General Anatomy
Lateral arm flap anterograde and retrograde supply
Radial collateral artery, radial recurrent artery
What is the parkland formula
4 x Kg x %TBSA (1/2 given in first 8 hours, remaining in 16 hours)
Penile replantation – what artery/vein should you anastomose?
Deep dorsal artery and vein
Name 3 lasers that can be used for vascular lesions (hemoglobin chromophore)
KTP, Pulsed dye, Nd: YAG, IPL
Name the syndrome: Multiple enchondromas + telangiectasias
Maffucci
Name the borders and neurovasculature in the triangular space
Teres major, teres minor, triceps
Circumflex scapular artery
Lidocaine and Marcaine are an ___ (ester/amide) and are excreted in the (liver/renal system)
Amide, liver
Is prior abominoplasty a contraindication for VRAM in pelvic reconstruction?
Yes
What agent can be administered before dermabrasion to prevent hyperpigmentation?
Hydroquinone
Name the syndrome: large facial port wine stain in VI/V2 distribution + leptomeningeal venous malformations
Sturge-weber
Name the borders and neurovasculature in the quadrangular space
Teres major, teres minor, triceps, surgical neck of the humerus
Radial collateral artery, axillary nerve
Max doses for the following: plain lidocaine, lidocaine w epi, bupivacaine w or w/o epi
Plain lido: 4.5-5mg/kg
lido with epi: 7mg/kg
bupivacaine 2.5-3mg/kg
In phalloplasty using radial forearm free flap, what two recipient nerves are typically anastomosed to for tactile sensation and erogenous sensation?
Tactile: ilioinguinal
erogenous: dorsal clitoral nerve
MOA hydroquinone
Block conversion of dopamine to melanin; blocking tyrosinase
Name the syndrome: capillary malformation overlying venous/lymphatic malformation + extremity hemihypertrophy
Klippel-trenaunay
Nerve providing sensation to axilla, medial arm, lateral chest; can be injured in ALND
Intercostobrachial nerve
Main side effects of the following medications: Silvadene, sulfamylon, silver nitrate
Silvadene: leukopenia
sulfamylon: acidosis
silver nitrate: hyponatremia/hypokalemia
Most common complication of vaginal reconstruction
Vaginal stenosis
Name 1 of the 2 lasers best to improve scar color, and 1 of the 2 best for improving scar texture/thickness
Color: pulsed yellow, Nd:YAG
Texture: Fractional Er:YAG, Fractional CO2
In patients with giant congenital nevus and many satellite lesions, what imaging should be ordered?
Neurocutaneous melanosis, MRI brain and spine
The pedicle for the free fibula flap travels between what two muscles of the lower extremity?
Tibialis posterior (anterior) and FHL (posterior)
In hydrofluoric acid burns, what is the main electrolyte abnormality and what should be given as treatment?
Hypocalcemia, calcium carbonate/gluconate
Name two local flap options that will provide sensation in vaginal reconstruction and the nerves that supply the sensation
Singapore (pudendal thigh flap) – posterior labial branches of the pudendal nerve
PAP – posterior femoral cutaneous nerve
Mechanism of greater dermal injury with CO2 laser compared to Er:YAG?
Er:YAG has 10x greater affinity for water and pulse rate is shorter
Name the syndrome: similar features as Klippel-trenaunay but has AVM on MRI
Parks-Weber