901-910 MCQ in Facial Plastic and Reconstructive Surgery

901-910

901) Which of the following measurements noted below represents the distance indicated by the "X" in the drawing?

A. 0.5 cm
B. 1.0 cm
C. 2.0 cm
D. 2.5 cm
E. 3.0 cm

902) Which of the following lasers uses a VISIBLE GREEN LIGHT (wavelength 532 nm)?

A. CO2 laser
B. Nd:YAG laser
C. KTP laser
D. Argon laser
E. Erbium laser

903) Which of the following arteries supplies the Juri Flap distally and proximally?

A. Anterior branch of the Superficial Temporal Artery and the Occipital Artery
B. Posterior branch of the Superficial Temporal Artery and Occipital Artery
C. Anterior and posterior branches of the Superficial Temporal Artery
D. Anterior branch of the Superficial Temporal Artery and Postauricular arteries
E. Posterior branch of the Superficial Temporal Artery and Postauricular Arteries

904) Which of the following statements about Pharyngoplasty is FALSE?

A. It is designed to create a partial nasopharyngeal stenosis.
B. It is designed to obturate the middle of the velopharyngeal area.
C. It is designed to obturate the lateral portion of the velopharynx.
D. It is indicated when there is good velar movement but poor lateral wall motion.
E. It is indicated when there is poor velar movement but good lateral wall motion.

905) Which of the following guidelines regarding steroid therapy for Hemangioma is INCORRECT?

A. Steroid treatment provokes a better response in the involuting hemangioma phase than in the Proliferating Hemangioma phase.
B. Steroids are given for a rapidly growing hemangioma that seriously distorts facial features.
C. Steroids are given for a lesion where there is bleeding, ulceration or infection.
D. Steroids are given for a lesion that interferes with essential, normal, and physiological functions.
E. Steroids are given for large or multicentric hemangiomas that causes bleeding and/or high cardiac output failure.

906) Which of the following anatomical landmarks identifies more precisely the location of the frontal branch of the Facial Nerve in Temporal Endoscopic Forehead Dissection?

A. The Zygomatic Arch
B. The Temporal Sentinel Vein
C. The Superficial Fat Pad
D. The Arc Marginalis
E. The Deep Temporalis Fascia

907) Which of the following statements is related to the Tip Recoil Phenomenon?

A. Rotation
B. Projection
C. Tip Support
D. Width to the Lower Lateral Cartilage
E. Width of the tip

908) Which of the following substances is produced by THE LYMPHOCYTES in the immune response to wound repair?

A. EGF (Epidermal Growth Factor)
B. FGF (Fibroblast Growth Factor)
C. IGF-1(Insulin-like Growth Factor)
D. PDGF (Platelet Derived Growth Factor)
E. TGF-beta (Transforming Growth Factor-beta)

909) Into which of the following classifications would a patient selected for Scalp Reduction due to Androgenetic Alopecia fall?

A. Norwood and Hamilton classification of Alopecia Class I
B. Norwood and Hamilton classification of Alopecia Class II
C. Norwood and Hamilton classification of Alopecia Class VI
D. Norwood and Hamilton classification of Alopecia Class VII
E. Frontal Alopecia

910) Which of the following is the proper and the safest plane of dissection in Endoscopic Midface Lift ?

A. Above the Superficial Temporal Fascia
B. Below the Superficial Temporal Fascia
C. Above the Deep Temporal Fascia
D. Below the Deep Temporal Fat Pad
E. Above the Temporalis Muscle


ANSWERS & REFERENCES


901) C     2.0 cm

Weinberger M. S., Becker D. G., Toriumi D. M.: Rhytidectomy, chapter 33 in Otolaryngology-Head and Neck Surgery, (Cummings, Fredrickson, Harker, Krause, Richardson, Schuller, editors) , 1998, pp. 648-659

Larrabee Jr W. F, Makielski K. H., Cupp C.: Facelift Anatomy, Facelift, Facial Plastic Surgery Clinics of North America, Nov. 1993, Vol. 1, No. 2, pp. 135-152

902) C     KTP laser

Ries W. R. , Powitzky E. S. : Lasers in Facial Plastic Surgery, Chapter 8 in Facial Plastic and Reconstructive Surgery, Papel I.D. , editor), Second Edition, 2002, pp.79-95

Ries W. R. , Wittkopf M. : Lasers in Facial Plastic Surgery, Chapter 10 in Facial Plastic and Reconstructive Surgery, Papel I.D. , editor), Third Edition, 2009, pp. 99-118

903) B     Posterior branch of the Superficial Temporal Artery and Occipital Artery

Rousso D. E.: The Use of Scalp Flaps for Frontal Alopecia, Hair Replacement Surgery, (Konior R. J., Rousso D. E. , editors), Facial Plastic Surgery Clinics of North America, May 1994, Vol. 2, No. 2, pp.183-202

904) E     It is indicated when there is poor velar movement but good lateral wall motion.

Smith M. E., Gray S. D., Pinborough-Zimmerman J.: Velopharyngeal Inadequacy , Chapter 69 in Facial Plastic and Reconstructive Surgery, Papel I.D. , editor), Second Edition, 2002, pp.873-888

Smith M. E., Gray S. D., Pinborough-Zimmerman J.: Velopharyngeal Inadequacy , Chapter 80 in Facial Plastic and Reconstructive Surgery, Papel I.D. , editor), Third Edition, 2009, pp.1127-1141

905) A     Steroid treatment provokes a better response in the involuting hemangioma phase than in the Proliferating Hemangioma phase.

Smith J. D.: Vascular Lesions of the Head and Neck , chapter 5 in Pediatric Facial Plastic and Reconstructive Surgery ( Smith J.D., and Bumsted R. M, editors), 1993, pp. 53-78

906) B     The Temporal Sentinel Vein

Quatela V. C., Graham III D., Sabini P.: Rejunenation of the Brow and Midface, Chapter 16 in Facial Plastic and Reconstructive Surgery, (Papel I. D., editor), Second Edition, 2002, pp.171-184

Graham III D., Quatela V. C., Sabini P.: Endoscopic Approach to the Brow and Midface, Chapter 20 in Facial Plastic and Reconstructive Surgery, (Papel I. D., editor), Third Edition, 2009, pp.227-241

907) C     Tip Support

Nolst Trenité G. J.: Surgery of the Nasal Tip: Intranasal Approach, Chapter 36 in Facial Plastic and Reconstructive Surgery, (Papel I. D., editor), Second Edition, 2002, pp. 414-428

Tardy Jr., M.E., Toriumi D. M., Hecht D. A.: Philosophy and Principles of Rhinoplasty, Chapter 32 in Facial Plastic and Reconstructive Surgery, (Papel I. D., editor), Second Edition, 2002, pp. 369-389

Tardy Jr., M.E., Toriumi D. M., Hecht D. A.: Philosophy and Principles of Rhinoplasty, Chapter 40 in Facial Plastic and Reconstructive Surgery, (Papel I. D., editor), Third Edition, 2009, pp. 507-528

908) E     TGF-beta (Transforming Growth Factor-beta)

Fisher E., Frodel Jr. J. L.: Wound Healing, Chapter 2, in Facial Plastic and Reconstructive Surgery (Papel I.D., editor), Second Edition, 2002, pp.15-25

Fisher E., Frodel Jr. J. L.: Wound Healing, Chapter 2, in Facial Plastic and Reconstructive Surgery (Papel I.D., editor), Third Edition, 2009, pp.15-25

909) C     Norwood and Hamilton classification of Alopecia Class VI

Unger M.G.: Scalp Reduction in Hair Replacement Surgery, Facial Plastic Surgery Clinics of North America, (Konior R.J. and Rousso D. E. editors), May 1994, Vol. 2, No. 2, pp.163-181

910) C     Above the Deep Temporal Fascia

Quatela V. C., Graham III D., Sabini P.: Rejunenation of the Brow and Midface, Chapter 16 in Facial Plastic and Reconstructive Surgery, (Papel I. D., editor), Second Edition, 2002, pp.171-184

Graham III D., Quatela V. C., Sabini P.: Endoscopic Approach to the Brow and Midface, Chapter 20 in Facial Plastic and Reconstructive Surgery, (Papel I. D., editor), Third Edition, 2009, pp.227-241
---------------------------------------
Updated: July 25, 2017

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
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Updated: July 25, 2017

921-930 MCQ in Facial Plastic and Reconstructive Surgery

921-930
-------------------------------
Updated: May 26, 2018

921) Which of the following muscles is the ONE indicated by the arrow in the drawing below ( medial view of the left hemimandible)

A. Mylohyoid
B. Lateral Pterygoid
C. Medial Pterygoid
D. Masseter
E. Geniohyoid

922) Which of the following tumor thicknesses ( in mm ) of cutaneous malignant melanoma, based on retrospective non-randomized studies, is the one in which elective neck dissection is recommended for treatment?

A. 0.0-0.75 mm
B. 0.76-1.5 mm
C. 1.6-4.0
D. 4.1 -4.5 mm
E. 4.51 mm or greater

923) What percentage of sensitivity, when used in combination, the barium swallow and the esophagoscopy have for the identification of esophageal perforation after a gunshot wound to the neck?

A. 60%
B. 70%
C. 80%
D. 90%
E. 100%

924) With respect to corrective surgery of the upper third of the aging face, which of the following approaches involves dissection at the subcutaneous level?

A. Coronal
B. Pre-tichial
C. Post-trichial
D. Midforehead
E. Endoscopic

925) A patient with diagnosis of facial/neck hemangioma is allergic to propanolol. Which of the following prednisone doses is the one indicated in the management of Hemangioma using steroid therapy?

A. 0.5 mg/kg/day
B. 1.0 mg/kg/day
C. 2.0 mg/kg/day
D. 4.0 mg/kg/day
E. 5.0 mg/kg/day

926) Which of the following complications can occur in the lateral aspect of dissection for Coronal/Hemicoronal Flaps if the surgery proceeds WITHIN the Superficial Temporal Fat Pad?

A. Hematoma of the fat pad
B. Infection of the fat pad
C. Abscess of the fat pad
D. Atrophy of the fat pad
E. Paralysis of the Frontalis branch of the Facial Nerve

927) Which of the following facial aesthetic units is done LAST in Deep Chemical Peeling?

A. Forehead
B. Cheeks
C. Perioral
D. Nose
E. Periorbital

928) Which of the following mechanisms is involved in the CONDUCTION BLOCKADE of local anesthetics?

A. Sodium ion influx is directed to flow through specific channels into the cell.
B. Potassium ion influx is directed to flow through specific channels into the cell.
C. Calcium ions are directed to flow through specific channels into the cell.
D. Sodium and Potassium ions are directed to flow through specific channels into the cell.
E. Potassium and Calcium ions are directed to flow through specific channels into the cell.

929) Which of the following adverse conditions IS ASSOCIATED with wounds closed under a great degree of tension?

A. Decresed tensile strength
B. Hypertrophic scar
C. Infection
D. Keloid
E. Pigmentary skin changes

930) Which of the following statements about the “Pinch” Blepharoplasty Technique is FALSE?

A. It is usually performed for the transconjunctival removal of fat in Lower Eyelid Blepharoplasty.
B. The removal of transconjunctival fat is done after the “Pinch” Skin Excision.
C. The line of incision is 5 mm below the lateral margin of the eyelid, leaving an island of intact skin of 5 mm height.
D. Straight scissors are used to excise the “wall” of skin, leaving the Orbicularis Muscle intact.
E. The skin margins after excision should be “just kissing”.

ANSWERS & REFERENCES


921) B     Lateral Pterygoid

Goss C.M:Gray's Anatomy, Chapter 4, Lea & Febiger, 1973, pp.152-153

922) C     1.6-4.0

Medina J. E.: Malignant Melanoma of the Head and Neck, Facial Skin Malignancy I, Otolaryngologic Clinics of North America, Vol. 26, No. 1, February 1993, pp. 73-83

Hendrix J. D., Slingluff C.L.: Diagnosis and Treatment of Cutaneous Malignancies, Chapter 52 in Facial Plastic and Reconstructive Surgery, (Papel I.D., editor), Third Edition, 2009, pp. 675-702

http://emedicine.medscape.com/article/846566-overview

923) D     90%

Stiernberg C.M., Jahrsdoerfer R. A., Gillenwater A., Joe S. A., Alcalen S. V.: Gunshot Wounds to the Head and Neck, Arch. Otolaryngology Head and Neck Surgery, June 1992 ,Vol. 118, pp.592-596

924) D     Midforehead

Kerth J. D., Toriumi D. M.: Management of the Aging Forehead, Arch. Otolaryngology-Head and Neck Surgery, Vol. 116, Oct. 1990, pp. 1137-1142

Adamson P. A., Dahiya R.: The Aging Forehead, chapter 179 in Head and Neck Surgery - Otolaryngology , 4th Edition, (Bailey, Johnson, Newlands, editors), Lippincott Williams & Wilkins, 2006, pp. 2663-2683

925) C     2.0 mg/kg/day

Smith J. D.: Vascular Lesions of the Head and Neck , chapter 5 in Pediatric Facial Plastic and Reconstructive Surgery ( Smith J.D., and Bumsted R. M, editors), 1993, pp. 53-78

Waner M., Suen J.Y., Dinehart S.: Treatment of Hemangiomas of the Head and Neck, Laryngoscope 102, Oct. 1992, pp.1123-1132

926) E     Paralysis of the Frontalis branch of the Facial Nerve

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

927) E     Periorbital

McCollough E.G., Hillman Jr. R.A.: Chemical Face Peel, Symposium of the Aging Face, Otolaryngology Clinics of North America, May 1980, Vol. 13, No.2, pp. 353-365

Mandy S. H., Monheit G. D.: Dermabrasion and Chemical Peels, Chapter 25 in Facial Plastic and Reconstructive Surgery, (Papel I.D., editor), Third Edition, 2009, pp. 301-320

928) A     Sodium ion influx is directed to flow through specific channels into the cell.

Ehlert T. K., Arnold D. E.: Local Anesthesia for Soft Tissue Surgery, Facial Plastic Surgery, Otolaryngologic Clinics of North America, Oct. 1990, Vol.23, No. 5, pp. 831-844

Fletcher M.:Anesthesia in Facial Plastic Surgery, Chapter 14 in Facial Plastic and Reconstructive Surgery, (Papel I.D., editor), Second Edition, 2002, pp. 145-152

Fletcher M.:Anesthesia in Facial Plastic Surgery, Chapter 17 in Facial Plastic and Reconstructive Surgery, (Papel I.D., editor), Third Edition, 2009, pp. 189-197

929) B     Hypertrophic scar

Kokoska M. S., Thomas J.R.: Scar Revision, chapter 5 in Facial Plastic and Reconstructive Surgery, (Papel, editor), Second Edition, Thieme, 2002, pp. 55-60

Kokoska M. S., Thomas J.R.: Scar Revision, chapter 5 in Facial Plastic and Reconstructive Surgery, (Papel, editor), Third Edition, Thieme, 2009, pp. 59-65

930) B      The removal of transconjunctival fat is done after the “Pinch” Skin Excision.

Rosenfield L. K.: The Pinch Blepharoplasty Revisited, Plastic and Reconstructive Surgery, April 2005, Vol. 115, No.5 pp. 1405-1412

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Updated: May 26, 2018

931-940 MCQ in Facial Plastic and Reconstructive Surgery

931-940

931) Which of the following measurements related to surgical repair of the cleft lip below depicted below is CORRECT?


A. Millard (3 to 5 + X = 8 to 9)
B. Millard (2 to 6= 8 to 9)
C. Millard (3 to 5 = 8 to 9)
D. Tennison-Randall (3 to 5 + X = 8 to 9)
E. Tennison-Randall (2 to 6= 8 to 9)

932) Which of the following criteria allows THE BEST POSSIBLE results in a Closed Suction Lipectomy?

A. Generalized facial accumulations (non-obese patient)
B. Ptosis and excess skin folds
C. Good laxity of the skin
D. Good bony contour
E. Male gender

933) Which of the following reconstructive flaps is THE BEST CHOICE after wound breakdown with exposed major neck vessels post radical neck dissection and radiation therapy?

A. Deltopectoral flap
B. Lateral trapezius flap
C. Lower trapezius flap
D. Superior trapezius flap
E. Temporalis muscle flap

934) Which of the following statements about Jejunum Free Flap is FALSE?

A. It is an adequate option for hypopharyngeal reconstruction.
B. The second loop of the jejunum is usually used for reconstruction.
C. The harvesting of the jejunal flap is performed with a two-team approach.
D. The flap should be oriented in an isoperistaltic fashion.
E. Externalizing a small segment of jejunum outside the neck is not necessary.

935) Which of the following flaps is the MOST USEFUL for reconstruction after Total Glossectomy?

A. Lateral Trapezius Island Myocutaneous Flap
B. Latissimus Dorsi Free Flap
C. Pectoralis Major Musculocutaneous Flap
D. Radial Forearm Free Flap
E. Superficial Temporal Parietal Fascia flap

936) Which of the following percentage about the overall Jejunal  Free Flap success rate is TRUE?

A. 90%
B. 80%
C. 70%
D. 60%
E. 50%

937) Which of the following statements about Residual Alveolar Ridge Cleft is TRUE?

A. The most common indication for grafting is inadequate oral feeding.
B. The most common bone graft used for closure is cranial bone.
C. The use of cancellous bone fragments is the ideal choice.
D. The best timing for primary repair is at the time of closure of the Cleft Lip.
E. Normal chewing with the front teeth can begin two weeks postop after Alveolar Bone Grafting.

938) In a Periocular Surgical Zone II Full-thickness Eyelid Excision, what is the maximal eyelid defect that can be closed primarily with the assistance of canthotomy and cantholysis ?

A. Defect less than 20% of eyelid width
B. Defect less than 30% of eyelid width
C. Defect less than 40% of eyelid width
D. Defect less than 50% of eyelid width
E. Defect less than 60% of eyelid width

939) Which of the following eyelid or periorbital areas is MOST commonly involved by Basal Cell Carcinoma of the skin?

A. Lateral Canthal area
B. Lower Lid
C. Medial Canthus
D. Periorbital area
E. Upper Lid

940) In which of the following areas is the surgical option for hemangioma is favored rather than observation for purpose of Involution?

A. Cheek area
B. Forehead
C. Lower side of the face and neck
D. Nasal tip
E. Scalp


ANSWERS & REFERENCES


931) A     Millard (3 to 5 + X = 8 to 9)

Sykes J. M.: Diagnosis and Treatment of Cleft Lip and Palate Deformities, Chapter 65 in Facial Plastic and Reconstructive Surgery, (Papel I.D., editor), Second Edition, 2002, pp. 813-829

Capone R. B., Sykes J. M.: Evaluation and Management of Cleft Lip and Palate Deformities, Chapter 76 in Facial Plastic and Reconstructive Surgery, (Papel I.D., editor), Third Edition, 2009, pp. 1059-1078

Ness J. A., Sykes J.M.: Basics of Millard Rotation-Advancement Technique for Repair of the Unilateral Cleft Lip Deformity, Facial Plastic Surgery, July 1993, Vol. 9, No. 3, pp. 167-176

932) C     Good laxity of the skin

Kridel R. W. H., Konior R. J.: Suction Lipectomy, Chapter 21, in Facial Plastic and Reconstructive Surgery, (Papel and Nachlas, editors), 1992, pp.184-192

Kridel R. W. H., Kelly P. E., Castellano R. D.: Suction Liposuction of the Face and Neck: The Art of Facial Sculpture, Chapter 24, in Facial Plastic and Reconstructive Surgery, (Papel. I. D. , editor), 2009, pp.286-300

933) D     Superior trapezius flap

Aviv J. E., Urken M. L., Lawson W., Biller H. F.: The Superior Trapezius Myocutaneous Flap in Head and Neck Reconstruction, Arch. Otolaryngology-Head and Neck Surgery, July 1992, Vo. 118, pp. 702-706

Annino Jr. D. J., Shu R. S.: Musculocutaneous Flaps in Chapter 46 in Facial Plastic and Reconstructive Surgery, Second Edition, (Papel I. D. ,editor), 2002, pp. 560-566

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

934) E     Externalizing a small segment of jejunum outside the neck is not necessary.

Burkey B. B., Coleman Jr. J. R.: Microvascular Flaps, Chapter 47 in Facial Plastic and Reconstructive Surgery, (Papel I. D., editor), 2002, pp. 567-590

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

935) B     Latissimus Dorsi Free Flap

Haughey B. H.: Tongue Reconstruction: Concepts and Practice, Laryngoscope 103, Oct. 1993, pp. 1132-1141

Burkey B. B., Coleman Jr. J. R.: Microvascular Flaps, Chapter 47 in Facial Plastic and Reconstructive Surgery, (Papel I. D., editor), 2002, pp. 567-590

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

936) A     90%

http://emedicine.medscape.com/article/881905-treatment#a17

937) A     The most common indication for grafting is inadequate oral feeding.

Davis P. T., Hochman M. , Funcik T.: Alveolar Cleft Bone Grafts, Facial Plastic Surgery, July 1993, Vo. 9, No. 3, pp. 232-238

938) D     Defect less than 50% of eyelid width

Spinelli H. M., Jelks G. W.: Periocular Reconstruction: A Systematic Approach, Plastic and Reconstructve Surgery, Maqy 1993, Vol. 91, No. 6, pp. 1017-1024

939) B     Lower Lid

Funk G. F., Hoffman H. T., Carter K. D.: Special Considerations in the Management of Malignant Skin Lesions about the Eye, Facial Skin Malignancy II, Otolaryngologic Clinics of North America, April 1993, Vol. 26, No. 2, pp. 215-230

940) D     Nasal tip

Jackson I. T. Carreño R., Potparic Z., Hussain K.: Hemangiomas, Vascular Malformations, and Lymphovenous Malformations: Classification and Methods of Treatment, Plastic and Reconstructive Surgery, June 1993, Vol. 91, No. 7, pp. 1216-1229

---------------------------------------
Updated: July 25, 2017

941-950 MCQ in Facial Plastic and Reconstructive Surgery

941-950

941)Which of the eyelid or periocular surgical zones is the one indicated by the letter “X”?

A. Zone I
B. Zone II
C. Zone III
D. Zone IV
E. Zone V

942) Which of the following anatomical structures of the Scalp represents a NATURAL RESISTANCE BARRIER to the spread of malignant neoplasms of the scalp?

A. Dermis
B. Subcutaneous Connective Tissue
C. Epicranium
D. Subaponeurotic Connective Tissue
E. Pericranium

943) The Epidermal Growth Factor (EGF) is derived from:

A. Fibroblasts
B. Lymphocytes
C. Macrophages
D. Neutrophils
E. Platelets

944) Which of the following early post-operative complications is MOST commonly seen with the use of Pharyngeal Flap Surgery in children?

A. Airway obstruction
B. Aspiration
C. Dehiscence
D. Neck stiffness
E. Pneumonia

945) Which of the following is NOT a laser/tissue surface interaction?

A. Absorption
B. Concentration
C. Reflection
D. Scatter
E. Transmission

946) Which of the following substances MOST commonly comprises the prosthetics used in Nasal Reconstruction today?

A. Gelatin-glycerin misture
B. Polymethyl methacrylate
C. Prevulcanized latex
D. Silicone
E. Vulcanized rubber

947) Which of the following nasal types LESS FREQUENTLY requires nasal alar modifications?

A. Asian
B. African American
C. Caucasian
D. Mestizo
E. Oriental

948) Which of the following lasers has a visible-wavelength in the Electromagnetic Spectrum?

A. Argon
B. CO2
C. Er:YaG
D. Erbium
E. Nd:Yag

949) Which of the following is NOT a characteristic of Hemangioma?

A. Present at birth
B. Female/male ratio is 3:1
C. Rapid growth proliferation
D. Slow involution
E. MRI most accurate diagnostic procedure.

950) Which of the following events is MOST commonly associated with the Superior Trapezius Flap?

A. Infection
B. Necrosis
C. Dehiscence
D. Venous Congestion
E. Limited Arc of Rotation



ANSWERS & REFERENCES


941) B     Zone II

Spinelli H. M., Jelks G. W.: Periocular Reconstruction: A Systematic Approach, Plastic and Reconstructive Surgery, May 1993, Vol. 91, No. 6, pp. 1017-1024

942) C     Epicranium

Malignant Neoplasms of the Scalp, Etiology, Resection, and Reconstruction, Facial Skin Malignancy II, Otolaryngologic Clinics of North America, April 1993, Vol. 26, No. 2, pp. 279-293

943) E     Platelets

Fisher E. , Frodel Jr. J. L.: Wound Healing, Chapter 2 in Facial Plastic and Reconstructive Surgery, (Papel I. D. editor), Second Edition, 2002, pp. 15-25

Shenaq S. M., Rabinovsky E. D.: Gene Therapy for Plastic and Reconstructive Surgery, What’s New in Plastic Surgery, Clinics in Plastic Surgery, Jan, 1996, Vol. 23, No. 1, pp. 157-171

944) A     Airway obstruction

Valnicek S. M., Zuker R. M., Halpern L. M., Roy L.: Perioperative Complications of Superior Pharyngeal Flap Surgery in Children, Plastic and Reconstructive Suregery, April 1994, Vol. 93, No. 5, pp.954-958

945) B     Concentration

Ries W. R., Powitzky E.S.:Lasers in Facial Plastic Surgery, Chapter 8 in Facial Plastic and Reconstructive Surgery, (Papel I. D. editor), Second Edition, 2002, pp. 79-95

946) D     Silicone

Arcuri M. R., LaVelle W. E.: Prosthetics in Nasal Reconstruction, Facial Plastic Surgery, Vol. 10, No. 4, October 1994, pp.382-388

947) C      Caucasian

Tardy Jr. M.E., Patt B. S., Walter M. A.: Alar Reduction and Sculpture, Facial Plastic Surgery, Oct. 1993, Vol. 9, No. 4, pp. 295-305

948) A     Argon

Ries W. R., Powitzky E.S.:Lasers in Facial Plastic Surgery, Chapter 8 in Facial Plastic and Reconstructive Surgery, (Papel I. D. editor), Second Edition, 2002, pp. 79-95

949) A     Present at birth

Richards A. M.: Key Notes on Plastic Surgery, Blackwell Science, 2002, pp. 158-159

950) E     Limited Arc of Rotation

Aviv J. E., Urken M. L., Lawson W., Biller H. F.: The Superior Trapezius Myocutaneous Flap in Head and Neck Reconstruction, Arch. Otolaryngology-Head and Neck Surgery, July 1992, Vo. 118, pp. 702-706

Annino Jr. D. J., Shu R. S.: Musculocutaneous Flaps in Chapter 46 in Facial Plastic and Reconstructive Surgery, Second Edition, (Papel I. D. ,editor), 2002, pp. 560-566

---------------------------------------
Updated: July 25, 2017

951-960 MCQ in Facial Plastic and Reconstructive Surgery

951-960

951) Which of the following surgical techniques used in Rhinoplasty is the one represented in the drawing below?

A. Flaring Suture
B. Intradomal Sutures
C. Septocolumellar Suture
D. Tip Suspension Suture
E. Transdomal Sutures

952) Which of the following anatomical structures is localized between the Deep Temporal Fascia and the Temporalis Muscle?

A. Superficial Fat Pad
B. Intermediate Fat Pad
C. Deep Temporal Fat Pad
D. Temporal Fascia proper
E. Masseter Muscle

953) Which of the following is the source of Interferon?

A. Fibroplasts and Lymphocytes
B. Macrophages and Neutrophils
C. Masts Cells and Lymphocytes
D. Neutrophils and Lymphocytes
E. Platelets and Muscle cells

954) Which of the following statements about the Oriental Epicanthal Fold is TRUE?

A. 70% of Oriental Eyelids exhibit an Epicathus.
B. Effacement of the fold is based on a Bilateral Rotation Flap.
C. Effacement of the fold will create a wider nasal bridge.
D. Elongation is performed in the lateral direction.
E. A large epicanthus will require W-plasty advancement.

955) Which of the following nasal inadequacies is BEST corrected with an Umbrella Graft?

A. Saddle nose
B. Inadequate tip rotation
C. Inadequate tip projection
D. Inadequate internal nasal valve
E. Inadequate tip rotation and projection

956) Which of the following statements relating to the Infraorbital Foramen Nerve is TRUE?

A. The Infraorbital Foramen is located on a vertical line dropped from the Medial Limbus of the Iris.
B. The infraorbital foramen is located approximately 20 mm below the Orbital Rim.
C. The Transcutaneous Nasolabial Approach is the best for blocking the Infraorbital Nerve.
D. The areas numbed by blocking the Infraorbital Nerve are the nose and the upper lip.
E. The direct injection of anesthesia into the Infraorbital Foramen is contraindicated.

957) Your must close an 8 cm. x 8 cm. circular defect on the malar surface of the face of a 47-year-old man, using the “Round Block” “Purse-String” Suture. Multiple large numbers of concentric redundant skin folds are formed with such closure, associated with a considerable distortion of nearby structures. Which of the following managements is the best to use in this particular situation?

A. Full thickness skin graft to decrease skin tension
B. Conservative management for 1 month
C. Chemical Peeling after healing is completed
D. Botulinum Toxin injection during the healing process
E. Botulinum Toxin injection in the postoperative process

958) A 47-year-old woman is complaining of the gradual onset of bilateral facial masses, left greater than right, over several years. No other complaints are reported. The physical examination revealed bilateral, well-demarcated, walnut-sized masses located in the lower cheek area above the jowl. The most common successful management of this condition is:

A. Deep Plane Face Lift
B. Excesion of the enlarged Nasolabial Folds
C. Intraoral Buccal Lipectomy
D. Midface Lift
E. SMAS Face Lift

959) Which of the following statements is FALSE regarding use of the Endonasal Spreader Graft for management of Internal Nasal Valve Insufficiency?

A. Autogenous materials are used for grafting.
B. The Upper Lateral Cartilage should be divided from the Septum.
C. Grafts are placed between the Nasal Septum and the Upper Lateral Cartilage.
D. Grafts are placed subperichondrally.
E. Grafts can be secured in a tight-fitting tunnel.

960) Which of the following, with reference to Temporalis Muscle Transfer for management of Facial Paralysis will improve the abnormal bulge of the muscle?

A. Transfer the middle third of the muscle
B. Transfer the lateral third of the muscle
C. Transfer the medial third of the muscle
D. Transfer the entire muscle with a wider tunnel
E. Transfer the entire muscle below the zygomatic arch


ANSWERS & REFERENCES


951) A     Flaring Suture

Park SS.: The flaring suture to augment the repair of the dysfunctional nasal valve, Plast Reconstr Surg. 1998 Apr;101(4):1120-1122

http://emedicine.medscape.com/article/841574-overview

952) C     Deep Temporal Fat Pad

Quatela V. C., Graham III D., Sabini P.: Rejuvenation of the Brow and Midface, Chapter 16 in Facial Plastic and Reconstructive Surgery, (Papel I. D. , editor), Second Edition, 2002, pp.171-184

Graham III H. D., Quatela V. C., Sabini P.: Endoscopic Approach to the Brow and Midface, Chapter 20 in Facial Plastic and Reconstructive Surgery, (Papel I. D. , editor), Third Edition, 2009, pp.227-241

953) A     Fibroplasts and Lymphocytes

Fisher E. , Frodel Jr, J. L.: Wound Healing in Chapter 2 in Facial Plastic and Reconstructive Surgery (Papel I. D., editor), Second Edition, 2002, pp. 15-25

Fisher E. , Frodel Jr, J. L.: Wound Healing in Chapter 2 in Facial Plastic and Reconstructive Surgery (Papel I. D., editor), Third Edition, 2009, pp. 15-25

954) E     A large epicanthus will require W-plasty advancement.

McCurdy Jr. J. A.: Management of the Epicanthal Fold, Surgery in the Asian Patient, Facial Plastic Surgery Clinics of North America, Feb. 1996, Vol. 4, No. 1, pp. 25-33

McCurdy, Jr. J. A.: Cosmetic Surgery of the Asian Face, Chapter 28 in Facial Plastic and Reconstructive Surgery, (Papel I.D. , editor), 2002, pp.322-343

955) C      Inadequate tip projection

Peck Jr., G. C., Michelson L., Segal J., Peck Sr. G.C.: An 18-year Experience with the Umbrella Graft in Rhinoplasty, Plastic and Reconstructive Surgery, Vol. 102, No. 6, Nov. 1998, pp. 2158-2165

956) D     The areas numbed by blocking the Infraorbital Nerve are the nose and the upper lip.

Zide B. M., Swift R.: How to Block and Tackle the Face, Plastic and Reconstructive Surgery, March 1998, Vol. 101, No. 3, pp.840-851

957) B      Conservative management for 1 month

Tremolada C., Blandini D., Beretta M., Mascetti M.: The "Round Block Purse-String Suture: A Simple Method to Close Skin Defects with Minimal Scarring, Plastic and Reconstructive Surgery, July 1997, Vol.100, No. 1, pp. 126-131

958) C     Intraoral Buccal Lipectomy

Matarasso A.: Pseudoherniation of the Buccal Fat Pad: New Clinical Syndrome, Facial Plastic and Reconstructive, Sept. 1997, Vol.100, No.3, pp. 723-730

959) B     The Upper Lateral Cartilage should be divided from the Septum.

André R. F., Paun S. H., Vuyk H.D.: Endonasal Spreader Graft Placement as Treatment for Internal Nasal Valve Insufficiency, No Need to Divide the Upper Lateral Cartilages from the Septum, Arch. Facial Plastic Surg., Jan-Feb. 2004, Vol. 6, pp. 36-40

960) C     Transfer the medial third of the muscle

Sherris D. A..: Refinament in Reanimation of the Lower Face, Arch. Facial Plastic Surg., Jan-Feb. 2004, Vol. 6, pp. 49-53

---------------------------------------
Updated: July 25, 2017

961-970 MCQ in Facial Plastic and Reconstructive Surgery

961-970

961)Which of the following auricular congenital malformations is the ONE represented in the drawing below?

A. Cup ear
B. Microtic ear
C. Macrotic ear
D. Cryptotic ear
E. Telephone ear

962) Which of the following will NOT predispose to Nasal Tip Bossa formation secondary to Rhinoplasty?

A. Open approach
B. Asymmetric dome cartilages
C. Presence of sharp edges
D. Wide separation of the domes
E. Weakening the cephalic margin of the lower lateral cartilages

963) Which of the following is CRITICAL to the safety of Blepharoplasty patients with preoperative Dry Eyes?

A. No excision of eyelid skin
B. “Pinch” Technique for excision of skin redundancy
C. Preservation of Orbicularis Muscle and its function
D. Transconjuntival Approach
E. Fat removal through a buttonhole incision in the Orbicularis Muscle

964) Which of the following reconstruction techniques is THE BEST for closing 9 cm. x 12 cm. defect of the scalp with bone exposure?

A. Bilateral Rotation –Advancement flap
B. Triple Rhomboid Flap
C. Skin Grafting after drilling down to the diploic layer of the bone
D. Pectoralis Myocutaneous Flap
E. Orticochea “Banana Peel” flap

965) Which of the following deformities is related to the bilateral disarticulation of upper lateral cartilages?

A. “Rocker” deformity
B. “Step” deformity
C. “Open roof ” deformity
D. “V”-deformity
E. “Inverted V”-deformity

966) Which of the following reconstruction lip techniques is UNLIKELY to produce Microstomia?

A. Primary closure
B. Abbe Flap
C. Estlander Flap
D. Karapandzic Flap
E. Gillies Flap

967) Which of the following facial areas has THE HIGHEST PRIORITY for reconstruction after facial burns?

A. Eyelid
B. Lower lip
C. Upper lip
D. Neck
E. Cheek

968) Which of the following statements about Bilateral Cleft Lip Repair is FALSE?

A. The Prolabium contains muscle.
B. The Prolabial Flap is marked at the midline.
C. The Prolabial “Forked” Flaps are marked laterally .
D. The “Forked” Flaps are incised, elevated and sutured laterally into the floor of the nose.
E. The Orbicularis Oris Muscle should be reoriented and sutured over the Premaxilla.

969) Which of following herbal and supplemental medicines used by cosmetic patients WILL INHIBIT AND PROLONG wound healing?

A. Glucosamine
B. Ginseng
C. Garlic
D. Vitamin E
E. Chondroitin

970) Which of the following eyelid structures IS RELATED to the muscle of Riolan?

A. Tarsus
B. Meibomian Gland
C. Gray Line
D. Orbital Septum
E. Müller’s Muscle


ANSWERS & REFERENCES


961) A     Cup ear

Bardach J.: Surgery for Congenital and Acquired Malformations of the Auricle, Chapter 152, (Cummings, Fredriickson, Harker, Krause, Schuller, editors), Volume 4, Mosby, 1986, pp. 2861-2898

http://emedicine.medscape.com/article/1288708-overview

962) A     Open approach

Kridel R. W. H., Yoon P. J., Koch R. J.: Prevention and Correction of Nasal Tip Bossae, Arch. Facial Plastic Surgery, Sept-Oct. 2003, Vol. 5, pp. 416-422

Becker D. G.: Complications in Rhinoplasty, chapter 49 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, pp. 639-648, 2009

963) C     Preservation of Orbicularis Muscle and its function

Saadat D., Dresner S. C.: Safety of Blepharoplasty in patients with preoperative Dry Eyes, Arch. Facial Plastic Surgery, March-April . 2004, Vol.6, pp.101-104

964) E     Orticochea “Banana Peel” flap

Frodel J. L., Ahlstrom K.: Reconstruction of Complex Scalp Defects, The “Banana Peel” Revisited, Arch. Facial Plastic Surgery, March-April . 2004, Vol.6, pp.54-60

http://emedicine.medscape.com/article/876972-treatment

965) E     “Inverted V”-deformity

Becker D. G.: Complications in Rhinoplasty, chapter 49 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, pp. 639-648, 2009

http://emedicine.medscape.com/article/843439-treatment

966) E     Gillies Flap

Cupp C. L., Larrabbe Jr. W.F: Reconstruction of the lips, Operative Techniques in Otolaryngology-Head and Neck Surgery, Vol. 4, N0. 1, March, 1993, pp. 46-53

DeFatta R. J., Williams III E. F.: Lip Reconstruction, Chapter 61 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, pp. 841-854, 2009

http://emedicine.medscape.com/article/1289799-overview

967) A     Eyelid

http://emedicine.medscape.com/article/879183-overview

968) A     The Prolabium contains muscle.

Skykes J. M. , Tollefson T. T.: Management of the cleft lip deformity, Facial Plastic Surgery Clinics of North America, Vol. 13, No. 1, 2005, pp. 157-167

969) D     Vitamin E

Heller J., Gabbay J. S. , Ghadjar K., Jourabchi M. , O’hara C., Heller M., Bradley J. P.: Top-10 List of Herbal and Supplemental Medicines Used by Cosmetic Patients: What the Plastic Surgeon Needs to Know? Plastic and Reconstructive Surgery, Feb. 2006, Vol. 117, No. 2, pp. 436-445

970) C     Gray Line

Burkat C. N. , Lemke B. N.: Anatomy of the Orbit and Its Related Structures, Otolaryngology Clinics of North America, Advances in Oculo-facial Surgery, ((Bosniak S.L., editor) , October 2005, Vol. 38, No. 5, pp.825-856

http://emedicine.medscape.com/article/838696-overview


---------------------------------------
Updated: July 25, 2017

971-980 MCQ in Facial Plastic and Reconstructive Surgery

971-980

971) Which of the following is the BEST treatment option for management of this irregular, hypertrophic scar of 8 months duration?


A. Kenalog Injections
B. Dermabrasion
C. Laser Resurfacing
D. 12 months wait since initial trauma
E. Multiple Z-plasty

972) Which of the following statements about the Radial Forearm Free Flap is TRUE?

A. It will require mandatory harvesting of bone segment.
B. The lateral antebrachial Nerve is used to obtain a sensate flap.
C. Allen’s test is rarely used for preoperative assessment.
D. Primary closure of the donor site is usually accomplished.
E. Pathologic fracture risk is insignificant.

973) Which of the following is the effect produced by Botulinum Exotoxin A?

A. Inhibits the release of Acetylcholine at the presynaptic level.
B. Inhibits the release Acetylcholine at the postsynaptic level.
C. Inhibits the release of neurotransmitters which affect the interneurons.
D. Induces the release of Acetylcholine at the presynaptic level.
E. Induces the release Acetylcholine at the postsynaptic level.

974) Which of the following herbal and supplemental medicines used by cosmetic patients will most likely cause hypoglycemia?

A. Chondroitin
B. Glucosamine
C. Ginseng
D. Garlic
E. Vitamin E

975) Which of the following statements regarding The Orticochea ( “Banana Peel” ) Flap for scalp defects is FALSE?

A. The technique will require mobilization of the entire scalp.
B. The technique is based in two large and wide scalp flaps.
C. The technique is useful in severely debilitated patients who can not tolerate lengthy general anesthesia.
D. The technique will serve well for scalp defects up to 30% of the total scalp area.
E. The technique is based on Axial Flaps.

976) When is there near complete return of sensory and motor function after placement of the Abbé Cross Lip Flap?

A. 2months
B. 6 months
C. 8 months
D. 10 months
E. 12 months

977) After scar formation, when is it appropriate to perform Dermabrasion?

A. 2 weeks
B. 4 weeks
C. 8 weeks
D. 10 months
E. It is contraindicated

978) Which of the following represents an INCORRECT relationship between flap and blood supply?

A. Rectus Myocutaneous Free Flap / Deep Superior Epigastric Vessels
B. Forehead Flap / Supraorbital and Supratrochlear Arteries
C. Latissimus Dorsi Flap / Thoracodorsal Artery
D. Deltopectoral Flap / Internal Mammary Arteries
E. Lateral Arm Free Flap / Posterior Radial Collateral Artery

979) Which of the following anatomical structures DIVIDES the Lacrimal Gland into an Orbital Lobe and a Palpebral Lobe?

A. The Müller muscle
B. The Medial Canthal Tendon
C. The Levator Aponeurosis
D. The Orbital Septum
E. The Superior Oblique Muscle

980) Which of the following dosages is the MAXIMUM DOSAGE LIMIT (MG/KG) of Bupivacaine without Epinephrine?

A. 1.5 mg/Kg
B. 2.5 mg/Kg
C. 3.5 mg/Kg
D. 4.0 mg/Kg
E. 5.0 mg/Kg


ANSWERS & REFERENCES


971) D     12 months wait since initial trauma

Kokoska M. S., Thomas J. R.: Scar Revision, Chapter 5, in Facial Plastic and Reconstructive Surgery (Papel I. D., editor), 2002, pp. 55-60

Kokoska M. S., Thomas J. R.: Scar Revision, Chapter 5, in Facial Plastic and Reconstructive Surgery (Papel I. D., editor), 2009, pp. 59-65

http://emedicine.medscape.com/article/838297-overview

972) B     The lateral antebrachial Nerve is used to obtain a sensate flap.

Burkey B.B., Coleman Jr., J. R.: Microvascular Flaps, Chapter 47 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, pp.578-560, 2002

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

973) A     Inhibits the release of Acetylcholine at the presynaptic level.

Blitzer A. , Binder W. J. , Brin M. F. : Botulinum Exotoxin A (Botox) for Facial Wrinkles, chapter 23, in Facial Plastic and Reconstructive Surgery (Papel I. D., editor), 2002, pp. 262-268

Lam S.M.: The basic science of botulinum toxin, Botox, ( Dayan S.H., Guest Editor), Facial Plastic Surgery Clinics of NorthAmerica, November 2003, pp.431-438

974) B     Glucosamine

Heller J., Gabbay J. S. , Ghadjar K., Jourabchi M. , O’hara C., Heller M., Bradley J. P.: Top-10 List of Herbal and Supplemental Medicines Used by Cosmetic Patients: What the Plastic Surgeon Needs to Know? Plastic and Reconstructive Surgery, Feb. 2006, Vol. 117, No. 2, pp. 436-445

975) B     The technique is based in two large and wide scalp flaps.

Frodel J. L., Ahlstrom K. : Reconstruction of Complex Scalp Defects, Arch. Facial Plastic Surg. , Vol. 6, Jan-Feb. 2004, pp. 54-60


http://www.emedicine.com/plastic/topic82.htm

976) E     12 months

Cupp C. L., Larrabbe Jr. W.F: Reconstruction of the lips, Operative Techniques in Otolaryngology-Head and Neck Surgery, Vol. 4, N0. 1, March, 1993, pp. 46-53

DeFatta R. J., Williams III E. F.: Lip Reconstruction, Chapter 61 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, pp. 841-854, 2009

977) C     8 weeks

Kokoska M. S., Thomas J. R.: Scar Revision, Chapter 5, in Facial Plastic and Reconstructive Surgery (Papel I. D., editor), 2002, pp. 55-60

Kokoska M. S., Thomas J. R.: Scar Revision, Chapter 5, in Facial Plastic and Reconstructive Surgery (Papel I. D., editor), 2009, pp. 59-65

978) A     Rectus Myocutaneous Free Flap / Deep Superior Epigastric Vessels

Burkey B.B., Coleman Jr., J. R.: Microvascular Flaps, Chapter 47 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, pp.578-560, 2002

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

979) C     The Levator Aponeurosis

Burkat C. N. , Lemake B. N. : Anatomy of the Orbit and Its Related Structures, Otolaryngology Clinics of North America, Vol. 38, No. 5, 2005, pp. 825-856

980) B     2.5 mg/Kg

Fletcher M.: Anesthesia in Facial Plastic Surgery, Chapter 14 in Facial Plastic and Reconstructive Surgery, Second Edition, (Papel I. D., editor), 2002, pp.145-152

Fletcher M.: Anesthesia in Facial Plastic Surgery, Chapter 14 in Facial Plastic and Reconstructive Surgery, Third Edition, (Papel I. D., editor), 2009, pp. 189-197

---------------------------------------
Updated: July 25, 2017

981-990 MCQ in Facial Plastic and Reconstructive Surgery

981-990

981) The drawing below represents the right bony orbit. Which of the following anatomical structures DOES NOT pass through the opening indicated by the arrow?

A. Oculomotor Nerve
B. Trochlear Nerve
C. Abducens Nerve
D. Infraorbital Nerve
E. V1 Nerve

982) Which of the following free tissue transfer flaps used for Head and Neck Reconstruction is considered IDEAL for total mandibular reconstruction?

A. Fibula Osteocutaneous Free Flap
B. Scapular Osteocutaneous Free Flap
C. Iliac Crest Osteocutaneous Flap
D. Radius Osteocutaneous Free Flap
E. Rib Osteocutaneous Free Flap

983) Which of the following in the adult male patient represents INCORRECT motivation for Cosmetic Plastic Surgery?

A. Internal motivation
B. A clear disfigurement noted by patient and surgeon
C. Occupational appearance important to the patient
D. Corrective surgery planned for a short time
E. Aging adequately but patient wants to look younger

984) Which of the following surgical incisions is MOST commonly used in the correction of Craniofacial Deformities?

A. Bilateral Rhitidectomy Incision
B. Bilateral Lateral Rhinotomy with infraorbital extension
C. Bicoronal Insicion
D. Midface Degloving Incision and Bilateral Brow Incision
E. Bilateral Intraoral Buccal Incision

985) Which of the following is the CORRECT plane of elevation for the Forehead Flap?

A. Subcutaneous
B. Subgaleal
C. Subperiosteal
D. Between the Frontalis Muscle and the subcutaneous layer
E. Between the Frontalis Muscle and the Galea Aponeurosis

986) Which of the following indicates the LOCATION in the Orbit of the Optic Foramen?

A. Greater Wing of the Sphenoid
B. Lesser Wing of the Sphenoid
C. Orbital Roof of the Frontal Bone
D. Lateral Orbital Wall of the Orbit
E. Medial Orbital Wall of the Posterior Ethmoid

987) Which of the following areas is MOST commonly complicated by skin flap necrosis in Rhytidectomy?

A. Temporal
B. Preauricular
C. Postauricular
D. Midcheek
E. Submental

988) Which of the following represents ADEQUATE management of a displaced fracture of the Body of the Mandible in a 7 year old patient.?

A. Soft diet, analgesics and antibiotics
B. Closed reduction with fixation using Orthodontic Splints.
C. Open reduction with Ivy Loop Fixation
D. Open reduction with Maxillomandibular Fixation
E. Open reduction with Miniplates Fixation

989) Which of the following examinations is MOST likely to detect ocular damage after Argon laser?

A. Fluorescein Eye Drops
B. Direct Eye Fundus evaluation
C. Corneal and Conjuntival Under Magnification
D. Refraction evaluation
E. Slit Lamp evaluation

990) Which of the following statements about the Radial Forearm Flap is FALSE?

A. It is a Fascial Flap.
B. It is a Fasciocutaneous Flap.
C. It can be harvested with or without bone.
D. It is based on the Radial and Ulnar Arteries.
E. It is a sensate flap.

ANSWERS & REFERENCES


981) D      Infraorbital Nerve

Burkat C. N. , Lemke B. N. : Anatomy of the Orbit and Its Related Structures, Otolaryngology Clinics of North America, Vol. 38, No. 5, 2005, pp. 825-856

982) A     Fibula Osteocutaneous Free Flap

Burkey B.B., Coleman Jr., J. R.: Microvascular Flaps, Chapter 47 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, pp.578-560, 2002

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

Genden E. M., Buchbinder D., Urken M.L.: Mandible Recontruction and Osseointegrated Implants, Chapter 48 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, pp.591-600, 2002

983) D     Corrective surgery planned for a short time

http://www.emedicine.com/plastic/topic36.htm

984) C     Bicoronal Insicion

Vander Kokk C. A., Carson B. S., Guarnieri M.: Craniomaxillofacial Deformities, Chapter 63 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, pp. 795-802, 2002

985) B     Subgaleal

Park S. S.: Local and Regional Cutenous Flaps, Chapter 44 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, pp. 540-542, 2002

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

986) B     Lesser Wing of the Sphenoid

Burkat C. N. , Lemke B. N. : Anatomy of the Orbit and Its Related Structures, Otolaryngology Clinics of North America, Vol. 38, No. 5, 2005, pp. 825-856

987) C     Postauricular

Perkins S., Dayan S.: Rhytidectomy, Chapter 15 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, pp. 167-170, 2002

Perkins S., Naderi S.: Rhytidectomy, Chapter 19 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, pp. 207-225, 2009

Clevens R. A.: Avoiding Patient Dissatisfaction and Complications in Facelift Surgery, Facelift: Current Approaches, Facial Plastic Surgery Clinics of North America (Prendiville S.,Guest Editor), Nov. 2009, Vol. 17, No. 4, pp. 515-530

988) B     Closed reduction with fixation using Orthodontic Splints.

Burkat C. N. , Lemke B. N. : Anatomy of the Orbit and Its Related Structures, Otolaryngology Clinics of North America, Vol. 38, No. 5, 2005, pp. 825-856

989) B     Direct Eye Fundus evaluation

Russell Ries W., Powitzky E. S.: Lasers in Facial Plastic Surgery, Chapter 8 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, pp. 79-95, 2002

Russell Ries W., Wittkopf M.: Lasers in Facial Plastic Surgery, Chapter 10 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, pp. 99-118, 2009

http://emedicine.medscape.com/article/1120837-overview

990) D      It is based on the Radial and Ulnar Arteries.

Chepeha D. B., Teknos T. N.: Microvacular Free Flaps in Head and Neck Reconstruction, Chapter 162 in Head & Neck Surgery-Otolaryngology, (Bialey B.J, editor), Third Edition, 2001, pp.2045-2047

Burkey B.B., Coleman Jr., J. R.: Microvascular Flaps, Chapter 47 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, 2002, pp.569-571

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

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Updated: July 25, 2017

991-1000 MCQ in Facial Plastic and Reconstructive Surgery

991-1000

991) With respect to the reconstructive technique used in the repair of Unilateral Cleft Lip as depicted in the drawing below, which of the following measurements is INCORRECT? A. 1 to 2 = 1 to 3
B. 1 to 2 + 1 to 3 = 6 mm
C. 2 to 4 = 8 to 10
D. 3 to 5 to X = 8 to 9 to 10
E. 2 to 6 = 8 to 7

992) Which one of the following anatomical structures is NOT related to the Triangular Space in the design of the Scapula Free Flap?

A. Long Head of the Triceps
B. Teres Minor Muscle
C. Teres Major Muscle
D. Serratus Anterior Muscle
E. Circumflex Scapular Artery

993) Which of the following statements about Jejunal Free Flap is TRUE?

A. It is an unreliable flap when used for 360º circumferential pharyngoesophageal defects.
B. The maximum length of Jejunum harvested is 15 cm.
C. The second arcade of Jejunum is the best for Pharyngeal Reconstruction.
D. Isoperistaltic orientation of the Jejunum is unnecessary.
E. External monitoring of the Jejunum is not helpful.

994) Which of the following porous implant “pore” sizes carries the LOWER RISK of infection?

A. 1 μm
B. 20 μm
C. 40 μm
D. 50 μm
E. 60 μm

995) The ratio of cranial vault to facial skeleton (CRANIOFACIAL RATIO) in an infant is:

A. 8:1
B. 6:1
C. 5:1
D. 4:1
E. 2:1

996) Which of the following statements about the anterior scalping flap of Converse is INCORRECT?

A. It is an option for reconstruction of subtotal or total nasal tissue losses.
B. Most of the incision is hidden behind the hairline.
C. The working portion of the flap is raised from the medial portion of the Forehead.
D. It may to be rolled on itself.
E. The defect in the forehead is filled with a Full Thickness Skin Graft (FTSG) from the postauricular Area.

997) Which of the following statements about a Pinched Nasal Tip is INCORRECT?

A. It is usually iatrogenic.
B. It is caused by excesive resection of the Lower Lateral Cartilage
C. It is involved collapse of the Internal Nasal Valve.
D. Autogenous Nasal Septal Cartilage is used for correction.
E. A precise pocket is formed with a Close Rhinoplastic Approach.

998) Which of the following statements in cervicofacial liposuction is FALSE?

A. The patient surgical area is marked while sitting upright
B. 4 mm blunt-tipped suction cannula can be used
C. 2 atm negative pressure is usually applied for suctioning
D. The cannula openings is always directed away from the dermis
E. Puncture skin incisions for liposuction are made in the nasal vestibule, posterior lobular crease, and submental crease.

999) Which of the following mm Hg is recommended in order to INFLATE the thigh tourniquet used in the harvesting of a Free Fibula flap?

A. 50 mm Hg
B. 150 mm Hg
C. 250 mm Hg
D. 350 mm Hg
E. 500 mm Hg

1000) Which implant particle size can NOT be phagocytized by tissue macrophages?

A. 15 μm
B. 25 μm
C. 35 μm
D. 55 μm
E. 65 μm



ANSWERS & REFERENCES

991) D     3 to 5 to X = 8 to 9 to 10

Sykes J.M.:Diagnosis and Treatment of Cleft Lip and Palate Deformities , Chapter 65 in Head & Neck Surgery-Otolaryngology, (Bialey B.J, editor), Third Edition, 2001, pp. 819-822

Ness J. A. , Sykes J. M.: Basics of Millard Rotation-Advancement Technique for Repair of the Unilateral Cleft Lip Deformity, Facial Plastic Surgery, Vol.9, No. 3, July 1993, pp.167-176

Capone R.B., Sykes J. M.: Evaluation and Management of Cleft Lip and Palate Disorders, Chapter 76 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, pp.1059-1078, 2009

992) D     Serratus Anterior Muscle

Chepeha D. B., Teknos T. N.: Microvascular Free Flaps in Head and Neck Reconstruction, Chapter 162 in Head & Neck Surgery-Otolaryngology, (Bialey B.J, editor), Third Edition, 2001, pp.2058-2060

Burkey B.B., Coleman Jr., J. R.: Microvascular Flaps, Chapter 47 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, 2002, pp.579-580

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

993) C     The second arcade of Jejunum is the best for Pharyngeal Reconstruction.

Chepeha D. B., Teknos T. N.: Microvacular Free Flaps in Head and Neck Reconstruction, Chapter 162 in Head & Neck Surgery-Otolaryngology, (Bialey B.J, editor), Third Edition, 2001, pp. 2060-2061

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

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

994) E     60 μm

Costantino P. D., Friedman C. D., Soft-Tissue Augmentation and Replacement in the Head and Neck, General Consideration, Otolaryngologic Clinics of North America, Vol. 27, No. 1, February 1994, pp. 1-12

995) A     8:1

Muntz H. R., Shapiro A.: Pediatric Maxillofacial Trauma, Chapter 34 in Complications in Pediatric Otolaryngology (Josephson G. D., Wohl D. L., editors), Tayoor & Francis, 2005, pp. 553-566

996) C     The working portion of the flap is raised from the medial portion of the Forehead.

Leach J.: Reconstruction of Nasal Tissue Defects, A Self-Instructional Package, American Academy of Otolaryngology-Head and Neck Surgery Foundation, 1998, pp. 60-75

997) C     It is involved collapse of the Internal Nasal Valve.

Kamer F. M.: Revision Rhinoplasty, Chapter 178 in Head and Neck Surgery-Otolaryngology, (Bailey, B. J., Johnson J. T., Newlands S.D., editors) , 3rd Edition, pp. 2291-2302, 2001

998) C     2 atm negative pressure is usually applied for suctioning

Kridel R. W.H., Kelly P. E., Castellano R. D.:Liposuction of the Face and Neck: The Art of Facial Sculpture, Chapter 24 in Facial Plastic and Reconstructive Surgery (Papel I.D. & Nachlas N. E, editors), Thieme, Third Edition, pp. 286-300, 2009

http://emedicine.medscape.com/article/842367-overview

999) D     350 mm Hg

Chepeha D. B., Teknos T. N.: Microvacular Free Flaps in Head and Neck Reconstruction, Chapter 162 in Head & Neck Surgery-Otolaryngology, (Bialey B.J, editor), Third Edition, 2001, pp.2055-2057

1000) E     65 μm

Quatela V. C., Sabini P., Synthetic Implants, Chapter 6 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, 2002, pp. 61-72

Costantino P. D., Friedman C. D., Soft-Tissue Augmentation and Replacement in the Head and Neck, General Consideration, Otolaryngologic Clinics of North America, Vol. 27, No. 1, February 1994, pp. 1-12

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Updated: August 5, 2017