Chapter 19 - Plastic and Recontructive Surgery

Replantation of a digit begins with the attachment of which structure(s)?

Bone.

How is the recepient site prepared prior to placement of an STSG? Why?

By debritment. To prepare the wound bed to accept the graft.

Radial hypoplasia

Club hand, congenital, failure of the radium to develop

What is the common name for the umbilical template used during abdominoplasty? What is its purpose?

Cookie cutter, It makes a perfect circle for the umbilicous

What is the cause of cheiloschisis and palatoschisis.

Disruption in normal fetal development.

What is the purpose of a mesh graft device?

Expand the size of the skin that has been procured.

In utero, the development of the lip and palate is complete by the _____.

First trimester of intrauterine life.

What is the most common type of polydactyly?

Fith-finger duplications.

What anatomic area is prepped prior to draping for hand surgery?

For surgery that involves the fingers, hand or wrist, the patient should be instructed to cut the nails short, thoroughly clean the subungual areas during the preoperative bath or shower, remove artificial nails and nail polish.

Only 20% of cleft deformities are genetic. What is/are the cause(s) of the remaining 80%?

Maternal age, environmental factors as; cigarette smoking, drug and alcohol abuse, infection, and vitamin deficiencies.

MPJ

Metcarpophalangeal joint; a synovial hinge type joint consisting of a metacarpal that articulates with a phalange. AKA a knuckle.

Name the structures that are contained in the anterior (palmar) compartment of the hand.

Nine flexor tendons and the median nerve.

Rhinoplasty

surgical repair of the nose

Sebum

the oily secretion of the sebaceous glands

Xenograft

tissue from an animal of one species used as a temporary graft (as in cases of severe burns) on an individual of another species

What is the function of the palate?

To separate the nose from the mouth, this aids in swallowing and speech.

What causes the formation of a ganglion cyst?

Trauma or tissue degeneration.

Syndactyly

birth defect in which there is partial or total webbing connecting two or more fingers or toes

Synthesis

combining parts or separate things into a whole; the whole so formed; PL. syntheses; V. synthesize

Aesthetic

concerning or characterized by an appreciation of beauty or good taste

Which tissue layer(s) is/are affected by a second degree burn?

epidermis and dermis

Gynecomastia

excessive development of the breasts in males

Figure 19-3

http://www.delmarlearning.com/companions/content/1418051683/student/study_guide/Figure19-03.jpg

Cheilo

lip

Poly-

many

Integumentary

of or relating to the integument

Elliptical

rounded like an egg

Carpal tunnel

space between carpal bones and flexor retinaculum

Schisis

split, fissure

Sweat glands are also known as the _____ glands.

sudoriferous

Arthrodesis

surgical fixation of a joint

Define neoplasm. Is a neoplasm malignant?

tissue that grows more rapidly than normal and continues to grow even after the stimuli that initiated the growth cease, and that serves no useful function. May or may not be malignant.

Ganglion cyst

tumor of tendon sheath or joint capsule, commonly found in the wrist

Use the rule of Nines to determine the percentage of the body surface area affected by a third-degree burn of the chest, back and left arm.

40.5 %

Describe the difference between the nasal and rhinoplasty instrumentation.

A rhinopladty set just contains instruments used in reshaping the nose.

What is a ganglion cyst?

A tumor of tendon sheath or joint capsule, commonly found in the wrist.

Provide two indications for joint replacement in the hand.

A. Correct the deformities B. Reduce the pain caused by rheumatoid arthritis.

List four incision options for augmentation mammoplasty that produce a minimal or completely?

A.Tunneling device (if necessary) B. Temporary inplant sizers (if necessary) C. Permanent implants D. Syringes and solution to fill implants

Name the three functions of the subcutaneous tissue layer.

Anchors the skin to the underlying structures, provides insulation and protection to the internal organs.

Name three treatment options for a ganglion cyst.

Aspiration of the fluid from the cyst. Surgical removal. Spontaneously resolved.

How is sterile mineral oil used used during procurement of an STSG?

Place on the skin over the deratone and traction is used by the STSR

What is the advantage of tumescent liposuction over the traditional method?

Presence of the local anesthetic may allow the patient to be awake with mild sedation rather than under general anesthesia and may provide some immediate postoperative pain control. The vasoconstrictive properties of the epinephrine provide introperative hemostasis. The mixture also helps to liquefy the fat, making suctioning easier.

Neme the secretion that is produced in the sebaceous glands. What is the purpose of the secretion?

Sebum, helps with fluids regulation and also acts to keep the skin and hair soft and pliable.

STSG

Split Thickness Skin Graft; Involves the epidermis and approximately half of the dermis.

Replantation

The replacement of an organ or other structure to the site from which it was previously lost or removed; also known as reimplantation.

Why is palatoplasty considered a clean, rather than sterile, procedure?

This is considered a clean, rather than a sterile procedure because the aerodigestive tract is entered.

Why is the extremity wrapped with an Esmarch bandage prior to tourniquet inflation?

To drain blood from extremity.

What is the purpose of a tacking suture used during a rhytidectomy?

To hold the skin in place until the desired level of tension is achieved.

What is the cause of rheumatoid arthritis (RA)?

Unknown but a viral or bacteria protein is suspected.

What is the purpose/function of a dermatone?

Used to cut thin slices of skin for grafting.

What is the cause of ptosis of the eyelid?

Weaknes or paralysis of the levator oculi.

Cleft

a long narrow opening

Dermatome

a surgical instrument used to cut very thin slices of skin

Name the bacteria that are the main causative agents of acne vulgaris.

a. Corynebacterium acnes b. Staphylococcus albus c. Pityrosporon ovale

Name two diseases of the hand that are caused by stenosing tenosynovitis.

a. De Quervain's Disease b. Trigger Finger

List two possible sources for the oscillating-blade-type dermatome.

a. Electricity b. Nitrogen

Name and briefly describe the three types of sudoriferous glands.

a. Merocrine sweat glands - coiled tubular glands that discharge their secretions directly onto the surface of the skin. More numerous than apocrine glands. sweat produced here is 99% water, alos contains electrolytes, organic nutrients, and waste. b. Apocrine sweat glands - larger than merocrine glands, limited to the axillae & external genitalia where they open up into hair follicles. Activated in response to pain, emotional stress & sexual arousal. c. Ceruminous gland - a gland in the ear canal that produces cerumen or ear wax.

List three manifestations of palmar fascia contraction (Dupuytren's disease).

a. Nonpainful nodule in the palm of the hand near the forth or fith digit. b. Dimpling or pit in the same locations. c. Longitudinal fibrous band or cord extending from the palm toward the fingers.

Name the two divitions of the dermis, and briefly describe them.

a. Reticular layer - thick deep layer that provides collagen for strength and elastin for pliability of the skin. b. Papillary layer - named for its papilla, or projections, which are the groundwork for fingerprints.

Give three examples of common malignant neoplasms of the skin.

a. basal cell carcinoma b. Squamos cell carcinoma c. melanoma

Name two major layers of the integumentary system.

a. epidermis b. dermis

List the major functions of the skin

a. protection from extrinsic forces, such as ultraviolet rays b. defense against disease c. preservation of fluid balance d. body temperature maintenance e. excretion of waste via sweat f. Sensory imput through receptors for temperature, pain, touch, and presure

Name the five layers of the epidermis in sequence from the outermost to the innermost layers

a. stratum corneum b. stratum lucidum c. stratum granulosum d. stratum spinosum e. stratum basale

Augmentation

an addition; the process of increasing