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Emergency Medicine > Plastic Surgery > Flashcards

Flashcards in Plastic Surgery Deck (22)
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1
Q

What organisms are characteristic of cat bites?

A

Pasteurella

2
Q

What organism is worrisome in ~15% dog bites?

A

Capnocytophagia canimoris

  • can cause disseminated sepsis in elderly and aplenic patients.
  • Gram negative.
3
Q

What are the ideal timing of laceration closures for hand/leg, trunk and face?

A

Hand/leg 8 hours

4
Q

What is the timing of suture removal for face, scalp/trunk, extremities/joints?

A

face: 5 days
scalp/trunk: 7 days
extremities/joints: 10-14 days

5
Q

What are the contents of the carpel tunnel? (10 structures)

A
  • Median n.
  • Flexor digitorium profundus (4)
  • Flexor digitorum superficialis (4)
  • Flexor pollicis longus
6
Q

What are the intrinsic m. of the hand? (5 categories)

A
  1. Thenar m (abductor pollicus brevis, opponens pollicis, flexor pollicis brevis)
  2. Hypothenar (opponens digiti minimi, flexor digiti minimi, abductor digiti minimi)
  3. Adductor pollicus
  4. Lumbricals
  5. Interossei
7
Q

What is the thenar m. innervated by?

A

Median n. in some cases partially by the ulnar.

8
Q

What are the flexors of the hand?

A
Flexor pollicus longus/brevis
Flexor carpi radialis
Flexor retinaculum
Flexor digitorum
Flexor digitorum profundus
Flexor digitorum superficialis
Palmaris longus
Flexor carpi ulnaris
Flexor digiti minimi
9
Q

The extensor tendons of the hand are separated by how many fibro-osseous canals or compartments?

A

6

10
Q

What are the 9 extensors of the hand?

A

Abductor pollicus longus
Extensor pollicus brevis

Extensor carpi radialis longus
Extensor carpi radialis brevis

Extensor pollicus longus

Extensor digitorum (communis)
Extensor indicis (proprius)

Extensor digiti minimi

Extensor carpi ulnarus

11
Q

What are the 4 classic signs (Kanavel) of flexor tenosynovitis?

A
  1. Position of flexion
  2. Pain on passive extension
  3. Fusiform swelling
  4. Tenderness on palpation of synovial sheath.
12
Q

What is the motor and sensory function of the radial n.?

A

Motor: wrist extension

* in hand: purely sensory: Dorsum only

13
Q

What layer does superficial partial thickness burns involve?

Deep partial thickness?

A
  • Epidermis, Dermis (the papillary layer) sparing the hair follicles, sebaceous and sweat glands.
  • Deep partial thickness involves the reticular layer of the dermis (involving hair follicles, sweat glands etc)
14
Q

What physical exam findings are characteristic of superficial burns?

A

Erythema, very painful - sunburn like

NO blisters

15
Q

Physical exam findings of superficial partial thickness burns?

A
  • Erythema
  • Blistering
  • Very painful
  • Cap refill present.
16
Q

What time period should superficial partial thickness burns heal?

A

14-21 days (2-3 weeks)

17
Q

Physical exam findings of deep partial thickness burns?

A
  • May have blisters
  • Yellow/white (not erythematous)
  • NO cap refill
  • No sensation
    Hard to distinguish from full thickness burns
18
Q

What time period should deep partial thickness burns heal?

A

3 weeks - 2 months

May need surgical intervention and skin grafting

19
Q

Physical exam findings of full thickness burns (formerly 3rd degree)?

A
  • Charred skin
  • Pale
  • Painless
  • Leather like
  • Goes into the subcutaneous fat tissue
    ALL need skin grafting bc all dermal elements are destroyed.
20
Q

Physical exam findings of 4th degree burns?

A

Extends to muscle and bone.

- Sometimes req amputation or extensive reconstruction

21
Q

What is the parkland formula?

A

4cc x Kg x % BSA burn (not including superficial burns)
Ringers Lactate
- 1/2 given in first 8 hours, rest over 16 hours.
- U/O goal: 0.5-1 cc/kg/hr

22
Q

What is tenosynovitis?

A

Inflammation of the synovium surrounding tendons

The synovium is a thin layer of tissue only a few cells thick which lines the joints and tendon sheaths. The synovium acts to control the environment within the joint and tendon sheath. It does this in two ways: first, it acts as a membrane to determine what can pass into the joint space and what stays outside; second, the cells within the synovium produce substances that lubricate the joint.