Osler Day 1 - Plastic Surgery "Quiz" FINAL

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1.

2.

1st branchial arch gives

rise to... (8)

2nd arch gives rise to... (6)

auricle
Meckel's cartilage,
Reichert's cartilage,
the malleus, the incus,
the mandible,
sphenomandibular ligament
anterior three hillocks
auricle,
stapes,
styloid process,
stylohyoid ligament,
lesser cornu of the hyoid, and
upper part of the hyoid body

3.

3rd arch gives rise to

greater cornu of the hyoid and

lower part of the hyoid body

4.

4th-5th-6th arches

thyroid, arytenoid,
corniculate, and cuneiform
cartilages

5.

6.

5-6 feet pictures of body lens?

50-55mm lens

11.

12.

13.

14.

15.

16.

Aplasia cutis
congenital

<2cm diameter scalp defect usually

midline vertex, maybe associated with
scull defect and/or dura/brain exposed;
treat with dressing changes

Area of
ANTERIOR
septum where
vessels converge
=?

Little's area

Artery
undermined in
facelift supplying
preauricular
skin

Transverse facial artery

blepharochalasis
syndrome

Recurrent episodes of edema of the eyelids

without associated pain or erythema.

Blue and green?

Alexandrite q-switched (BGreen = BC =

old = Alexander the Great)

Branchial pouch
vs groove/cleft?

6 hillocks origin and

destination?
Branchial arches, brancial pouches
(inside) and/or pharyngeal grooves
(outside)
17.

Branchial pouch
vs groove/cleft?

First 3 hillocks = from 1st

pharyngeal arch. Last 3
hillocks (posterior) from 2nd
arch.
1st tragus
2nd helical crus/root
3rd superior helix
4th/5th antihelix
6th antitragus.
7.

8.

9.
10.

I-IV branchial arches, 1-4 brancial

pouches (inside) and/or pharyngeal
grooves (outside); c= foramen cecum;
d=thyroglossal duct; e = sinus cervicalis

585nm

KTP - tunable dye laser

Targets oxyhemoglobin - port
wine and telangiectasias

Absent breast
parenchyma?

Amazia; still NAC. (Amastia

both missing).

18.

Absent NAC?

Athelia

19.

After facelift ___ months

til phenol peel? Regional
peeling can be done when?

3 months; perioral at same

time
20.

Cap contr worse

with ...

worse with silicone (actually same now),

submamm, smooth (now not necessarily)

Degrees of
levator function
with mm?

Normal 12-15mm
Good 8-12
Fair 5-7
Poor 2-4

Ear mm
protrusion
normal?

10-12mm helical apex

16-18mm midpoint
20-22mm lobule

Excessive tearing = ? =
not uncommon after
bleph; treat with
reassurance

Epiphora

22.

Face pre/post pics lens?

90-105 lens

23.

First groove gives rise to

External auditory meatus

(between 1st and 2nd arch)

Fitzpatrick 1-3 have

increased risk of what
complication after
phenol peel?

Hyperpigmentation

Frontosinus drains
into...

middle meatus... as well as

High wavelength,
absorbed by water

CO2, 10600nm

How does tretinoin

cause antiaging?

1. initiation of papillary (Type

III) collagen synthesis in the
dermis, 2. formation of blood
vessels, 3. increased
glycosaminoglycan deposition,
and 4. exfoliation of retained
stratum corneum.

21.

24.

25.

26.

27.

28.

29.

30.

31.

32.

33.

34.

36.

37.

38.

39.

40.

Ideal location of medial

canthus

Halfway from pupil to center of

nasal bridge

In prominent ear,
scaphoconchal angle?
Cephaloauricular angle
in men and women?
Concha usually larger
than ___ mm?

>90 degrees
>25 in men, >21 in women
1.5cm

Inferior meatus
receives?
Middle meatus?
Superior meatus?
Other site?

-NL duct
-Frontal sinus, max sinus, ant
ethmoids
-posterior ethmoidal air cells
-sphenoid sinus into
sphenoethmoid recess

Lateral orbital wall (2)

Greater wing sphenoid

Zygomatic

Lateral walls nasal cavity

innerv?

Sphenopalatine ganglion and

posterior nasal nerve
(Posterolateral walls is internal
br of nasocilliary)

Lesser occipital nerve

sensation to the superior aspect

of the auricle along the cranial
surface and superior surfaces of
the external auditory canal
(posterior canal AurTemp
nerve)

Levator
shortening/advancement
expected advancement?

35.

41.

42.

43.

44.

1-2mm

45.

46.
47.

48.

49.

50.

Lobule, lower 1/2 of

lateral, posterior
auricle innervation?

Great auricular (C2,3)

Mental nerve tooth

landmark

2nd premolar

Nasal pit is
characteristic finding
of what mass?

Dermoid cyst?

Nasolacrimal duct
drains into...

inf meatus

Neck lipo best in ... (4)

Young pt
Elastic skin
>2cm pinch
Supraplatysmal fat

Non compressible
mass that doesn't
transilluminate?

Glioma. Often has overlying

telangiectasia

Normal ear mm
height? Helical rim is
what %?

55-60mm; 2x width
10% of height (<7mm)

Normal internal valve

angle?

10-15 degrees

Orbital bones

Ethmoid
Frontal
Lacrimal
Maxillary
Palatine
Sphenoid (gr and lesser wings)
Zygomatic

Parotid duct
landmark

2nd maxillary molar

Peak plasma how

many hours after
infiltration for
tumescent?
Dose max?

12 hours
35mg/kg

Posterior 3 hillocks

antihelix, antitragus

Posterolateral walls of
nasal cavity innerv?

Internal br of nasocilliary nerve

(lateral walls is sphenopalatine
ganglion and posterior nasal
nerve)

Ptosis grading (3)

Mild 1-2mm below normal

Moderate 3mm
Severe 4mm

Purple tatoos
removal?

rUby q-switched
May darken/"rust" if Fe in dye

Relatively shallow
laser, use for port
wine and other?

Pulsed-dye laser

51.

52.

53.

54.

55.

56.

57.

58.

59.

60.

61.

62.

63.

64.

65.

Remove black/blue?
Green/blue?

Q-switched Nd:YAG at
1064nm
...at 532nM or Q-switched
Alexandrite

Repair for mild ptosis if

instillation of 2.5%
phenlyephrine corrects lid
to normal (5mm)?
Consists of?

Mullerectomy (Fasanella
Servat).
transconjunctival resection
of a portion of the tarsus,
conjunctiva, and Mueller's
muscle

Repair used for moderate

ptosis and good levator
function? Expected
advancement?

Levator
shortening/advancement

Repair used for severe

ptosis (4mm) with absent
levator function?

Frontalis sling

Rippling worse
saline/silicone,
subpec/subgland,
texture/smooth

Saline, submamm, texture

Septum inferior
innervation

Nasopalatine (anterior
ethmoid nerve superiorly)

Skin upper 1/3 at radix innerv

supraorbital (infratroch does

superolat external nose)

Sphenoid sinus drains

where?

sphenoethmoid recess; above

and behind superior concha

Stop isotretinoin how long

before skin resurfacing?
How do you know skin is
ready?

24 months
patient should be examined
for the presence of skin
oiliness which indicates that
the dermal appendages have
recovered

Superior septum arterial

supply? Posterior septum?

Ant/post ethmoid arteries

Sphenopalatine posterior
septum (despite
sphenopalatine ganlion and
posterior nasal nerve doing
lateral walls)

Tretinoin increases which protein?

Does what to epidermis?

Type III
(Embryonic)
collagen.
Epidermis thickens
and exhibits
hyperplasia.

Unilateral hypoplasia breast or

absence of breast, with deformities
of chest wall, overlying muscles, and
upper extremity. All missing ___ of
___ on affected side.

Sternal head of pec

major

Upper lateral surface of ear

innervation?

Auriculotemp; also
get within posterior
wall of canal
(superior canal =
lesser occip)

Vessel injury in area most common

epistaxis?

Anterior ethmoid

Wait __ years before undergoing

skin resurfacing after stopping
isotretinoin?

What forms angle of internal nasal

valve?

formed between the

caudal end of the
upper lateral
cartilage and the
septum

What med given with tretinoin to

maximize effect?

Alpha-hydroxy
acids

73.

What neutralizes TCA peel?

Dermis/water

74.

Wolff's Law

Law stating that

stress is necessary
for preservation of
strength and
volume in grafted
bone

Z-plasty incr length? (5 degree with

% change)

30 degree 25%
45 degree 50%
60 degree 75%
75 degree 100%
90 degrees gives
120%

66.

67.

68.

69.

70.

Superior septum
innervation

ant ethmoid (nasopalatine

inferiorly); external br of ant
eth gets lobule

Superolat ext nose; upper

1/3 of nose at radix?

Infratrochlear; supraorbital n.

Surgical correction of
blepharophimosis
syndrome

Repair epicanthal folds

Correct ptosis

Suture thigh fascia to this

in thighplasty?

Colles fascia

Tip nose innervation

ext br ant eth (...think ...

superior septum is anterior
ethmoid)

71.

72.

75.