911-920 MCQ in Facial Plastic and Reconstructive Surgery

911-920

911) Which of the following statements regarding the flap below is FALSE?

A. It is based on branches of the Internal Mamary Arterial System.
B. It is perfused predominately by the first Internal Mamary Artery.
C. 2/3 of the medial aspect is an Axial Flap, and the distal third is a Random Flap.
D. The Deltoid and Pectoralis fascias are included in the flap.
E. It is designed with a length/width ratio of 2.5:1 to be used without delay.

912) Which of the following represents THE BEST course of action after a deep puncture knife wound to Zone III of the neck with swelling and hematoma at the level of puncture entry? The patient is an hemodynamically stable 22 year old male?

A. Direct laryngoscopy and Ba swallow
B. Chest and lateral neck X-rays
C. CT of neck and base of skull
D. Neck exploration
E. Angiography

913) Which of the following statements about maxillofacial fractures is FALSE?

A. LeFort I level fracture is more frequently encountered than the LeFort II.
B. LeFort II level fracture is more frequently encountered than the leFort III.
C. LeFort III is the least frequently encountered of the LeFort fractures.
D. All LeFort fractures may involve the Pterygoid Plates.
E. LeFort fractures are more commonly associated with intracranial injuries than ophthalmologic injuries.

914) Which of the following statements regarding Midforehead Browlift is FALSE?

A. It is a desirable procedure for the man with a receding hairline
B. No hairline distortion is produced and no undermining is performed above the incision
C. The browlift is always done prior to the upper lid blepharoplasty
D. The incisions on either side of the forehead should be always at the same level.
E. The Fusiform Skin Excision is centered over a natural rhytid and is widest over the lateral arching point of the brow.

915) Which of the following sutures is related "to sutures that cause a flap or edge of SMAS tissues to overlap deeper structures and even other SMAS elements" and are used in Face Lift Procedures?

A. Plicating Sutures
B. Imbricating Sutures
C. Suspending Sutures
D. Gilles Sutures
E. Purse String Sutures

916) Which of the following management is the BEST for an obstruction distal to the common canaliculus of the lacrimal drainage system?

A. External Dacryocystorhinostomy
B. Endoscopic Dacryocystorhinostomy
C. Conjunctivorhinostomy
D. Canalicular dilatation
E. Canalicular stenting

917) Which of the following dissection techniques regarding the hemicoronal and coronal flaps in the lateral region of the dissection should NOT be executed?

A. Dissection is done superficial to the superficial layer of the Deep Temporal Fascia.
B. Dissection with identification of the Superficial Temporal Fat and its covering Fascia.
C. Dissection in a subfascial plane over and lateral to the Superficial Fat Pad.
D. Dissection below to the deep layer of the Deep Temporal Fascia.
E. Dissection superiosteally after reaching the lateral orbital rim and zygoma

918) Which of the following IS RELATED to Composite Rhytidectomy?

A. Musculocutaneous flap containing both skin and Platysma Muscle
B. Musculocutaneous flap containing both Platysma Muscle and cheek fat
C. Musculocutaneous flap containing both Orbicularis Oculi and Oris
D. Musulocutaneous flap containing Orbicularis Oculi and cheek fat
E. Musculocutenous flap containing Orbicularis Oculi, cheek fat, and Platysma

919) The cause of pediatric fractures involving ONLY the mandible is most likely related to?

A. Altercations
B. Biking accidents
C. Child abuse
D. Fall accidents
E. Motor vehicle accidents

920) In performing a Composite Rhytidectomy the proper plane of dissection will be ON TOP of which of the following anatomical structures?

A. Cheek fat
B. Masseter Muscle
C. Orbicularis Oculi Muscle
D. Orbicularis Oris Muscle
E. Zygomatic Major and Minor Muscles


ANSWERS & REFERENCES


911) B     It is perfused predominately by the first Internal Mamary Artery.

Sessions D. G., Cummings C.W., Weymuller E. A.Jr , Makielski K. H., Wood P.: Atlas of Access & Reconstruction in Head & Neck Surgery, 1992, pp.230-232

Baker S. R.: Malignant Neoplasms of the Oral Cavity, Chapter 73 in Otolaryngology-Head and Neck Surgery, (Cummings, Fredrickson, Harker, Krause, Schuller, editors), Second Edition, 1993, pp. 1248-1305

912) E     Angiography

Stewart M. G.: Penetrating Face and Neck Trauma, in Chapter 68 in Head and Neck Surgery-Otolaryngology, Third Edition, (Bailey B. J., editor), 2001, pp.813-821

Stewart M. G.: Penetrating Face and Neck Trauma, in Chapter 72 in Head and Neck Surgery-Otolaryngology, Third Edition, (Bailey B. J., editor), 2006, pp. 1017-1026

913) A     LeFort I level fracture is more frequently encountered than the LeFort II.

Doerr T. D., Mathog R.H.: Le Fort Fractures (Maxillary Fractures), Chapter 71 in Facial and Reconstructive Surgery, (Papel I.D. editor), Second Edition, 2009, pp. 991-1000

Haug R. H., Greenberg A. M.: Etiology, Distribution and Classification of Fractures, Chapter 2 in Craniomaxillofacial Fractures, Principles of Internal Fixation Using the AO/ASIF Technique, (Greenberg A.M., editor), 1993, pp. 5-19

Haug R. H., Likavec M.J.: Etiology, Evaluation of the Craniomaxillofacial Trauma Patient, Chapter 3 in Craniomaxillofacial Fractures, Principles of Internal Fixation Using the AO/ASIF Technique, (Greenberg A.M., editor), 1993, pp. 21-40

914) D     The incisions on either side of the forehead should be always at the same level.

Cook T. A., Brownrigg P. J., Wang T.D., Quatela V. C.: The Versatile Midforehead Browlift, Arch. Otolaryngology-Head and Neck Surgery, Vol. 115, February 1989, pp. 163-168

915) B     Imbricating Sutures

Webster R. C., Smith R. C., Smith K.F.: Face Lift, Part 4, Use of Superficial Musculoaponeurotic System Suspending Sutures, Head and Neck Surgery, Jan-Feb. 1984, pp.780-791

916) B     Endoscopic Dacryocystorhinostomy

Osguthorpe J. D., Hoang G.:Nasolacrimal Injuries, Evaluation and Management, Current Issues in Head and Neck Trauma, Otolaryngologic Clinics of North America, Vol. 24, No. 1, February 1991, pp.59-77

917) D     Dissection below to the deep layer of the Deep Temporal Fascia.

Shumrick K. A., Kersten R.C., Kulwin D. R., Sinha P. k., Smith T. L.: Extended Access/Internal Approaches for the Management of Facial Trauma, Otolaryngology Head Neck Surgery, Oct. 1992, Vol. 118, pp. 1105-1112

Shumrick K. A.: Recent Advances and Trends in the Management of Maxillofacial and Frontal Trauma, Facial Plastic Surgery, Jan. 1993, Vol. 9, No. 1, pp.16-28

918) E     Musculocutenous flap containing Orbicularis Oculi, cheek fat, and Platysma

Hamra S. T.: Composite Rhytidectomy, Plastic and Reconstructive Surgery, July 1992, Vol. 90, No. 1, pp. 1-13 

919) C      Child abuse

Siegel M. B., Wetmore R. F., Potsic W. P., Handler S. D., Tom L.W.C.: Mandibular Fractures in the Pediatric Patient, Otolaryngology Head and Neck Surgery, May 1991, Vol. 117, pp.533-536

920) E      Zygomatic Major and Minor Muscles

Hamra S. T.: Composite Rhytidectomy, Plastic and Reconstructive Surgery, July 1992, Vol. 90, No. 1, pp. 1-13
---------------------------------------
Updated: July 25, 2017