Surg 105--Chapter 29 (Fuller) Flashcards
Surgery that is performed to improve appearance but not function; also called cosmetic surgery.
aesthetic surgery
A tissue graft in which the donor and recipient are of the same species.
allograft
To enlarge a structure.
augment
The surgical transplantation of tissue from one part of the body to another in the same individual.
autograft
A graft derived from live tissue, whether human or animal.
biological graft
A type of graft or implant material made of synthetic absorbable material.
biosynthetic
A biological graft composed of different types of tissues such as skin and muscle.
composite draft
The surgical removal of dead skin. debris, and infectious material from a wound.
debridement
A medical device used for removing single thickness skin grafts.
dermatome
Drying or dehydration of tissue.
desiccation
Tissue that has been burned (second- and third-degree burns) but remains adherent to the wound.
eschar
Tissue that is non-elastic and may constrict underlying structures, impairing vital functions
eschar
Excision of eschar to release stricture in surrounding tissues.
escharotomy
Multiple longitudinal incisions made in the fascia to release severe swelling or stricture which can result in necrosis.
fasciotomy
A skin graft composed of the epidermis and dermis.
full-thickness skin graft (FTSG)
A dressing impregnated with a water-based gel that prevents the wound from drying and encourages healing.
hydrodressing
A scar which contains excess tissue and may be inflamed and usually reduces within 6 months.
hypertrophic scar
A synthetic, natural, or biosynthetic substance used to fill in or replace an anatomical structure.
implant
A hypertrophic scar occurring in dark-skinned individuals, may become a bulbous and usually does not reduce over time.
keloid
A procedure in which a malignant tissue mass is removed and cut into quadrants before frozen section.
mohs surgery
Damage to the skin caused by ultraviolet light.
photodamage
Surgery performed to restore form and function that have been lost because of trauma, radical surgery, or congenital anomaly.
plastic and reconstructive surgery
To fold tissue and secure it in place surgically.
plicate
Derived from pig tissue.
porcine
Drooping or sagging of any anatomical structure.
ptosis
A skin graft that consists of the epidermis and a portion of the papillary dermis.
split-thickness (or partial-thickness) skin graft (PTSG)
A surgical method of providing support to an anatomical structure; the term may also refer to the support device itself.
stent
In plastic surgery, a _____ is used to maintain contact between a skin graft and the graft site.
stent dressing
A graft derived from synthetic material compatible with body tissue; may be soft, semisolid, or liquid.
synthetic graft
A surgical technique in which a plane of tissue is created or an existing tissue plane is lifted, such as skin from the fascia.
undermine
A graft made up of tissue taken from one species and grafted into another species.
xenograft
What is the primary goal of plastic and reconstructive surgery?
restoration of form and function
What is the outer layer of the skin?
epidermis
What are the primary tissue cells of the epidermis?
keratinocytes
What are the layers of the epidermis?
- stratum corneum
- stratum lucidum
- stratum granulosum
- stratum spinosum
- stratum germinativum (basale)
The most superficial layer of the epidermis, relatively transparent and composed of dead keratinocytes that are filled with a protein called keratin.
stratum corneum
Composed of dead or dying cells that are flattened and densely packed; may not be found on regions of the body with thin skin
stratum lucidum
Several cell layers thick and produces keratin.
stratum granulosum
Contains undifferentiated cells that become specialized as they migrate to the skin surface.
stratum spinosum
The deepest layer of the epidermis attached to the dermis; cells in this layer undergo mitosis, producing keratinocytes that migrate through the layers of the epidermis; melanocytes also are found in this layer.
stratum germinativum (basale)
Lies between the epidermis and the subcutaneous fatty layer.
dermis
Contains numerous sensory receptors which inform the brain about environmental change or danger.
dermis
What are the two types of sweat glands found in the human body?
- apocrine sweat gland
- eccrine sweat gland
Arise from the dermis and are located mainly in the axilla and groin; open out into the hair follicle.
apocrine sweat glands
Secrete sweat over the surface of the body through small tubules.
eccrine sweat glands
The soft tissues of the face include _____.
- skin
- fat
- muscle
- fascia
- ligaments
The subcutaneous fatty tissue of the face is separated into deep and superficial layers by a tissue planes called the _____.
superficial musculoaponeurotic system (SMAS)
What are the three types of debridement?
- chemical
- surgical
- pressurized
Skin lesions are removed for diagnostic purposes and to prevent or treat malignancy.
excision of superficial lesions
Of the three types of malignant lesions (basal cell carcinoma, squamous cell carcinoma, and malignant melanoma), which is the lesion of the most concern
malignant melanoma
Performed to remodel a previous scar or to remove a keloid.
scar revision
What instrument is used to undermine the tissue during a scar revision?
Metzenbaum scissors
The removal of nonviable tissue from a non-healing or traumatic wound?
debridement
Requires repeated debridement to remove dying and dead tissue so that healing can continue?
burn wounds
Only the outer layer of the epidermis is injured. The skin is red or pink, dry, and painful to touch?
superficial partial thickness first degree burn
The epidermis and various degrees of the epidermis is injured. The skin is blistered, red, and moist. The burn is very sensitive to environmental exposure and touch?
partial thickness second degree burn
The epidermis and full dermis are injured. These burns are characterized by a white, smooth, shiny surface with dry blisters and edema?
full thickness second degree burn
The skin, subcutaneous tissue, muscle, and bone are burned. Centered in an area of second-degree injury. The skin may be white, brown, or black and appears waxy. There is no pain because nerves have been destroyed?
full thickness third degree burn
Has a tourniquet effect on the affected body part and thus can extensively damage underlying muscle, bone, and vascular tissue?
circumferential eschar
Removed during debridement to allow healing and to reduce constriction
eschar
During debridement of burns, lap sponges soaked in a solution of _____ and _____ are applied to control bleeding.
sterile saline and topical epinephrine (1:1000)
During debridement of burns, the concentration most often used is _____, with _____.
1000 mL of normal saline, with 4 mL of topical epinephrine
Performed to replace skin that has been lost as a result of trauma, disease, or infection?
skin grafting (split-thickness skin graft)
The dermatome should always be handed to the field with the depth gauge set to _____.
0
What is applied to the graft site to reduce friction as the blade of the dermatome glides over the skin?
mineral oil
What instruments does the surgeon use to remove skin grafts?
- a free-hand skin graft knife (full-thickness graft)
- a dermatome (split-thickness graft)
Provides coverage and vascularization to a soft tissue defect.
pedicle graft (flap graft)
Pedicle grafts are classified as _____ or _____.
near or distant
Resection of the eyelid is done to improve vision of the upper visual fields.
blepharoplasty
Performed to lift the supportive structures of the brow and alleviate drooping of skin, muscle, and fascia?
brow lift (open and endoscopic)
What are the three approaches a surgeon may use for a brown lift?
- coronal (behind the hairline)
- pretrichial (at the hairline)
- direct (at the level of the brow)
Redundant and sagging supportive tissue of the face is reduced or modified to provide a more aesthetic appearance?
rhytidectomy
Removes the epidermis and a portion of the dermis to reduce facial lines and wrinkles?
laser skin resurfacing
Performed to give normal contours to the chin or cheek?
facial implant (facial augmentation)
What is mentoplasty?
chin augmentation
What is malar augmentation?
cheek augmentation
Surgical creation of the external ear?
otoplasty
Performed to correct a congenital malformation of the external ear or to create an ear destroyed by trauma?
otoplasty
Performed to increase the size and improve the shape of the breast?
augmentation mammoplasty
Excess breast tissue removed and the breast is reconstructed to provide an aesthetic appearance?
reduction mammoplasty
What is macromastia?
excessively large breasts
What is gynecomastia?
macromastia is males
Performed to reconstruct the breast without the use of implants?
transverse rectus abdominis myocutaneous (TRAM) flap
In this procedure, a tissue flap containing skin, subcutaneous tissue, and muscle is raised from the lower abdomen and transferred to the mastectomy site?
transverse rectus abdominis myocutaneous (TRAM) flap
Performed to remove excess deep fat?
liposuction
Performed to remove excess skin and adipose tissue from the abdominal wall.
panniculectomy (abdominoplasty)
Plastic surgery involves _____.
the treatment of congenital defects and anatomical abnormalities caused by disease and injury
When a patient arrives for surgery, special _____ needs must be met.
psychological
What are the vital functions of the skin?
- protects underlying tissues and organs
- excretes organic waste and stores nutrients
- excretes water and dissipates heat as a means of thermoregulation
- its sensory organs transmit touch, pressure, pain, and temperature
Layer of the skin that is thicker on areas of the body that are weight bearing?
stratum corneum
Provides nourishment and enervation to the epidermis?
dermis
Aids thermoregulation of the body by producing “goose bumps” in a cold environment?
hair muscle (erector pili muscle)
The most common type of skin cancer?
basal cell carcinoma
The second most common type of skin cancer?
squamous cell carcinoma
The rarest of the skin cancers but accounts for the most fatalities from skin cancer?
melanoma
A mechanical dermatome can be powered by _____.
compresses air or electricity
What are the most commonly used models of mechanical dermatomes?
Brown (most common), Padget, Zimmer
What are examples of drum dermatomes?
Reese and Padget
What is used to remove a full-thickness skin graft?
graft knife
The _____ laser is used for facial resurfacing?
carbon dioxide (CO2)
Implants that are porous, cause little inflammatory reaction, and remain stable in the body?
polyethylene (Medpor) implants
Implants that have been used in cardiovascular procedures for many years?
gore-tex
_____ cannot take place until debridement is complete.
grafting
Enzymes are used to dissolve tissue?
chemical debridement
Tissue is removed using sharp dissection with surgical instruments?
surgical debridement
Debridement is performed using a fine jet spray of saline?
pressurized saline
Third-degree burns develop _____.
eschar
Free-hand skin graft knife is used for _____.
full-thickness graft
A dermatome is used for _____.
split-thickness graft
During a rhytidectomy, the excisional areas are injected with _____ to maintain hemostasis.
1% lidocaine with epinephrine
Round implants are used for _____.
an elective procedure on an intact breast.
Anatomical implants are used _____.
after masectomy or if the breast is very small
During an augmentation mammoplasty, the surgeon creates a pocket in the _____.
pectoralis major
During an augmentation mammoplasty, the resevoir is filled with _____.
150 - 300 mL of saline
During an augmentation mammoplasty, the tissue expander is filled in _____ increments.
60 mL
During liposuction, a large volume of lidocaine and epinephrine diluted in _____ is injected into the targeted tissue.
lactated Ringer solution
Superficial aspiration is performed with a _____ cannula.
2 or 3 mm
Deep aspiration is performed with a _____ cannula.
4 or 5 mm
What position is used for panniculectomy?
semi-Fowler
