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DERMATOLOGY Premade cards > Surgery > Flashcards

Surgery Flashcards

(117 cards)

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1
Q

What nerves innervate the conchal bowl?

A

CNVII, IX, X

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2
Q

A ring block around the entire ear will numb the whole thing except:

A

concha AND external auditory canal

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3
Q

Innervation of the majority of the posterior ear

A

Greater auricular nerve

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4
Q

What nerve is damaged in Frey syndrome?

A

Auriculotemporal nerve (a branch of the mandibular nerve)

Frey syndrome is also called auriculotemporal nerve syndrome which is facial flushing, sweating in response to gustatory stimuli - usually and injury of the parotid nerve

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5
Q

What chemical does Botox prevent the release of?

A

Acetylcholine from the presynaptic terminal

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6
Q

Which part of the Botox protein binds to SNAP25? Heavy chain or light chain?

A

Light chain

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7
Q

What does the heavy chain of Botox do?

A

Binds to the axon terminal

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8
Q

SNAP25 is what type of protein?

A

A SNARE Protein

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9
Q

Which serotypes is SNAP/SNARE cleaved by? (A-E)

A

A & E

VS VAMP which is cleaved by B,D,F,G

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10
Q

Which type of neurotransmitter does Botox block - sympathetic or nonsympathetic?

A

Acetylcholine so it is sympathetic

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11
Q

Property of lasers in which the light waves travel in PHASE together

A

Coherence

Vs collimation which means the light waves travel in parallel. Together these two properties give a laser its ability to be precise

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12
Q

Property of lasers in which light waves travel in parallel to each other

A

Collimation

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13
Q

The emission of ONE well-defined wavelength, rather than a band or variety of wavelength

A

Monochromicity

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14
Q

What is the Fresnel reflectance property?

A

The property of skin that causes 4-7% of light to be reflected because of the difference in the refractive index of the stratum corneum and the Aires

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15
Q

What is the absorption coefficient in the skin? And what does it depend on

A

The absorption coefficient is the probability of a photon being ABSORBED (rather than reflected or scattered) by its target chromophore. And it depends on the CONCENTRATION OF CHROMOPHORES present

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16
Q

Name the three primary skin chromophores

A

Water, melanin, hemoglobin

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17
Q

Name the spectrum of light that melanin absorbs photons in?

A

Broadly across the visible and UV spectrum

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18
Q

Name the spectrum of light that hemoglobins absorb photons in?

A

UV, and specifically green, blue, and yellow regions

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19
Q

Name the spectrum of light that Water absorbs photons in?

A

Infrared spectrum

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20
Q

Name the spectrum of light that the chromophores absorb photons in:
Melanin
Hemoglobin
Water

A

Melanin - Broad UV, Visible light
Hemoglobin - UV, Green, Blue, Yellow
Water - Infrared

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21
Q

Name the wavelengths of the most deeply penetrating lasers

A

650-1200nm

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22
Q

What is the cut-off wavelength when a laser switches from being deep penetrating to superficial

A

1200nm

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23
Q

The least penetrating wavelengths are within which spectrum?

A

Far Infrared and far UV spectrums

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24
Q

Two most superficially penetrating lasers

A

Erbium Yag

CO2 laser

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25
Which type of collagen gets melted during laser therapy?
Type I collagen
26
Definition of thermal relaxation time
The time it takes a heated tissue to cool to HALF of its original temperature
27
What is the relationship between the size of a tissue and it's thermal relaxation time
Thermal relaxation time is equal to the square of the target dimension (in millimeters)
28
The optical pulse duration in photothermolyis is equal to what:
The Thermal relaxation time (TRT)
29
Name the two most common continuous wave lasers (vs pulsed)
Argon and NG:YAG
30
Peak absorption of oxyhemoglobin
577nm (within yellow spectrum)
31
Wavelength of PDL laser
560-600nm *b/c PDLs are used to treat vascular lesions, and oxyhemoglobin's peak absorption spectrum is 577nm
32
Deepest penetrating laser and its absorption wavelength
Nd:YAG 1064nm
33
Wavelength of PDL laser
560-600nm
34
Wavelength of Nd:YAG laser
1064nm (deepest penetrating laser, good for dermal vessels)*
35
Wavelength of Alexandrite laser
755nm
36
Best kind of lasers for treating pigmented lesions and tattoos
Q switched lasers (like Q-switched Ruby and Alexandrite)
37
Q-switched ruby & Alexandrite lasers are useful for removing what kind of lesions?
Pigmented nevi & black/green tattoo pigment
38
Deep black tattoos and dermal melanocytic nevi (like Nevus of Ota) are best treated with which laser?
Q switched Nd:YAG
39
Q switched Nd:YAG laser is used to treat what
Deep black tattoos (Dermal involvement) & Dermal melanocytosis (like Nevus of Ota) *b/c Nd:YAG laser is 1064nm, the deepest penetrating, down to dermis
40
Which laser creates thousands of micro thermal treatment zones in the epidermis and dermis
Fraxel (fractional photothermolysis)
41
How does Fraxel work?
Creates thousands of microthermal treatment zones
42
Highest risk of blindness with which kind of lasers
Near-Infrared Q-switched lasers
43
What kind of media is a PDL laser?
Liquid media (rhodamine dye)
44
Name two lasers with Gas media?
``` CO2 laser Xenon chloride (excimer laser) ```
45
To achieve selective photothermolyis, do you want your pulse duration to be less than or greater than your thermal relaxation time (TRTs)?
You want you pulse duration to be LESS THAN your TRT
46
Continuous laser is low or high power?
Continuous laser is low power, pulsed laser is high power
47
Name some examples of continuous wave lasers
CO2, argon
48
Which types of lasers have the shortest TRTs (thermal relaxation times)
Q-switched lasers
49
What percentage of light is reflected off the skin? (As opposed to absorbed or scattered)
4-7%
50
How do you decrease the amount of scatter and therefor increase the amount of absorption in your laser treatment?
Increase the spot size
51
How is epidermal damage minimized during laser treatment?
Skin cooling
52
Parallel cooling is only effective in lasers with a pulse duration greater than what time?
>5ms
53
Lasers in the UV range (ex: excimer) cause damage to what part of the eye?
Lens, causes cataracts
54
What is essentially the only laser in the UV range?
Excimer laser 308nm
55
Lasers that target melanin or hemoglobin (visible light and/near infrared) damage what part of the eye?
Retina (highly pigmented), uvea and iris
56
What is the difference between monochromicity and coherence?
Monochromicity is light that is all ONE wavelength | Coherence is the property of all the wavelengths traveling in PHASE together
57
Any laser that targets water can cause damage to what part of the eye
Cornea/sclera
58
Greatest fire hazard for which lasers
CO2 & Erbium:Yag
59
Pulse width is the same thing as
Pulse duration
60
How can you increase the depth of penetration
Increase the spot size (this will decrease the scatter somehow)
61
Least penetrating wavelengths
Far UV and far IR
62
What happens if the pulse duration is greater that the TRT?
Undesired damage of surrounding tissues
63
What is the primary mechanism of vessel rupture with PDL
CAVATATION
64
Which have the smallest thermal relaxation times and therefore need the shortest Pulse duration times/pulse width: Tattoo ink/melanosome Vessels Hair follicles
Tattoo ink and melanosome for pigmented nevi
65
What part of the eye does PDL damage?
The retina (bc it targets oxyhemoglobin and melanin, and the retina has a high melanin concentration)
66
Laser treatment of choice of Poikiloderma of Civatte
IPL
67
What is the treatment of choice for leg veins?
Long pulsed Nd:YAG laser (because it penetrates deeper)
68
Treatment of choice for erythrotelangiectatic rosacea
IPL or long pulse Nd:YAG
69
What is the target for laser hair removal
Melanin in the hair shaft (bulb and bulbar stem cells)
70
Most efficacious laser to use for laser hair removal
Diode (but comes with a greater risk of post inflammatory hyperpigmentenation in aa persons)
71
Best laser to use for hair removal in darker skin types
Nd:Yag 1064nm (but this is not the most efficacious, Diode laser is)
72
Resurfacing lasers target what chromophore
Water
73
Site of eye damage in resurfacing lasers
Cornea/sclera (because the target chromophore is water)
74
What is the desired immediate endpoint of tattoo removal and what is it due to?
Immediate tattoo whitening, and this is accomplished by CAVITATION (the same concept as ablative blood vessels)
75
What kind of laser do you want to use for tattoo removal? (Long wavelength, continuous, pulse-dyed, Q-switched)
Q-switched - because you need the short pulsed powerful one
76
Which two lasers are the only ones that can treat green tattoos
Ruby and alexandrite
77
Which three lasers treat the three B's of tattoos?
Ruby, Alexandrite, and Nd:YAG treat the three B's (black, brown, blue)
78
Which type of laser can treat Yellow, white, red or violet
Nd:YAG
79
Nd:YAG cannot treat what color of tattoo?
Green
80
Name some examples of ablative lasers & non ablative lasers
Ablative- Er:YAG, CO2 Nonablative- PDL, Nd:YAG, Diode, IPL
81
Psoriasis can be treated with what kind of laser?
Excimer laser (308 nm) makes sense bc nbUVB is 311-312
82
Depth of Excimer laser
308
83
Depth of Argon laser
500nm (488-514nm)
84
KTP laser
532nm
85
PDL wavelength
585-600nm
86
Ruby laser wavelength
694nm
87
Alexandrite wavelength
755nm
88
Diode laser wavelength
800nm
89
Nd:YAG wavelength
1064nm
90
Erbium:Gas wavelength
1540nm
91
Erbium:YAG wavelength
2940nm
92
CO2 laser wavelength
10,600nm
93
Brand Name for Poly-L-lactic acid filler
Sculptra
94
What type of material is Sculptra
Poly-L-Lactic acid filler
95
Zyderm is what kind of filler material
Bovine collagen
96
Polymethyl-methacrylate beads and bovine collagen combine to make what kind of filler?
Artefill (permanent filler)
97
Permanent filler is made of what kind of material?
Poly-methyl-mecacrylate (ArteFill)
98
Zyplast is what kind of filler?
Bovine collagen
99
Radiesse is what kind of filler?
Calcium hydroxyapatite
100
What area of the face runs the highest risk of injection necrosis
Glabellar region
101
Highest risk for anaphylaxis with which filler?
Bovine collagen (Zyplast, Zyderm)
102
Which filler can you see on X-ray films?
Radiesse (Calcium hydroxyapetite) it is radio-opaque*
103
Used in HIV lipoatrophy
Sculptra (Poly-L-lactic acid)
104
What property of HA fillers increases the durability of the structure?
of crosslinks
105
Name the brand name for each filler substance: Poly-L-lactic acid Calcium-hydroxyapetite Bovine collagen Polymethyl-methacrylate and bovine collagen Hyaluronic Acid
``` Poly-L-lactic acid: Sculptra Calcium hydroxyapetite: Radiesse Bovine collagen: Zyderm/Zyplast PMMA/Collagen: Aretfill Hyaluronic Acid: Juvederm, Restylene ```
106
``` Name the substance found in each filler: Sculptra Radiesse Zyderm/Zyplast Artefill Juvederm/Restylene ```
``` Sculptra: Poly-L-lactic acid Radiesse: Calcium-hydroxyapetite Zyderm/Zyplast: Bovine Collagen Artefill: Polymethylmethacrylate/collagen Juvederm/Restylene: Hyaluronic acid ```
107
Superficial vein causing varicose veins
Small and great saphenous vein *vs femoral and politeal veins which are deep veins
108
What is the temperature required to destroy keratinocytes (with LN2) How about melanocytes?
- 40 to -50C to kill keratinocytes | - 5C to kill melanocytes
109
Laser of choice for facial telangiectasias
KTP OR PDL *KTP more for spider telangiectasias?
110
Eye damage with IPL
Retina, iris, uvea
111
What are the components of Jessners
JESSER IS A LESR Lactic acid Ethanol Salycilic acid Resorcital
112
What angle do they place the follicular units during hair transplant?
30-45 degree angles
113
How many hairs is in one follicular unit
4-5
114
What treatment do you give pregnant women for treatment of: RMSF Lyme disease
RMSF: Chloramphenicol | Lyme disease: Amoxicillin
115
Which branch of the trigeminal nerve (V) has both sensory and motor functions?
V3 (Mandibular branch) does motor to muscles of mastication and sensory to the lower face
116
Boiling point for liquid nitrogen
-196 degrees Celsius
117
What artery supplies the paramedian forehead flap?
Supratrochlear

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