SUR 105 - Test 2

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Author:
jb124
ID:
199264
Filename:
SUR 105 - Test 2
Updated:
2013-02-10 14:17:57
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Plastic Reconstructive Surgery
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Description:
Plastic/Reconstructive Surgery
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  1. primary goal of plastic and reconstructive treatment
    restoration of form and function
  2. performed to improve appearance but does not address function (cosmetic surgery)
    aesthetic surgery
  3. basis of plastic surgery
    fulfill fundamental need for social acceptability
  4. vital functions of skin/integumentary system
    • protects underlying tissues and organs
    • excretes organic waste and stores nutrients
    • excretes water and dissipates heat for thermoregulation
    • its sensory organs transmit touch, pressure, pain, and temp
  5. outer layer of skin
    epidermis
  6. primary tissue cells of epidermis
    keratinocytes
  7. 5 epidermal layers
    • stratum corneum
    • stratum lucidum
    • stratum granulosum
    • stratum spinosum
    • stratum germinativum (stratum basale)
  8. most superficial epidermal layer - transparent and composed of dead keratinocytes filled with keratin
    stratum corneum
  9. extremely thin epidermal layer - may not be found on thin skin regionsĀ 
    stratum lucidum
  10. thick epidermal layer that produces keratin
    stratum granulosum
  11. epidermal layer that contains undifferentiated cells that become specialized as they migrate to skin surface
    stratum spinosum
  12. deepest epidermal layer - its cells undergo mitosis - contains melanocytes (produce melanin)
    stratum germinativum
  13. function of dermis layer
    provides nourishment and enervation to the epidermis
  14. what are blood vessels of dermis responsible for?
    oxygenation of tissue and thermoregulation
  15. skin layer that contains numerous sensory receptors for pain, touch, heat, cold, and pressure
    dermis
  16. examples of skin appendages
    • hair
    • sweat
    • oil glands
  17. what does a hair follicle consist of?
    • hair
    • sebaceous gland
    • muscle
    • sometimes apocrine gland
  18. visible portion of hair
    hair shaft
  19. hair muscle
    erector pili muscle - aids thermoregulation by producing goose bumps
  20. 2 types of sweat glands
    • apocrine - located in axilla and groin
    • eccrine - secrete sweat over body surface through small tubules
  21. what is sebum?
    combination of wax, lipids, cholesterol, triglycerides
  22. soft tissues of the face
    • skin
    • fat
    • muscle
    • fascia
    • ligaments
  23. tissue plane that separates the subcu tissue into deep and superficial layers
    superficial musculoaponeurotic system (SMAS)
  24. fat is densest in which regions of the face?
    cheek and neck regions
  25. defect of palate
    cleft palate
  26. defect of lip
    cleft lip
  27. when is surgical treatment for cleft lip performed?
    at 10 to 12 weeks for initial repair
  28. most common type of skin cancer
    basal cell carcinoma
  29. second most common skin cancer
    squamous cell carcinoma
  30. rarest of skin cancers but accounts for most fatalities from skin cancer
    melanoma
  31. burn involving epidermis only
    first-degree (partial-thickness burn)
  32. burn involving both epidermis and dermis
    second-degree (partial-thickness burn)
  33. burn causing permanent damage to skin and underlying tissues
    third-degree (full-thickness burn)
  34. solution commonly used for face preps
    pHisoHex
  35. what are graft sites prepped with?
    nonstaining solutions
  36. what instruments is sharp dissection performed with?
    tenotomy or fine metz scissors and toothed tissue forceps
  37. with what is a large split-thickness graft removed?
    dermatome
  38. dermatome set includes:
    • blade guards
    • screwdriver
    • disposable blade
  39. most commonly used mechanical dermatome
    Brown
  40. used less often than other types of dermatomes
    drum dermatome (Reese and Padgett)
  41. used to remove full-thickness skin graft
    graft knife
  42. split-thickness graft modified by what?
    graft mesher
  43. purpose of aeration of skin graft by the graft mesher
    • prevent blood and serum from accumulating under the graft during healing
    • allows graft to stretch, increasing surface area and providing precise fit
  44. techniques for which pneumatic power drill is used
    • model bone tissue with rotating burr or cutter
    • create anchor holes for wire or screws
    • cut through bone with oscillating saw blade
  45. Endobrow instruments include:
    • 4- or 5-mm endoscope in 0- and 30-degree angles
    • cannulas
    • periosteal elevators
    • blunt and sharp dissection instruments
  46. what is CO2 laser used for?
    facial resurfacing procedures
  47. objective of stenting
    to apply pressure over graft site to prevent accumulation of serum or blood between graft and recipient site
  48. augment
    build up tissue
  49. 2 fundamental types of grafts
    • biological
    • synthetic
  50. biosynthetic grafting material
    absorbed by body or enhances healing, but not derived from biological tissue
  51. graft transferred from one individual to another
    allograft (homograft)
  52. commonly used allografts
    skin, bone, cartilage
  53. biological graft taken from one area of body and transplanted to another area in the same patient
    autograft
  54. commonly used autografts
    skin, bone, cartilage, fat
  55. biological graft consisting of more than one tissue type
    composite graft
  56. graft that contains only dermis
    split-thickness (partial-thickness) (STSG)
  57. graft that contains dermis and epidermis
    full-thickness (FTSG)
  58. graft made of tissue taken from one species that is grafted into another species
    xenograft
  59. synthetic, natural, or biosynthetic substance used to fill in or replace an anatomical structure
    implant
  60. silicone implants used for what types of purposes?
    breasts, cheek, chin
  61. polyethylene implants
    porous, cause little inflammatory reaction, remain stable, but difficult to sculpt and can damage tissue when removed
  62. when/where are Gore-Tex implants used?
    • cardiovascular procedures
    • facial augmentation
  63. removing diseased, damaged, or infected tissue
    debridement
  64. enzymes are used to dissolve tissue - impregnated into wound dressings
    chemical debridement
  65. tissue removed using sharp dissection with surgical instruments
    surgical debridement
  66. debridement performed using fine jet spray of saline - used most commonly in burn and trauma patients
    pressurized saline debridement
  67. how is soft tissue remodeled?
    sculpted by sharp and blunt dissection or with laser
  68. how is dense connective tissue remodeled?
    sculpted with a variety of drills and bone cutters
  69. positioning for excision of superficial lesions
    • prone for lesions of back and buttocks
    • lateral for lesions of hip and shoulder
    • supine for facial or limb procedures
  70. if surgical wound can be closed by primary intention, what anesthetic is used?
    local
  71. how is skin lesion removed and cut during Mohs surgery?
    cut into quadrants before frozen section, which are used to map the tumor and determine exact location of malignant margins
  72. purpose of scar revision
    to remodel a previous scar or remove keloid
  73. scar that develops excess tissue and may be red or raised
    hypertrophic scar
  74. healing time of hypertrophic scar
    generally heals after 6 months and may resolve over a period of years
  75. scar that forms at wound site and may become bulbous and unsightly, and can invade nearby tissue
    keloid scars
  76. what does skin from first-degree burn look like?
    red or pink, dry, and painful to touch
  77. what does skin from partial-thickness second-degree burn look like?
    • blistered, red, and moist
    • very sensitive to environmental exposure and touch
  78. what does skin from full-thickness second-degree burn look like?
    white, smooth, shiny surface with dry blisters and edema
  79. what does skin from third-degree burn look like?
    • white, brown, or black, and appears waxy
    • no pain
  80. devitalized, nonelastic tissue that adheres to wound site
    eschar
  81. what are lap sponges soaked in for debridement of burns?
    sterile saline and topical epinephrine
  82. desiccation
    drying
  83. what is applied to graft site to reduce friction as the blade glides over the skin?
    mineral oil
  84. purpose of pedicle graft
    provide coverage and vascularization to soft tissue defect
  85. graft that is raised from the donor site but not immediately severed free
    pedicle graft (flap graft)
  86. types of pedicle grafts
    • near
    • distant
  87. advancement flap
    raised from tissues in immediate area of the defect
  88. rotational flap
    semicircular and require some degree of turning to reach and cover recipient defect
  89. resection of the eyelid
    blepharoplasty
  90. drooping of anatomical structure
    ptosis
  91. brow lift approaches
    • coronal
    • pretrichial
    • direct
  92. coronal approach
    behind hairline
  93. pretrichial approach
    at the hair line
  94. direct approach
    at the level of the brow itself
  95. redundant and sagging supportive tissue of the face reduced or modified
    rhytidectomy
  96. what does laser skin resurfacing do?
    removes epidermis and portion of the dermis to reduce facial lines and wrinkles
  97. after entire face has been resurfaced, what is applied?
    hydrodressing
  98. chin augmentation
    mentoplasty
  99. cheek augmentation
    malar augmentation
  100. malar augmentation incision
    intraorally below the parotid duct
  101. surgical creation of external ear
    otoplasty
  102. what is used to recreate the antihelix on the anterior surface of the ear?
    Keith needles
  103. increasing size and improving shape of breast
    augmentation mammoplasty
  104. implants used for an elective procedure on intact breast
    round implant
  105. in postmastectomy reconstruction, where is pocket created for implant?
    musculofascial tissue of the pectoralis major
  106. in postmastectomy reconstruction, what is inserted into the pocket?
    tissue expander with saline reservoir
  107. amount of saline used to fill reservoir
    150 to 300 mL
  108. excess breast tissue removed and breast reconstructed
    reduction mammoplasty
  109. excessively large breasts
    macromastia
  110. macromastia in males
    gynecomastia
  111. tissue flap containing skin, subcutaneous tissue and muscle is raised from lower abdomen and transferred to mastectomy site
    TRAM flap
  112. why is TRAM flap performed?
    to reconstruct breast without use of implants
  113. in nipple reconstruction, areola is constructed from?
    full-thickness graft taken from medial thigh crease
  114. in nipple reconstruction, nipple is created with?
    full-thickness skin graft taken from labia
  115. performed to remove excess deep fat
    liposuction
  116. tubing required for liposuction
    large-bore tubing with high-vacuum apparatus
  117. performed to remove excess skin and adipose tissue from abdominal wall
    panniculectomy (abdominoplasty)

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