood supply enters the nose via the alar arcades
- D) Transcolumellar incisions are necessary for proper blood flow
C) Collateral blood supply enters the nose via the alar arcades
According to the passage, what is the clinical recommendation for nasal tip procedures concerning blood supply?
- A) Excessive defatting is advisable for better outcomes
- B) Nasal tip should be defatted to avoid complications
- C) Surgeons should reconstruct the underlying framework instead of defatting
- D) Transcolumellar incisions are crucial for proper blood flow
Surgeons should reconstruct the underlying framework instead of defatting
: In the angiographic study, what is the percentage of cases where the lateral nasal artery was consistently present?
A) 68.2%
- B) 100%
- C) 50%
- D) 22%
: B) 100%
What is the consequence of prior incisions in the alar region according to the passage?
- A) Improved blood supply to the nasal tip
- B) No effect on collateral blood supply
- C) Jeopardizing collateral supply to the nasal tip in secondary procedures
- D) Increased risk of alar flaring
C) Jeopardizing collateral supply to the nasal tip in secondary procedures
What artery provides collateral supply to the nasal tip via the nasal arcades, as mentioned in the passage?
- A) Facial artery
- B) Ophthalmic artery
- C) Infraorbital artery
- D) Dorsal nasal artery
C) Infraorbital artery
What is the primary concern related to the blood supply of the nasal tip in the context of surgical procedures?
- A) Lack of arterial supply
- B) Excessive bleeding
- C) Compromised vascularization due to excessive defatting
- D) Occlusion of the external carotid artery
C) Compromised vascularization due to excessive defatting
How many nasal vaults are there, and what are they named?
- A) Two - Upper and Lower
- B) Three - Bony, Upper Cartilaginous, and Lower Cartilaginous
- C) Four - Bony, Lateral Cartilaginous, Medial Cartilaginous, and Lower
- D) One - Bony Vault
B) Three - Bony, Upper Cartilaginous, and Lower Cartilaginous
What makes up the bony vault of the nose?
- A) Nasal bones only
- B) Ascending frontal process of the maxilla only
- C) Nasal bones and the ascending frontal process of the maxilla
- D) Upper lateral cartilages
C) Nasal bones and the ascending frontal process of the maxilla
Why are osteotomies rarely indicated above the canthal level in the bony vault?
- A) Thin bone and wide structure
- B) Thick bone and narrow structure
- C) Thick bone and wide structure
- D) Thin bone and narrow structure
B) Thick bone and narrow structure
What defines the keystone area in the upper cartilaginous vault?
- A) Medial crural ligaments
- B) Junction of upper lateral cartilages with nasal bones and septum
- C) Lower lateral cartilages
- D) Nasal bones
B) Junction of upper lateral cartilages with nasal bones and septum
What is the consequence of the loss of intricate relationships in the keystone area of the upper cartilaginous vault?
A) Inverted-V deformity
- B) Dorsal hump
- C) Loss of nasal tip projection
- D) Thickening of the nasal bones
A) Inverted-V deformity
What are the components of the lower lateral cartilaginous vault?
- A) Upper lateral cartilages and septum
- B) Medial, middle, and lateral crura
- C) Fibrous connections and anterior septal angle
- D) Piriform abutment and dorsal hump
B) Medial, middle, and lateral crura
According to the fresh-cadaver study by Adams et al, what was the mean loss of tip projection for open rhinoplasty versus closed rhinoplasty?
A) 1.98 mm for open, 3.43 mm for closed
- B) 3.43 mm for open, 1.98 mm for closed
- C) No significant difference
- D) 0.001 mm for open, 0.001 mm for closed
B) 3.43 mm for open, 1.98 mm for closed
What structures were manipulated in the fresh-cadaver study by Adams et al to assess nasal tip support in open and closed rhinoplasty?
- A) Nasal bones
- B) Lower lateral cartilages
- C) Nasal septum
- D) All of the above
D) All of the above
What was the primary reason for the larger loss of tip projection in open rhinoplasty in the study by Adams et al?
- A) Cephalic trim
- B) Interruption of the lower lateral cartilages
- C) Ligamentous disruption
- D) Septum removal
C) Ligamentous disruption