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Chapter 19 Flashcards

Plastics + Reconstruction (92 cards)

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1
Q

Dx procedures for plastics

A

before + after pics
visual exam
xray, CT, MRI

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2
Q

pharmacologic agents for plastics

A

tumescent solution
cocaine

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3
Q

forms of tumescent solution

A

saline: hydro dissection
epinepherine: hemostasis
lidocaine: anesthetic
wydase: fat liquifier

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4
Q

characterisitcs of cocaine used for plastics

A

4% controlled substance
vasoconstrictor
anesthetic
used in rhinoplasty

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5
Q

instrumentation and equipment for plastics

A

plastic set
nasal set
dermis

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6
Q

what comes in a plastic set

A

lipo set
breast augmentation set
breast + abdominoplasty set
minor ortho
- hand sets

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7
Q

what comes in a nasal set

A

rhinoplsty set

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8
Q

what comes in a dermis set

A

dermatome
mesh graft device

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9
Q

what is dermatome

A

cuts thin slices of skin for split thickness skin graft

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10
Q

what are the types of dermatome

A

handheld: small graft
drum: large flat graft
oscillating

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11
Q

process of doing dermatome

A
  • chlorhexidine gluconate applied
  • skin tension
  • dermatone cuts to desired thick
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12
Q

what is a mesh graft device

A

expands the size of skin graft so it can cover more area

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13
Q

characteristics of autograft

A

split thickness
remove epi+ half of dermis
used for large surface areas

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14
Q

characteristics full thickness skin graft (FTSG)

A

removes epi+ dermis
used for small or large deep surface areas

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15
Q

characteristics of homograft

A

same species
used in dressings/ face transplants

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16
Q

what are the determining factors for skin grafts

A

location of defect
condition of possible donor sites
cause of the defect

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17
Q

characteristics of free flap flap grafts

A

free flap
- comes from another location
- must micro anastomose
-no sensation

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18
Q

characteristics of pedicle flap flap grafts

A

remain attached to its blood supply
tunnel under the existing skin

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19
Q

pathology of burns

A

heat
cold
radiation
chemicals
electrical

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20
Q

surgical procedures for burns may include:

A

- debridement of necrotic
- skin grafts
- restoring function
- cosmetic

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21
Q

how many degrees of burn

A

4
4th one is burning bone

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22
Q

first degree burn characteristics

A

epidermis
no blister
heals within 1 week
no scarring

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23
Q

second degree burn characteristics

A

partial thickness
extremely painful blisters
superficial or deep
debridement + grafting maybe

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24
Q

third degree burn characteristics

A

full thickness
permanent tissue damage
skin grafting needed

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25
fourth degree burn characteristics
(char burns) surgery necessary grafting or amputation prone to infection extensive reconstruction
26
5 criteria of the abbreviated burn severity index
age of patient sex of patient presence of inhilation injury depth of burn (degree) percentage of body surface burned
27
two BSA methods
lund browder - chart variables according to age rule of nines
28
rule of nines categories
head and neck- 9% anterior trunk- 18% posterior trunk- 18% upper extremity- 9% lower extremity- 18% perineum- 1%
29
what is systemic response
more than 30% total body surface burned
30
characteristics of full thickenss skin graft
small but deep defects try to maintain blood supply + nerves dirty+ clean setups free and pedicle flaps
31
steps of full thickness skin graft
excise elsion (send to path) donor site: excise skin graft and cut to size undermine skin at donor site close donor site recipient site: suture graft in place bolster dressings in place
32
what to use for split thickness skin graft
use topical thrombin or epi for hemostasis on donor site pressure dressings
33
steps for a split thickness skin graft
donor site: lubricate and stretch skin cut and mesh graft hemostasis cover recipient site: suture into place bolster dressings applied
34
what lubricant do you use for skin grafting
mineral oil
35
scar revision techniquess
w plasty m plasty y-v plasty z plasty
36
Cause of dermatologchalasis
Sun exposure and age Collagen fibers lost
37
Blephroplasty
Surgical repair of eyelid
38
Considerations with blephrolasty
Bilateral Done local Avoid corneal abrasion Prolene to close for color
39
Procedure steps for blephrolasty
Mark tissue Incision with 15 blade Hempstead is Excise fat Close
40
What instrument do you excise fat with on blephrollasty
Westcott Bishop Harmon Caliper
41
What instrument do you use to close blephroplasty
Castroveijo needle
42
What is an endo brow lift
Reduce forehead wrinkles
43
Steps of endo brow lift
- Tumescent solution injected - 3-5 incisions made behind hairline - endoscope introduced - periosteum dissected - muscle elimination - periosteum fixation - closure
44
Two forms of periosteum fixation
Temporary Permanent
45
Pathology for malar deficiencies and asymmetries
When severe asymmetry Cosmetic Trauma Previous plastic procedures
46
Steps to malar implants
- Gingobuccola sulcus incision - periosteum in used - pocket created - implant inserted - irrigated - fixated with bolsters - wound closed
47
Another name for malar implants
Submalar augmentation
48
what is a mandbular dificiencies and asymmetry
improves the shape of the chin
49
what is a mentoplasty
synthetic implant placement - incision made under the jaw - extends the chin
50
what is ear microtia
congenital absence of part or all of ear - grade 1-4
51
waht implant is used for ear microtia
6=9th costal cartilage graft or synthetic implants
52
what is a rhinoplasty often odne in conjunction with
septoplasty mentoplasty
53
two types of implants for rhinolpasty
synthetic autograft - ear or rib
54
instruments/ equipment for rhinoplsty
nose set ENT prep stand headlamp packing splint
55
procedure steps for rhinoplsty
trim hair incision at base of nose - 15 on 7 repair closure splint
56
what instruments do you use for rhinoplasty repair
chisel or rasp boies elevator implants/ grafts
57
what is a rhytidectomy, what is it commonly done with
face lift laser resurfacing blephroplasty lipo
58
procedure steps for rhytidectomy
incision - 15 on 3 undermine skin from platysma smas dissected recessed + stitched stretch skin+ remove redundant tissu duplicate contralaterally close
59
pathology for a cleft lip and palate
cheiloschisis: cleft lip palatoschisis: cleft palate
60
how many people have cleft lip and palate
one in every 500 - 20% genetic - 80% maternal substances + age
61
what class is cheiloplasty/ palatoplasty
class ii procedure hard palate fixation device
62
how long can cheiloplasty/ palatoplasty be delayed
3-18 months
63
post op requirments of cheiloplasty/ palatoplasty
speech therapy and orthodont care
64
cheiloplasty steps
map it out excise both sides of cleft - 15 blade + adsons close mucous membrane of lip close obicularis oris muscle create cupids bow
65
what is the main thing you need to do when doing a palatoplasty
incise and undermine the mucous membrane
66
what isntruments do you use for palatoplasty
15 blade + tenotomy
67
specialties for hand surgery
neuro ortho plastics
68
considerations for hand proceures
placement of IV patient might be awake
69
pathology of hand trauma
cuts sprains fracturs burns degloving
70
surgical goals on hand surgery
restore function + appearnace
71
consider of replantation is viable
- what took it off - what is the location on finger - how bad was it damaged - care of severed part - time it was gone for
72
what does team 1 of replantation do for hands
debridement of the stump identify structures of *proximal* stump
73
what does team 2 of replantation do for hands
debridement the severed end identify structures of *distal* stump put tissue on ice
74
*order of replantation*
*bone tendon blood vessel nerve*
75
what suture do you use for replanting the tendons
non absorbable figure of 8
76
minimum arteries and veins you need when replanting
1 artery, 2 vein
77
what suture do you use for replantign the nerves
8-0 to 10-0
78
what is pollicization
finger to thumb transfer - not aesthetically pleasing
79
to to hand transplant anatomy in order
extensor policis long tendon flexor policis long tendon dorsal pedis artery saphenous vein
80
what is dupuytens contracture
contraction of palm - excess collagen - restricts movement and function
81
presentation of dupuytrens contracture
non painful node in palm dimpling in skin longitudinal fibrous chord from palm to finger
82
three types of congenital deformity
idiopathic: unknown environmental (maternal, medical, substance) genetic
83
what are the two acronyms for related deformaties
VACTERL VATER
84
what are the effects of surgical success for deformaties
age neurovascular involvement adjoining structure involvement relation to growth plate ability to perform motor tasks
85
what is radial dysplasia
failure of radius and soft tissue to develop fully
86
types of radial dysplasia
1-4 3 is most common
87
why do you fix radial dysplasia
to give function, not normality
88
5 types of repairs for radial dysplasua
soft tissue release centralization (centering wrist over forearm) replacement of radius
89
what is syndactyly
webbed digits
90
4 types of webbed fingers
simple complete simple incomplete complex complicated
91
surgical consideration for webbed fingers
may require bone or skin graft incision should allow for growth and not restrict movement
92
what is polydactyly
ducplication of digits full or complete

SURG TESTS (26 decks)

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