Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

735 > Plastics > Flashcards

Plastics Flashcards

(65 cards)

Start Studying
1
Q

Most frequently missed monitor in cosmetic procedure mishaps

A

Pulse oximetry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define medical error

A

Preventable adverse outcome that results from:

Improper management
Inadequate knowledge of underlying disease state

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Non-reimbursable conditions CMS

A

Retained object after surgery
Air emboli
Blood incompatibility
Pressure ulcers
Falls
CAUTI
Surgical site infection

Poor glycemic control**

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When do anesthesia related catastrophic events occur?

A

Maintenance
-not paying attention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

On average 78% of anesthesia deaths are related to what?

A

Human error

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Keratinocytes

A

Tough fibrous protein for protection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Melanocytes

A

Produce melanin which absorbs UV light

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Langerhans cells in the epidermis

A

Participate in immune system, allow recognition of invading microbes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Merkel cells

A

Detect touch sensation-are least numerous of the four cell types of epidermis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

3 layers of the skin and the cell types

A

Epidermis= keratinocytes, melanocytes, merkel cells, langerhans
Dermis
Subcutaneous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Full thickness skin graft

A

Epidermis, dermis and part of underlying fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Split thickness skin graft

A

Epidermis and some dermis

Typically harvested at 10/1000 of an inch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Zimmer tanner mesher

A

Uniformly punctures skin allowing for stretching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

3 steps of a skin graft

A

Imbibition

Inosculation

Revascularization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Imbibition

A

Occurs 48hrs after grafting and involves free absorption of nutrients into the graft

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Inosculation

A

Is the capillary ingrowth and linking of vessels between the graft and bed so that a blood supply is established

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Revascularization

A

Occurs when graft demonstrates both arterial inflow and venous outflow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Define skin flap and 3 classifications

A

Partially or completely isolated segment of tissue perfused with its own blood supply

• Fasciocutaneous:
• Musculocutaneous:
• Osteocutaneous:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Blood supply in skin flaps

A

• Random: has vessels
which nourish the tissue
and are smaller and less
defined

• Axial: tissue has an
anatomically defined
configuration of vessels
• Free: just like it sounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Are rectus sheath flaps ipsilateral or contralateral for breast surgery?

A

Contralateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Most common cause of flap failure in micro vascular surgery

A

Venous congestion**

Avoid fluid and communicate with surgeon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Common way to visualize tissue perfusion when grafting

A

Indocyanine green with spy system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

3 big considerations for anesthesia with flaps

A

Hypothermia- increases blood viscosity=venous congestion

Euvolemia

Blood loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Vasoconstrictors in flap surgery

A

Discuss goals and maintenance with surgeon!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Poiseuille equation
Flow through a tube! Only laminar flow Determined by: Radius Length Pressure difference Viscosity of fluid
26
Timeline for smoking cessation
8 hrs- vitals normalized 12 hrs- nicotine and CO levels drop One week-cilia begin to function
27
Smokers :(
Problems with wound healing Polycythemia=blood viscosity=venous congestion Cessation mandatory 3wks before and after
28
Mammoplasty vs mastopexy
Mammoplasty- augmentation or reduction Mastopexy- lifts breast on the chest wall
29
Silicone autoimmune issues with breast implants
The link has been disproved -current age guidelines: 22-silicone 18-saline
30
NAC-breast augmentation
nipple-areola complex (NAC) is innervated by the cutaneous branches of the intercostal nerves There is 15% incidence in altered NAC sensation 2 years postoperatively with direct correlation between implant size and the amount of sensory loss.
31
Anesthesia for breast implants
Frequent movement of table for symmetry check Arms at 90! Secure them LMAs Consider leg BP
32
Ulnar nerve injury plastics:
Common in breast implants • Cause: external nerve compression or stretch from mal-positioning or from incorrect flexion of the elbow. • Symptoms: inability to adduct the fifth finger with numbness and tingling, “claw hand” may also be seen. • How to prevent: supination of arm and use of padded arm boards
33
Common peroneal nerve injury
• Cause: Pressure from weight of the lower (downside) knee against the table or mattress pad in the lateral position. • Symptoms: Inability to dorsiflex the foot and loss of sensation over the dorsum of the foot (foot drop)
34
Purpose of tumescent and what it contains
Prolonged local effect Minimizes blood loss Lidocaine 0.05-0.5% Epi 1:1,000,000
35
Liposuction anesthetic considerations
Death happens when anesthesia is involved!! -otherwise 0 deaths -trying to take too much fat** Venous thrombus PE Pulm edema LAST
36
Lidocaine fun facts
 Anti-dysrhythmic  Local Anesthetic infiltrate of choice  Peripheral/regional anesthetic  Neuraxial anesthetic  Anti-tussive  Pain control (Lidocaine patches)  Reduces pain on Propofol injection  Main component in tumescent mixture
37
MOA of lidocaine
Blocks action potential VIA inhibition of voltage gated sodium channels disrupts the generation or propagation of an electrical nerve impulse, resulting in various degrees of sensation loss, decreased motor strength, and autonomic blockade along the nerve distribution
38
What increases lipid solubility of lidocaine and why does it have a relatively long duration of action?
Aromatic ring=lipid solubility Amide group stabilizes and prevents hydrolysis
39
Lidocaine: Metabolism Metabolite Excretion
CYP450 MEGX-monoethylglycinexylidide lol can cause seizures 10% excreted unchanged in urine
40
Plasma levels for toxicity of lidocaine
 3-5mcg/ml/kg: can illicit subjective signs of toxicity  5-10mcg/ml/kg: objective signs of toxicity occur
41
At what plasma level does cardiac arrest occur in lidocaine toxicity?
20mcg/ml/kg
42
What type of lidocaine do we use?
Methylparaben free -causes allergic reactions
43
What conditions will potentiate LAST** ***
Hypoxemia Hypercarbia Acidosis -Correct with 100% and hyperventilate
44
When using local injections two things you must do:
Monitor for signs of LAST Communicate with surgeon and calculate total safe doses for the patient
45
Explain lipid treatment for LAST
Give an intravenous bolus injection of Intralipid 20% 1.5ml/kg over 1 minute. Start an intravenous infusion of Intralipid 20% at 0.25 ml/kg/min
46
Abdominoplasty
surgical removal of loose, redundant abdominal skin and underlying subcutaneous fat, with repair of the rectus abdominal muscles as necessary.
47
Bleopharoplasty
the excision of a protrusion of supraorbital fat and resection of excessive skin of the eyelids.
48
Anesthesia considerations blepharoplasty
Pre and post visual acuity -watch for retrobulbar hematoma Oculocardiac reflex…somewhat dependent on skill of surgeon Usually MAC, May use electrocautery!!! Watch for FIREEEEEE
49
Rhinoplasty
surgical correction of the external appearance of the nose. Three steps may be done: 1. Tip remodeling (reduction or augmentation) 2. Hump removal 3. Narrowing of the nose.
50
Septoplasty
provides for surgical correction of any deformity of the nasal septum, the wall between the two nostrils.
51
Alarplasty
narrows the wide flaring and large opening of the nasal nostrils by wedge resection of the lateral nostrils with primary closure.
52
Septorhinoplasty
repairs the deviated septum in combination with a rhinoplasty.
53
Rhinoplasty considerations anesthesia!
Throat packs!! ETT Lotsa blood PONV Careful with O2 mask post op, no pressure on the nose!!
54
Anesthetic considerations for brow lift
Severe headache post op- with coronal approach Can injure supraorbital or supratrochlear nerve branches-permanent paresthesias
55
Rhytidectomy
Facelift PONV Increased risk for CVT Assess facial nerves preoperatively
56
Garlic and anesthesia
Inhibits platelet aggregation and increases INR
57
Ginkgo implications
Coagulopathy and enhances aspirins.nsaids, heparin
58
Ginseng
Hypertension/CNS stimulation
59
Echinacea-
decreases corticosteroid efficacy
60
Herbals with sedative properties
Kava: CNS depressant/sedative; potentiates barbiturates, benzodiazepines, and muscle relaxation; decreases the effect of L- dopa treatment. Valerian: CNS depressant; increases GABA levels. St. John's wort: inhibits serotonin reuptake (SSRI); leads to exaggerated blood pressure responses.
61
Herbals that prolong anesthesia
• Ephedra • Ginseng • Guarana • Licorice • St.John’s Wort • Yohimbe (Alpha2 blocker
62
Plastics recommendations for: Heparin Coumadin Plavix Aspirin NSAIDs Herbals
Heparin must be stopped at least 4 hours prior to surgery.  Coumadin must be stopped at least 48 hours prior to surgery.  Plavix must be stopped 5 days prior to surgery.  Aspirin must be stopped at least 6 days prior to surgery.  Often NSAIDS must be stopped one week before surgery, and  • All herbal supplements two weeks prior to surgery
63
what happens if we don’t remove intranasal packing?
Toxic shock
64
Ho often will facial trauma to the mandible also involve the C-spine?
10%
65
Caniomaxillofacial surgeries
Document throat packs Prepare for difficult intubation Do not extubate unless indicated

735 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions