Tuesday, April 27, 2010

271-280 MCQ in Facial Plastic and Reconstructive Surgery

271-280

271) Which of the following statements is TRUE regarding the local flap shown below?



A. The first flap should be ½ the size of the defect.
B. The second flap should be slightly smaller than the defect.
C. The major disadvantage is a high risk for pin cushioning.
D. This flap distributes tension mainly on the first flap.
E. The axis of the second flap has to be more than 180 degrees to the long axis of the original defect.

272) Which of the following statements is FALSE in rhytidectomy?

A. Rhytidectomy mainly corrects ptosis of the jowl.
B. Rhytidectomy will not correct creases and wrinkles of the face.
C. Rhytidectomy will not decrease prominent nasolabial folds.
D. Preserving the anterior hair tuft is fundamental in women.
E. Pretragal location of the incision is preferable in women.

273) Which of following statements is TRUE regarding the Rectus Myocutaneous Free Flap?

A. It is based on the deep inferior epigastric vessels.
B. Closure of the defect requires a full skin thickness graft.
C. The types of flap designs are very limited in this area.
D. The most common complication is necrosis of the donor site.
E. The main disadvantage is a short vascular pedicle available for anastomosis.

274) Which of the following statements is FALSE regarding the Latissimus Dorsi Free Flap?

A. The primary pedicle is the thoracodorsal artery and vein.
B. Harvesting of the flap will required a lateral decubitus position.
C. The location of the latissimus flap will allow a two-team approach.
D. Its pedicle is long and has large vessel diameters.
E. Sensory innervation is from the cutaneous branches of the intercostal nerves.

275) Which of the following statements regarding the Fibula Osteocutaneous Free Flap is TRUE?

A. The maximal size bone segment available with this flap is approximately 15 cm.
B. The fibula free flap is based on the anterior tibial artery.
C. The skin paddle is supplied by the septo-subcutaneous perforators from the peroneal artery.
D. The closure of the leg donor site can always be accomplished primarily.
E. Posterior splint to immobilize the donor leg in the immediate postoperative period is unnecessary.

276) Which of the following fractures of the mandible is BEST visualized with a radiographic Towne’s view?

A. Symphysis and parasymphyseal areas
B. Body
C. Angle
D. Coronoid Process
E. Condyle

277) Which of the following statements is FALSE regarding the use of Mandible Reconstruction Plates (MRP)?

A. Mandible Reconstruction Plates are ideal for reconstruction of oncologic mandible defects.
B. Mandible Reconstruction Plates are ideal for the reduction of highly comminuted mandible fractures.
C. Mandible Reconstruction Plates are ideal for reconstructing areas of osteomyelitis.
D. Mandible Reconstruction Plates are ideal for reconstruction of extensive traumatic defects resulting from shotgun injuries.
E. Mandible Reconstruction Plates will require at least two screws on either side of the defect.

278) Which of the following statements is TRUE regarding mandible plating techniques?

A. Wiring fractured bony fragments together will produce “primary” bone healing.
B. Dynamic compression plates (DCP) will not require a tension band across the upper alveolar border of the mandible.
C. Eccentric dynamic compression plates (EDCP) will require a miniplate along the upper alveolar border of the mandible.
D. A tension band can be a miniplate or an arch bar to be used in conjunction with dynamic compression plates (DCP).
E. Severely comminuted mandible fractures due to gunshot wounds will require both an eccentric dynamic compression plates (EDCP) at the inferior border of the mandible and miniplates at the alveolar border.

279) Which is the following statements regarding the Trapezius Myocutaneous Flap is TRUE?

A. The lateral trapezius island myocutaneous flap is the most reliable of the three trapezius flaps.
B. The superior trapezius myocutaneous flap is the least reliable of the three trapezius flaps.
C. The superior trapezius myocutaneous flap is not compromised by neck dissection.
D. The lateral trapezius island is based on the paraspinous perforator arteries.
E. The lower trapezius island myocutaneous flap will require skin grafting for closure of the donor site.

280) Which of the following statements regarding rhinoplasty osteotomies is TRUE?

A. Lateral osteotomy is done before the intermediate osteotomy.
B. Medial and lateral osteotomies can cross the frontal bone.
C. Medial ostetomy is done after the lateral ostetomy.
D. Lateral osteotomy follows a high, low, high pathway.
E. Perforating osteotomy is mandatory in all cases of rhinoplasty revision.


ANSWERS & REFERENCES



271) C     The major disadvantage is a high risk for pin cushioning.

Park S.S.: Local and Regional Cutaneous Flaps, Chapter 44, in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, pp. 539-540, 2002

Park S.S.: Local and Regional Cutaneous Flaps, Chapter 54, in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, pp. 721-743, 2009

272) E     Pretragal location of the incision is preferable in women.

Kridel R. W. H., Covello L. V.: Rhytidectomy, Chapter 180, Head and Neck Surgery-Otolaryngology (Bailey), Third Edition, Lippincott Williams & Wilkins, 2001, pp.2324-2327

Kridel R. W. H., Soliemanzadeh P.: Rhytidectomy, Chapter 177, Head and Neck Surgery-Otolaryngology (Bailey), Third Edition, Lippincott Williams & Wilkins, 2006, pp.2627-2649

273) A     It is based on the deep inferior epigastric vessels.

Burkey B. B., Coleman J. R.: Microvascular Flaps, Chapter 47 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Second Edition, p.p. 574-575, 2002

Burkey B. B., Coleman J. R.: Microvascular Flaps, Chapter 57 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Third Edition, p.p. 575-793, 2009

274) C     The location of the latissimus flap will allow a two-team approach.

Burkey B. B., Coleman J. R.: Microvascular Flaps, Chapter 47 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Second Edition, pp. 577-578, 2002

Burkey B. B., Schmalbach C. E., Coleman J. R.: Microvascular Flaps, Chapter 57 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Third Edition, pp. 765-793, 2009

275) C     The skin paddle is supplied by the septo-subcutaneous perforators from the peroneal artery.

Burkey B. B., Coleman J. R.: Microvascular Flaps, Chapter 47 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Second Edition, pp. 577-578, 2002

Burkey B. B., Schmalbach C. E., Coleman J. R.: Microvascular Flaps, Chapter 57 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Third Edition, pp. 765-793, 2009

276) E     Condyle

Garza J. R.: Mandibular Fractures, Chapter 61 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Second Edition, pp. 770-771, 2002

Garza J. R.: Mandibular Fractures, Chapter 72 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Third Edition, pp. 1001-1015, 2009

277) E     Mandible Reconstruction Plates will require at least two screws on either side of the defect

Kellman R. M.: Clinical Applications of Bone Plating Systems to Facial Fractures, Chapter 57 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Second Edition, pp. 727-728, 2002

Kellman R. M.: Clinical Applications of Bone Plating Systems to Facial Fractures, Chapter 68 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Third Edition, pp. 945-963, 2009

278) D     A tension band can be a miniplate or an arch bar to be used in conjunction with dynamic compression plates (DCP).

Constantino P. D., Wolpoe M.: Facial Plating Systems, Chapter 56 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Second Edition, pp. 710-712, 2002

Constantino P. D., Tadros M., Wolpoe M.: Facial Plating Systems, Chapter 67 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Third Edition, pp. 929-944, 2009

279) C     The superior trapezius myocutaneous flap is not compromised by neck dissection.

Annino Jr. D. J., Shu R.S.: Musculocutaneous Flaps, Chapter 46 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, p.p. 562-563, 2002

Annino Jr. D. J., Shu R.S., Gold D. R.: Musculocutaneous Flaps, Chapter 56 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, p.p. 757-764, 2009

280) D     Lateral osteotomy follows a high, low, high pathway.

Larrabee, Jr., W. F.: Open Rhinoplasty and the Upper Third of the Nose, Open Rhinoplasty, in Facial Plastic Surgery Clinics of North America, Volume 1, Number 1 August 1993, pp. 25-30

Most P. S., Murakami C. S., Larrabee Jr. W. F.: Surgery of the Bony Nasal Vault, Chapter 42 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, p.p. 547-553, 2009

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 Updated:  May 1, 2017


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