125 Questions
What is the main aim of plastic surgery?
To restore the function and appearance of damaged tissue and skin
What is the origin of the term 'plastic' in plastic surgery?
It derived from an ancient Greek word meaning to mold or give form
What is a common misunderstanding about the term plastic surgery?
It refers to using artificial materials in surgery
What type of tissue is plastic surgery primarily concerned with?
Skin and damaged tissue
What does the word 'plastikos' mean?
To mold or give form
What is the purpose of providing tension on the incision during surgery?
Separating tissue layers and controlling incision depth
In plastic surgery, what is recommended for skin closure techniques to avoid when leveling both wound edges?
Creating side-to-side step offs
Which technique is suggested to bring like margins together during skin closure?
Everting skin margins
Why is it important not to create 'death by a thousand cuts' during incision planning in plastic surgery?
To maintain a smooth cut for better healing
What risk is associated with inverted margins in skin closure techniques?
Formation of a larger scar bridge between tissue types
How long is the recommended timing for suture removal on the face?
5 to 7 days
How many wound edges should be leveled during the skin closure process?
Both
At what timing is the removal of sutures recommended for the neck?
5 days
How many days of timing is suggested for suture removal on the trunk and upper extremities?
7 days
What is the suggested duration for suture removal on the lower extremities?
7 to 10 days
In skin grafting, what distinguishes an axial flap from a random flap?
Blood supply mechanism
What is the fundamental ratio for the basic fusiform ellipse in closing a wound with a skin defect?
3:1 with 30-degree angles
What factor determines the survival of a skin graft according to Bennett's lecture on GRAFT?
Recipient site blood supply
Which type of skin graft requires undermining to advance the flap?
V-Y island flap
What technique involves tissue rearrangement to redirect tension in plastic surgery?
Z-Plasty
How much length increase can be achieved in a skin flap with a 30-degree angle Z-Plasty?
25%
In Z-Plasty, what is the significance of orienting the original lateral arms close to Relaxed Skin Tension Lines (RSTLs)?
It enhances the final length of the flap
Which type of skin graft relies entirely on blood supply from the recipient site for survival?
Full thickness graft
What is the purpose of using a porcine graft as a temporary biological dressing?
To prewound the recipient site and stimulate blood vessel formation
Why is it important to ensure that the wound bed is clean enough before placing a porcine graft?
To prevent gram-negative bacteria from thriving
When should a porcine graft typically be removed?
After 3-4 days
What happens if a porcine graft does not progress in 'take' during the healing process?
The autograft will not take either
Which type of skin graft is more prone to secondary contracture?
Full thickness skin grafts
What is the purpose of meshing a skin graft?
To allow fluid drainage and cover larger areas
What is the function of a stent or bolster dressing in skin grafting?
Reduces fluid accumulation
Which characteristic is associated with pie crusting in skin grafting?
Minimal expansion compared to meshing
Why is negative pressure wound therapy used in skin grafting?
To accelerate wound healing
What are reasons for skin graft failure?
Poor tissue handling and excessive stretching
Which factor plays a crucial role in selecting the placement of skin incisions?
Target tissue exposure
What is the consequence of making an incision perpendicular to Relaxed Skin Tension Lines (RSTLs) in plastic surgery?
Minimal available movement resulting in more tension
What is the significance behind choosing an incision orientation parallel to the skin's RSTLs?
Less tension during wound healing
Which medical professional performed a cadaveric study in 1861 to map the Relaxed Skin Tension Lines on the foot and ankle?
Karl Langer
What is the main reason why skin tension is crucial in choosing incisional placement?
To achieve optimal wound healing
How do incisions made across the skin's maximal tension typically affect scar appearance in wound healing?
Lead to stretched, hypertrophic scars
What is the primary function of providing tension on the incision during surgery?
Separate tissue layers and maintain control of incision depth
Why is it advised to draw 'crosshatches' for skin re-approximation but avoid creating them during incision planning?
To prevent the 'death by a thousand cuts' approach
In plastic surgery, what is the purpose of everted skin margins during skin closure?
To reduce the risk of unlike tissue approximation
What is a critical characteristic of good techniques for skin closure to avoid during suturing according to the text?
No vertical step off
Why do skin margins need to be leveled during skin closure in plastic surgery?
To avoid side-to-side step off in wound alignment
What is the function of a bolster dressing in skin grafting procedures?
To mechanically stabilize the graft in position
What is the ideal location for making an incision between two pedal angiosomes?
At the exact border of both angiosomes
Which type of angiosome does the dorsalis pedis artery supply?
Anterior Perforating
In the context of pedal angiosomes, where is the Lateral Plantar angiosome located?
Between the medial and lateral calcaneal angiosomes
Why is the subdermal arteriolar plexus significant in foot and ankle design?
It assists in creating pedal angiosomes for surgical techniques
What connection does the lateral plantar artery make with the dorsalis pedis artery?
In a circumferential wraparound pattern
What is the primary function of the lateral plantar angiosome?
Providing blood flow to the lateral sole and heel
What is the purpose of a Limberg rhomboid in plastic surgery?
To create a transpositional flap with angles of 60 and 120 degrees
What makes an autograft different from a xenograft in skin grafting?
An autograft relies on the recipient site's blood supply for survival
In skin grafting, what distinguishes an isograft from an allograft?
The isograft is from one genetically identical person to another
What is the key characteristic of a double rhomboid flap in plastic surgery techniques?
Creating a transpositional flap with two adjacent rhomboid shapes
What is the major drawback of skin grafting in comparison to synthetic skin substitutes?
Reliance on the recipient site's blood supply for graft survival
What is the main benefit of using a transpositional flap in plastic surgery?
Allowing for revascularization of the flap before releasing the pedicle
What is the purpose of using a stent or bolster dressing in skin grafting?
To decrease fluid accumulation
What factor primarily determines the survival of a skin graft?
Recipient vascularity
Why is it crucial to avoid creating 'death by a thousand cuts' during incision planning in plastic surgery?
To prevent tissue damage and ensure proper healing
Which type of skin graft is more prone to secondary contracture?
Full thickness skin grafts
What is the main disadvantage of Negative Pressure Wound Therapy (NPWT) or Vacuum Assisted Closure (Wound VAC) in skin grafting?
Attached to a pump
What is the primary characteristic of Pie Crusting technique in skin grafting?
Minimal expansion
When do Myofibroblasts in the recipient bed pull on the skin graft in skin grafting procedures?
During the process of secondary contracture
Why is meshing a skin graft recommended in certain cases?
To allow it to adhere to irregular surfaces
What characteristic sets biological skin substitutes like amnionic grafts apart from synthetic substitutes?
Ability to promote granulation
What common technical error can lead to skin graft failure?
Applying the graft with the dermis side facing down
What is claimed to be the normal degrees of ankle joint dorsiflexion for human ambulation?
10 degrees
Which muscle forms the superficial flexor group of the leg along with the gastrocnemius and plantaris muscles?
Triceps surae
How many joints does the gastrocnemius muscle crossover?
3
The triceps surae muscle consists of which of the following two muscles?
Gastrocnemius and Soleus
Which muscle crosses two joints in the lower extremity?
Gastrocnemius
What is a common clinical exam finding associated with equinus?
Forefoot pressure ulcers
Which of the following is NOT a type of equinus mentioned in the text?
Fibula equinus
What is a likely sequela of equinus according to the text?
Hypermobile first ray
In equinus, what is the clinical significance of the Silfverskiold Test being positive?
Indicates gastrocnemius contracture
Which of the following conditions is not mentioned as a cause of equinus in the text?
Patellar tendon rupture
What is a potential biomechanical result of equinus in the lower extremity?
Reduction in knee extension moment arm
What is a key characteristic of Equinus described in the text?
It is commonly associated with constricted ankle joint dorsiflexion
Which conditions are NOT mentioned as potentially related to Equinus in the text?
Headache and nausea
What is the normal range for ankle joint dorsiflexion?
0 degrees to 16.5 degrees nonweightbearing
What is one objective mentioned in the text regarding Equinus?
Describe the clinical examination of Equinus
Which term is NOT used as a symptom related to Equinus in the text?
Myocardial infarction
What is one of the conditions NOT directly treated by addressing the Equinus component?
Inguinal hernia
What radiographic findings are commonly seen in patients with Equinus?
Talar lipping and osteophytes
What is a non-invasive option to help reduce calf muscle tightness in equinus?
Night splint
What defines the condition described as Pseudoequinus in podiatric biomechanics?
Forefoot equinus position using less available ankle joint motion
How does wearing shoes with moderate heels help in managing equinus symptoms?
Takes stress off the Achilles tendon
What is a significant feature of casting or splinting in the plantarflexed position for Equinus treatment?
It targets the widest part of the talus for immobilization
What is a common treatment for equinus involving custom devices inside the shoes?
Orthotic devices
What is the primary treatment approach for Pseudoequinus?
Conservative treatment with immobilization devices
Which treatment option for equinus specifically focuses on keeping weight distributed properly in the foot?
Orthotic devices
Why are exercises that stretch the calf muscles recommended in equinus treatment?
To reduce calf muscle tightness
What differentiates Hemophilic Equinus Contracture from other Equinus types?
Association with repeated hemarthrosis
Which treatment option for equinus aims to relieve symptoms through footwear modification?
Heel lifts
How is Equinus primarily resolved?
Immobilization in a dorsiflexed position
What are the radiographic findings commonly associated with Equinus?
Talar lipping, osteophytes
What theory suggests that abnormal foot function occurs when 'equinus' is present?
Equinusentation
Which type of Equinus might describe a forefoot in equinus position using up limited ankle joint motion?
Pseudoequinus
Which muscle group forms the bulk on the back of the calf along with the plantaris muscle?
Superficial flexor group
Which Equinus type does well with conservative treatment and accommodative care?
Pseudoequinus
What is the primary muscle that crosses three joints in the lower extremity?
Gastrocnemius muscle
In Equinus, what is the distinguishing feature of the forefoot with an anterior cavus deformity?
Forefoot loads earlier
What is considered the normal amount of ankle joint dorsiflexion required for human ambulation?
10 degrees
What is a characteristic of the Charger view imaging for Equinus diagnosis?
Lateral projection with dorsiflexion stress
Which Equinus type results from trauma with improper immobilization and recurrent synovitis?
Recurrent synovitis Equinus
Which muscle is part of the triceps surae muscle group in the lower leg?
Gastrocnemius
What is a possible medical condition that could cause a clonic spasm of triceps surae?
Tonic spasm of triceps surae
Which factor could contribute to the development of an acquired Equinus?
Back pain
What could be a possible cause of an excessive pronation leading to Equinus?
Tarsal coalition
Which type of Equinus may involve a combination of Gastrocnemius and Osseous factors?
Pseudoequinus
Which condition is more likely to result in Pes valgus as a sequelae?
Excessive pronation
What could be a possible causative factor for Genu Recurvatum in Equinus?
Developmental Equinus
What extreme view is expressed about Equinus in the text?
Equinus should always be surgically treated without exception.
What is the implied attitude towards the surgical correction of Equinus in the text?
Surgery should be the first and only option considered for Equinus treatment.
What aspect of Equinus treatment is heavily promoted in the text?
Addressing Equinus surgically as soon as possible after diagnosis.
What ethical concern is raised related to Equinus in the text?
The undisclosed financial interests of healthcare professionals in Equinus surgery.
What is the extreme point of view presented regarding Equinus and its consequences?
Equinus is a severe issue that affects the entire body's functionality.
What message is strongly conveyed about Equinus surgery in the text?
Routine Equinus surgery is essential for overall body health.
What does the Hoke Achilles Lengthening Procedure primarily aim to reduce?
Forefoot pressure
In Z-Plasty, what does the 'Z' refer to in sagittal Z-lengthening?
Medial and lateral pieces
What is the commonality between Distal Z Lengthening and Percutaneous Tendo-Achilles Lengthening?
Utilization of TAL
What distinguishes the PTAL or TAL procedure from the open surgical correction of ankle equinus?
Length of the incision
In percutaneous Tendo-Achilles Lengthening, what surgical approach does the 'More Medial' technique utilize?
Medial approach
What is the primary reason for recommending the 'Triple Stab' minimal incision technique in the Hoke Achilles Lengthening Procedure?
Minimizing scarring
Learn about incision techniques for common pathologies, basic random flaps, indications for skin grafting, sites of harvest, complications, and treatment of donor sites in plastic surgery. Understand the origin of the term 'plastic' in plastic surgery.
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