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verstraete questions Flashcards

1
Q

what is an advancement flap

A

mucoperiosteal pedicle flap that is advanced along its long axis

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2
Q

what is an angularis oris flap

A

vestibular mucosal flap that is harvested just caudal to the commissure of the lip which includes the angularis oris artery

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3
Q

what is a double layer flap

A

two separate flaps that are utilized in the closure of a defect in two overlapping layers

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4
Q

what is an oronasal fistula

A

Acquired chronic communication between the oral and nasal cavities, lined by an epithelium

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5
Q

what is a split palatal U flap

A

bilateral transposition flaps in which each pedicle is based on the location of the major palatine artery

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6
Q

what is a transposition flap

A

a mucoperiosteal flap that is rotated on its base to cover a defect

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7
Q

what is a vestibular mucosal flap

A

a pedicle mucosal flap with associated connective tissue harvested from alveolar mucosa and buccal mucosa of the lip or cheek

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8
Q

Ch 42: In Lymph Node Staging of Oral and Maxillofacial Neoplasms in 31 Dogs and Cats by Herring JVD 2002, did the authors find that lymph node cytology was helpful?

A: Yes, if the mandibular lymph node is palpably enlarged, then on histopathology, you are likely to see evidence of metastatic disease.

B: No, the FNA from a mandibular lymph nodes is not likely to be consistent with histologic results of thesame lymph node.

C: Yes, but you can’t just FNA the mandibular lymph nodes, because metastatic disease only includes the mandibular lymph nodes 54.5% of the time.

D: No, because in these cases of SCC, fibrosarcoma, and melanoma, the most common way that metastases were found was on thoracic radiographs

A

Yes, but you can’t just FNA the mandibular lymph nodes, because metastatic disease only includes the mandibular lymph nodes 54.5% of the time.

Also found: pre-op cytology of lymph nodes agreed with histopath 90% of time in normal vs reactive vs mets

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9
Q

CH 42: In Prevalence of regional and distant metastasis in cars with advanced oral squamous cellcarcinoma: 49 cases (2005-2011), what do Soltero-Rivera et al. report on the prevalence of lymph node metastasis?

A: The prevalence of mandibular lymph node metastasis was 31% (15/49).

B: Of the patients with mandibular lymph node metastasis, it was usually related to a tumor located in the mandible instead of the maxilla.

C: It was more likely for there to be thoracic metastasis than lymph node metastasis. D: If there was found to metastasis, the survival time of the patient was less.

A

A: The prevalence of mandibular lymph node metastasis was 31% (15/49).

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10
Q

CH 41: Which of the following would most appropriately be repaired with a transposition flap?

A: A midline defect of the soft palate

B: A defect lateral to midline near the maxillary 3rd premolar

C: A defect lateral to midline near the maxillary 1st molar

D: A midline palatal defect affecting both the hard and soft palate

A

B: A defect lateral to midline near the maxillary 3rd premolar (best if rostral to PM4)

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11
Q

CH36: Which of the following signs on physical exam may lead you to suspect TMJ dyplasia?

A:No abnormalities on physicalexam or temporal muscle atrophy

B: Cranial nerve deficits

C: halitosis and drooling

D: Cavalier King Charles Spaniel and over 5 years

A

A:No abnormalities on physical exam or temporal muscle atrophy

tends to be 6month-5 year, cranial nerve deficit leans to trigeminal neuropraxia

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12
Q

CH22: What is a drawback to a long junctional epithelium?

A: Pocket recurrence is likely

B: root resorption and ankylosis are likely to occur

C: Periodontal regeneration occurs

D: The healing is slower

A

A: Pocket recurrence is likely

B- happens with bone first

C-happens with pdl first

D-no this would be 10X faster

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13
Q

CH22: What is the proposed activity of a root conditioner such as citric acid, tetracycline, or EDTA?

A: aids in attachment of a blood clot

B: Supports cementum growth

C: Clot stabilization

D: Osteoconduction

A

A: aids in attachment of a blood clot-YES

membrane Supports cementum growth

particulate supports Clot stabilization and osteoconduction

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14
Q

CH 6: What is the benefit of taking full mouth dental radiographs in a never before seen dog in your practice without pathology on oral exam?

A: You find clinically relevant lesions in 72.6% of dogs

B: You find clinically relevant lesions in 41.6% of dogs

C: You find clinically relevant lesions in 27.8% of dogs

D: You find clinically relevant lesions in 41.7% of dogs

A

C: You find clinically relevant lesions in 27.8% of dogs

in cat without pathology on exam: 41% so even more important in cats!

72.6% of dogs with pathology you find additional information on rads

find incidental lesions in 41% of dogs

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15
Q

CH9:Which of the following statements related to the instrument depicted below is true?

A: The technology is based on 6 piezoelectic discs

B: frequencies of 25-35 kHz are specific for soft tissue

C: Continuous motion with this instrument will help prevent thermal damage

D: Intraoperative bleeding is more with this instrument than with a surgical bur

A

based on 6 ceramic disks

cut bone 25-35kHz

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16
Q

what is cavitation and what technology uses it?

A

rapid formation and collapse of liquid bubbles (associated with ultrasonic units) that releases energy and aids in the cleansing action of scalers and helps with visualization and hemostasis with peizotomes

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17
Q

Ch 6: Which of the following methods of cutting soft tissue is true?

A: electrosurgery risks bone necrosis

B: radiosurgery results in better epithelialization than scalpel incisions

C: electrosurgery results in better epithelialization than scalpel incisions

D: electrosurgery results in less tissue damage than radiosurgery

A

electrosurgery risks bone necrosis and causes MORE tissue damage than radiosurgery

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18
Q

Ch 7: Which suture material has retained tensile strength 4 weeks after surgery?

A: Monocryl

B: polyglactin 910

C: polydioxanone

D: polyglecaprone 25

A

C. polydioxone (PDS) has 41% at 42 days

monocryl=polyglecaprone 25

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19
Q

Ch 8: Which of the following statements is true regarding char?

A: Char formation is beneficial because it blocks entry of the beam into tissue

B: Char formation may be reduced by using continuous wave mode of beam delivery

C: Accumulated char can promote widespread thermal injury

D: Passing the beam slowly is one method of reducing char formation

A

C: Accumulated char can promote widespread thermal injury

quick pulses create least amount of char

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20
Q

Versatility of the angularis oris axial pattern flap for facial reconstruction:

Question: What complication was seen most commonly in this study?

A: necrosing flap because of not including the panniculus carnosis layer

B: edema of the flap

C: success was 50% which was reported

D: success was 6-9/9 which is consistent with reported success rate of 89-100%

A

all flaps had edema and hair direction change

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21
Q

Ch 11: Which of the following is not an extraction mechanical principle?

A: wedge principle

B: wheel-and-axle motion

C: leverage

D: rotation

E: rocking

A

rocking-no, creates shear and breaks roots

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22
Q

Ch 12:Which is not a possible root variation of the feline 106/206?

A: single root

B: dichotomous root

C: 2 rooted

D: 3 rooted

A

3 rooted not possible

single root 28%

dichotomous 55%

double root 9%

JVD 1997 Verstraete

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23
Q

Ch 13: Bleeding associated with a mesial vertical releasing incision for surgical extraction of a maxillary canine tooth is most likely to be related to which vessels?

A: palatine artery

B: the lateral nasal branches of the infraorbital artery

C: branches of the major palatine artery

D: infraorbital artery

A

B: the lateral nasal branches of the infraorbital artery

C: branches of the major palatine artery

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24
Q

Ch 16: Why should fish oil be discontinued for 2 weeks prior to extractions?

A: Eicosapentaenoic acid decreases platelet aggregation

B: Docosahexaenoic acid decreases platelet aggregation

C: Eicosapenaenoic acid inhibits platelet production

D: Docosahexaenoic acid decreases platelet function

A

A: Eicosapentaenoic acid decreases platelet aggregation

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25
Q

CH 17: What is biologic width?

A: the physiologic dimension of the junctional epithelium and connective tissue attachment

B: apical to the junctional epithelium and ending at the marging of the alveolar bone

C: unkeratinized, highly permeable epithelium at the bottom of the sulcus which forms the epithelial attachment to the tooth surface

D: Distance from the free gingival margin to the base of the sulcus

A

the physiologic dimension of the junctional epithelium and connective tissue attachment

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26
Q

Select which instrument is the Orban gingivectomy knife.

A

C is Orban knife

B=kirkland

27
Q

CH 18: Which method should be avoided for gingivectomy?

A: blade (cold steel)

B: High speed with fluted or diamond bur

C: Fully filtered waveform (electrosurgery and radiosurgery)

D: Partially rectified waveform (electrosurgery and radiosurgery)

A

D: Partially rectified waveform (electrosurgery and radiosurgery) (Partially rectified waveform is made for coagulation of vessels less than 1.6mm but causes thermal necrosis and tissue shrinkage and thus is not for gingivectomy)

28
Q

what is the difference between radiosurgery and electrosurgery

A

electrosurgery=low frequency electrical energy, create heat between patient and grounding in direct contact and separation of tissues is via heat

radiosurgery= high frequency radio wave energy through patient between active electrode and passive antenna (ellman unit)-heat created via molecular friction, not from tip

29
Q

H 19: How should a sliding pedicle mucogingival flap be planned?

A: The flap should be 1.5 times wider than the recipient site

B: The flap should cover the root completely

C: You should make sure that a thick blood clot is present under the flap

D: You should plan to probe and radiograph the site in 7 days

A

flap should be 1.5 times wider than recipient site

30
Q

CH 33: Which of the following describes a true ankylosis?

A: Intracapsular fibrosis

B: fibrous adhesions between the zygomatic arch and mandible secondary to fracture

C: Infection of a fracture site causing immobility of the TMJ

D: Neoplasia causing immobility of the TMJ

A

A: Intracapsular fibrosis

31
Q

CH 34: Which of the following would be at highest risk for osteomyelitis?

A: Maxillary Fracture because maxilla is comprised of intramembranous bone

B: Mandibular fracture because the mandible is comprised of endochondral bone

C: Mandibular Fracture because of the thinner cortical plate

D: Maxillary fracture because the infection can be disseminated into the surrounding tissue

A

B: Mandibular fracture because the mandible is comprised of endochondral bone

  • closer to long bone, more risk of Infection compared to maxilla
  • maxilla has thinner cortical plate
32
Q
  1. In CT features of oral Squamous Cell Carcinoma in Cats: 18 cases (200-2008), what did Gendler et al report in regards to use of CT for cats with SCC?
    1. CT helped to predict survival time by more accurately defining mass extension and lymph node involvement
    2. CT helped in identifying lesions affecting the soft palate
    3. CT lesions characteristic of oral SCC in cats were mass lesion, marked, heterogenous contrast enhancement, and a high rate of adjacent osteolysis
    4. CT can be used to differentiate osteolysis associated with periodontal disease from osteolysis associated squamous cell carcinoma
A

CT lesions characteristic of oral SCC in cats were mass lesion, marked, heterogenous contrast enhancement, and a high rate of adjacent osteolysis

CT missed soft palate lesions in 3/4 cats!

33
Q
  1. In Risk factors associated with survival in dogs with nontonsillar oral squamous cell carcinoma 31 cases (1990-2010), which factor was found to most significantly affect the prognosis?
    1. Whether surgery was performed
    2. Whether margins were attained
    3. The tumor location
    4. The tumor subtype
A

a. whether surgery was performed

dogs treated with surgery had 1 year survival 93%

dogs with surgery had decreased risk of death by 91%

tumor location not associated with survival

even dogs with incomplete margins had survival benefit

34
Q

what is a gap arthroplasty

A

surgical excision of zygomatic arch, fossectomy (mandibular fossa) and coronoidectomy (below condylar process)

indication: extensive TMJ ankylosis or if it affects other bones of the skull

35
Q

in what order should fractures be repaired?

A

mandible first: simple to most complicated; caudal to rostral

symphysis last!

the maxilla: lateral to medial, then buttresses

36
Q

which of the following is not an extraction principle?

a. wedge
b. wheel and axle
c. leverage
d. rotation
e. rocking

A

rocking is not! causes shear force and root fractures

traction is!

37
Q

which is not a possible root variation of the feline 106/206?

a. single root
b. dichotomous root
c. 2 rooted
d. 3 rooted

A

d. 3 rooted

55% dichotmous; 28% single and 9% two

38
Q

Bleeding associated with a mesial vertical releasing incision during extraction of a maxillary canine tooth is most likely to be from which 2:

a. palatine artery
b. lateral nasal branch of infraorbital
c. branches of major palatine a
d. infraorbital a.

A

b. lateral nasal branches of infraorbital artery

AND

c. branches of major palatine A. (between 3rd incisor and canine)

39
Q

CH 56: What is the most common complication of commissurrorraphy?

A: Trauma from the teeth

B: Dehiscence of the mucosal layer

C: Dehiscence of the of the rostral margin

D: Subcutaneous emphysema

A

C. dehisence of rostral margin

SubQ emphysema is MC of maxillectomy

40
Q

What is the mode of action of chlorhexidine?

A: damages the cell wall

B: bacteriostatic at high concentrations

C: Anionic so binds positively charged surface of bacteria

D: It is bactericidal at all concentrations

A

a. Damages the cell wall

Chlorhexididine is a cationic bisguanide

Bacteriocidal at high conc

binds the negative charged surface of bacterial cell wall to make it permeable

41
Q

In Transmylohyoid orotracheal intubation in surgical management of canine maxillofacial fractures: an alternative to pharyngotomy endotracheal intubation. (Vet Surg 2015), what do Soukup and Synder recommend regarding this procedure?

A: Make the size of the incision the size of the tube at the level of the M1

B: You should always close the incision following the procedure

C: Encountering the sublingual artery risks significant bleeding during the procedure

D: Complications were encounteredin this procedure when the incision was made too caudal.

A

A: Make the size of the incision the size of the tube at the level of the M1

-no complications were noted, didnt have too caudal issue because always at M1, may encounter sublingual A but not an issue, left two open and closed 2

42
Q

CH 62: Bilateral carotid artery ligation could be used to achieve which of the following:

A: decrease lingual artery pressure in dogs

B: increase pressure in major and minor palatine in dogs

C: decrease lingual artery pressure in cats

D: increase pressure in the maxillary artery

A

a. decrease lingual A pressure in dogs

cant do bilateral in cats!

vertebral A in dogs makes it OK to do bilateral permanantly

43
Q

CH 63: What are the afferent lymphatics to the tonsils and where do the tonsils drain?

A: There are no afferents to the tonsils and the tonsils drain to the medial retropharyngeal lymph nodes.

B: The afferents are from the pharynx and tonsils drain to the medial retropharyngeal.

C: The afferents are from the palate and the tonsils drain to the mandibular lymph nodes.

D: The afferents are the medial retropharyngeal and the tonsils drain to the mandibular lymph nodes.

A

A: There are no afferents to the tonsils and the tonsils drain to the medial retropharyngeal lymph nod

bonus fact: tonsillar A comes from lingual A from external carotid A

44
Q

Which of the following is an accurate description of the tooth depicted and the appropriate treatment?

A: The tooth is embedded and an operculectomy should be performed

B: The tooth is impactedand the alveolar bone should be removed so that the full crown is exposed

C: The tooth is embedded and an operculectomy followed by orthodontic extrusion should be performed

D: The tooth is impacted and an operculectomy and the thin sheet of bone needs to be removed.

A

D: The tooth is impacted and an operculectomy and the thin sheet of bone needs to be removed.

the bone makes it impacted

45
Q

CH 58: How are osteoclasts controlled?

A: RANKL sticks to RANK on the precursor making it into an osteoclast

B: OPG sticks to RANKL on the precursor making it into an osteoclast

C: OPG sticks to RANK on the precursor making it into an osteoclast

D: RANK sticks to RANKL on the precursor making it into an osteoclast

A

A: RANKL sticks to RANK on the precursor making it into an osteoclast

C=inhibition (RANK is on OC waiting for either RANKL or OPG from OB to be active)

46
Q

CH 58: What did Nemec et al. in Osteonecrosis of the jaws in dogs in previously irradiated fields: 13 cases, conclude?

A: The dogs in this study were most likely to develop ORNJ lesions on the mandible contralateral to the mandible treated with radiation

B: Dental extractions in the radiated field are likely to trigger ORNJ

C: A clear line between devitalized bone and vital bone can be determined on CT

D: CT is necessary to determine persistence or recurrence of neoplasia instead of it just being ORNJ

A

B: Dental extractions in the radiated field are likely to trigger ORNJ

need histo to rule out recurrence (5 dogs had neoplasia); HUMANS had ORNJ on contralateral mandible, on CT would NOT see clear demarcation, would see: cortical defects, trabecular disorganization, air pockets, fractures, sequestra

47
Q

Describe the anatomic location of the mandibular salivary gland

A: in a v where the hypoglossal and lingual nerves cross

B: in a v where the lingual artery and facial artery join

C: in a v where the linguofacial vein and jugular join

D: ina v where the lingual nerve and lingual artery cross

A

C: in a v where the linguofacial vein and jugular join

shares a capsule with monostomatic sublingual gland!

48
Q

According to Proot et al, Parotidectomy for the treatment of parotid sialocoele in 14 dogs, which of the following were reported complications in surgical treatment of the sialocoele depicted below?

A: Recurrance of symptoms after surgery

B: Poor long-termsuccess

C: seromas, hemorrhage, wound dehiscence, permanent facial nerve paralysis

D: hemorrhage requiring blood transfusion

A

C: seromas (2), hemorrhage (1), wound dehiscence (1), permanent facial nerve paralysis (#2)

think: parotid duct and dorsal buccal branch of facial nerve together (like mm biopsy)

49
Q

This image from Boland et al.’s article Zygomatic salivary gland diseases in the dog: three cases diagnosed by MRI. JAAHA 2013, is an MRI with zygomatic salivary gland disease. Which of the following statements regarding disease of the zygomatic salivary gland is true?

A: The zygomatic salivary gland is most likely of the salivary glands to be diseased

B: The most likely disease to affect a salivary gland is neoplasia

C: A patient affected with exophthalmia suggests that the disease of the zygomatic salivary gland is more likely neoplastic

D: A patient affected with pain on opening the mouth suggests that the disease of the zygomatic salivary gland is more likely sialadenitis

A

B: The most likely disease to affect a salivary gland is neoplasia

50
Q

CH53: What is the timeline for BMP-induced inflammation?

A: Starts on the 3rdday, peaks at 2-3 weeks, resolves in 6 weeks

B: Starts post operatively, peaks at 2 weeks, resolves in 3 weeks

C: starts on the 3rdday, peaks at 1 week, resolves in 2-3 weeks

D: starts post postoperatively, peaks at 3 days, resolved in 2 weeks

A

C: starts on the 3rd day, peaks at 1 week, resolves in 2-3 weeks

51
Q

CH52: Which of the following structures may be encountered in using an angularis oris flap?

A: dorsal buccal branch of the facial nerve and parotid salivary duct

B: rostral auricular nerve plexus and parotid salivary duct

C: dorsal buccal branch of the facial nerve and the facial artery

D: Infraorbital artery and the facial artery

A

A: dorsal buccal branch of the facial nerve and parotid salivary duct

52
Q

Which of the following is true:?

A: if BMP is used, an additional plate will be added dorsal to the ventral plate

B: the inferior alveolar artery and vein should be ligated prior to mandibulectomy

C: The CRM infused with rh BLP should fit with room left for expansion

D: The plate should be contoured to the mandible after the mandibulectomy is performed to assure appropriate contour

A

B: the inferior alveolar artery and vein should be ligated prior to mandibulectomy

53
Q

In Regenerating Mandibular Bone Using rhBMP-2: Part 1 –Immediate Reconstruction of Segmental Mandibulectomies, what did Arzi et al. recommend for the technique described?

A: A concentration of rhBMP-2 at 1.0 mg/mL with a 50% soak volume

B: Use rhBMP-with a carrier such as CRM

C: to limit it’s use to young dogs, because resident stem cells are necessary

D: Oozing at about 3 days post operatively indicates inflammation and failure of the graft

A

B: Use rhBMP-with a carrier such as CRM

0.5mg/mL at 50% soak volume; oozing starts at 3 days and peaks at 7 days

contraindicated without a carrier like a CRM

54
Q

The most dorsasl intraosseous wire only stabilizes against what force?

  1. Rotation
  2. Bending
  3. Torsion
  4. Shear
A

b. bending

the ventral wire is added for stabilization to counteraction shear (ramus) and rotation (symphysis)

55
Q

How far from the alveolar crest is bone going to be >2mm and why is that important?

A
  • must go 3mm from the alveolar crest to have consistently >2mm thick bone
  • screws need at least 2mm thick bone for compression
  • snyder and soukup recommend placing a plate 6-9mm from alveolar crest for thicker bone
56
Q

Intraosseous wires rely on _______ created by tension of the wire and ____________ of the fracture fragments

A
  1. Intraosseous wires rely on STATIC created by tension of the wire and FRICTION of the fracture fragments
57
Q

Which of the following is not a fracture type that indicates repair via intraosseous wiring?

  1. Simple
  2. Stable
  3. Comminuted
  4. Interdigitating fragments
A

c. comminuted-intraosseous wires are for stable, interdigitating, simple fractures

58
Q
  1. Which is the correct order for repairing maxillary fractures?
    1. Lateral then medial then caudal buttress
    2. Caudal then medial then lateral buttress
    3. Caudal then lateral then medial
    4. Lateral then caudal then medial buttress
A

lateral-medial-caudal

-buttresses stronger in withstanding vertical force, not as strong in transverse forces

59
Q

What is the downside of using polymethyl methacyrlate in creating a custom intraoral splint?

a. requries extrinsic heat for polymerization
b. expensive
c. exothermic and can cause thermal injury
d. requires incremental curing of a large surface and this is time consuming

A

c. exothermic and can cause thermal injury

cheaper than BisGMA of protemp

60
Q

In Repair of bialteral comminuted mandibular fractures in a 12 week old puppy using locking and nonlocking maxillofacial reconstruction plates, which of the following were factors related to failure?

a. implant fracture, implant loosening, sequestrum formation
b. excessive bony callus, trauma to permanent tooth buds
c. sequestrum formation and trauma to permanent tooth buds
d. implant failure, endo of teeth near fracture line

A

a. implant fracture, implant loosening, sequestrum formation

61
Q

Where is it best to place a monocortical plate in dogs <10kg or >10kg?

a. 6-9mm below alveolar crest
b. 6-9mm below alveolar crest but not over PM4 and M1
c. 3mm below alveolar crest not over PM4 and M1
d. monocortical plates cant withstand the forces of mandibular fracture

A

b. 6-9mm below alveolar margin, not over PM4 or M1 roots
- thinner bone over both roots of PM4 and mesial M1 (where the mandibular canal goes more ventral in brachycephalic 2009 paper)
- AT 3mm is not enough, must be >3mm for >2mm in all sizes

62
Q

Placing an implant along the alveolar margin applies the tension-band theory and effictively neutralizes which force(s)?

a. bending
b. bending and shearing
c. bending, shearing and torsional
d. shearing and torsional

A

a. bending only

second plate is for torsion (symphysis) and shear (ramus)

63
Q

What suture still at strength left at 28 days?

a. poligrecaprone 25
b. Polydioxanone
c. Polyglactin 910
d. monocryl

A

b. PDS=polydiioxanone

monocryl=23-30% left at 14 days (0% at 21 days)

PDS=75% at 14 days (58% at 28D)

Vicryl= 74% at 14 days (0% at 28d)

64
Q

What is in the panniculus carnosis?

a. the angularis oris A
b. the angularis oris v.
c. the facial A
d. the platysma, sphincter colli superficialias, sphincter colli profundus

A

d. the platysma, sphincter colli superficialias, sphincter colli profundus

YOU HAVE TO HAVE THE PANNICULOUS CARNOSIS OR YOUR ANGULARIS ORIS FLAP WILL FAIL

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