Flaps

Question 1

What is the Mathes Nahai type of the tensor fascia lata flap? Pedicle(s)? Motor innervation? Sensory?

Answer 1

Type 1.
Pedicle: ascending branch lateral circumflex femoral artery;
Motor innervation: superior gluteal nerve;
Sensory innervation: lateral femoral cutaneous nerve

Pedicle: ascending branch lateral circumflex femoral artery; Motor innervation: superior gluteal nerve; Sensory innervation: lateral femoral cutaneous nerve

Question 2

What is the Mathes Nahai type of the vastus lateralis? Pedicle(s)? Motor innervation? Sensory?

Answer 2

Type 1;
Pedicle(s): descending branch lateral circumflex femoral artery;
Motor innervation: femoral nerve;
Sensory innervation: lateral femoral cutaneous nerve

Pedicle(s): descending branch lateral circumflex femoral artery; Motor innervation: femoral nerve; Sensory innervation: lateral femoral cutaneous nerve

Question 3

What is the Mathes Nahai type of the gastrocnemius? Pedicle(s)

Answer 3

Type 1; Pedicle(s): sural artery

Pedicle(s): sural artery

Question 4

What is the Mathes Nahai type of the iliac osseomusculocutaneous? Pedicle(s)?

Answer 4

Type 1;
Pedicle(s): deep circumflex iliac artery

Pedicle(s): deep circumflex iliac artery

Question 5

What is the Mathes Nahai type of the gracilis? Pedicle(s)? Motor innervation? Sensory?

Answer 5

Type 2;
Pedicle(s): ascending branch medial circumflex artery (dominant), superficial femoral artery (minor);
Motor innervation: obturator;
Sensory innervation: anterior femoral cutaneous

Pedicle(s): ascending branch medial circumflex artery (dominant), superficial femoral artery (minor); Motor innervation: obturator; Sensory innervation: anterior femoral cutaneous

Question 6

What is the Mathes Nahai type of the rectus femoris?

Answer 6

Type 2

Pedicle(s): descending branch of lateral circumflex femoral artery (dominant), superficial femoral artery (minor); Motor innervation: femoral nerve; Sensory innervation: anterior femoral cutaneous nerve

Question 7

What is the Mathes Nahai type of the soleus?

Answer 7

Type 2

Pedicle(s): popliteal artery, peroneal artery (dominant), posterior tibial artery (minor)

Question 8

What is the dominant pedicle for the rectus femoris flap?

Answer 8

Lateral femoral circumflex artery.

Question 9

What is the motor innervation of the rectus femoris flap?

Answer 9

Femoral nerve.

Question 10

What are the pedicles of the soleus flap?

Answer 10

Posterior tibial artery and peroneal artery.

Question 11

What is the sensory innervation of the soleus flap?

Answer 11

Sural nerve (if included).

Question 12

What is the motor innervation of the soleus flap?

Answer 12

Tibial nerve.

Question 13

What is the Mathes-Nahai type for the sternocleidomastoid flap?

Answer 13

Type II.

Question 14

What are the pedicles for the sternocleidomastoid flap?

Answer 14

Occipital artery and superior thyroid artery.

Question 15

What is the sensory innervation of the sternocleidomastoid flap?

Answer 15

No significant sensory innervation.

Question 16

What is the motor innervation of the sternocleidomastoid flap?

Answer 16

Accessory nerve (cranial nerve XI).

Question 17

What is the Mathes-Nahai type for the trapezius flap?

Answer 17

Type II.

Question 18

What are the pedicles of the trapezius flap?

Answer 18

Transverse cervical artery and dorsal scapular artery.

Question 19

What is the motor innervation of the trapezius flap?

Answer 19

Accessory nerve (cranial nerve XI).

Question 20

What is the Mathes-Nahai type for the rectus abdominis flap?

Answer 20

Type III.

Question 21

What are the pedicles for the rectus abdominis flap?

Answer 21

Superior epigastric artery and deep inferior epigastric artery.

Question 22

What is the sensory innervation of the rectus abdominis flap?

Answer 22

Intercostal nerves (T7-T12).

Question 23

What is the motor innervation of the rectus abdominis flap?

Answer 23

Intercostal nerves (T7-T12).

Question 24

What is the Mathes-Nahai type for the omental flap?

Answer 24

Type IV.

Question 25

What is the pedicle(s) of the omental flap?

Answer 25

Right and left gastroepiploic artery.

Question 26

What is the Mathes-Nahai type for the serratus anterior flap?

Answer 26

Type III.

Question 27

What are the pedicles for the serratus anterior flap?

Answer 27

Thoracodorsal artery and lateral thoracic artery.

Question 28

What is the sensory innervation of the serratus anterior flap?

Answer 28

Intercostal nerves (if included).

Question 29

What is the motor innervation of the serratus anterior flap?

Answer 29

Long thoracic nerve.

Question 30

What is the Mathes-Nahai type for the sartorius flap?

Answer 30

Type IV.

Question 31

What is the pedicle for the sartorius flap?

Answer 31

Branches of the superficial femoral artery.

Question 32

What is the motor innervation of the sartorius flap?

Answer 32

Femoral nerve.

Question 33

What is the Mathes-Nahai type for the latissimus dorsi flap?

Answer 33

Type V.

Question 34

What are the pedicles for the latissimus dorsi flap?

Answer 34

Thoracodorsal artery and perforators from intercostal and lumbar arteries.

Question 35

What is the motor innervation of the latissimus dorsi flap?

Answer 35

Thoracodorsal nerve.

Question 36

What is the Mathes-Nahai type for the pectoralis major flap?

Answer 36

Type V.

Question 37

What are the pedicles for the pectoralis major flap?

Answer 37

Thoracoacromial artery and internal mammary artery.

Question 38

What is the Mathes-Nahai type for the external oblique flap?

Answer 38

Type III.

Question 39

What are the pedicles for the external oblique flap?

Answer 39

Lower intercostal and deep circumflex iliac arteries.

Question 40

Describe the Mathes-Nahai classification of fasciocutaneous flaps

Answer 40

Type A is a direct cutaneous flap, in which the vascular pedicle travels deep to the fascia for a variable distance then pierces the fascia to supply the skin (e.g., groin flap, temporoparietal fascia flap). Type B is a septocutaneous flap, which has a vascular pedicle that courses within an intermuscular septum (e.g., lateral arm flap, radial forearm flap). Type C is a musculocutaneous flap and is based on a vascular pedicle that is traveling within the muscle substance (e.g., DIEP flap).

Question 41

Example of Mathes-Nahai Type A fasciocutaneous flap?

Answer 41

groin flap, temporoparietal fascia flap

Question 42

What is the Mathes-Nahai type for the radial forearm flap?

Answer 42

Type B

Question 43

what is the pedicle(s) for the lateral arm fasciocutaneous flap?

Answer 43

dominant pedicle: posterior radial collateral artery