Ota - Plastic Surgery (Ny!)

Front 1

Skin grafts can be used:
- to any soft tissue defect
- to the shallow planer defects
- to the exposed bone
- to the defect where a muscle is exposed

Back 1

Skin grafts can be used:
- to the shallow planer defects+
- to the defect where a muscle is exposed+

Front 2

Skin graft:
- consists of epidermis and dermis
- contains only the dermis
- contains only the epidermis
- is completely separated from the native blood supply

Back 2

Skin graft:
- consists of epidermis and dermis+
- is completely separated from the native blood supply+

Front 3

Autologous graft is:
- transferred from one region to another of the same individual
- transferred from one individual to another within the same species
- transferred between species
- transferred in cultured keratinocytes

Back 3

Autologous graft is:
- transferred from one region to another of the same individual+
- transferred cultured keratinocytes+

Front 4

Full thickness skin graft:
- survive transplantation less well
- can be used used on contaminated defects
- most constricts
- Is ussualy used to cover smaller well vascularised defects, most often in the face

Back 4

Full thickness skin graft:
- survive transplantation less well+
- Is ussualy used to cover smaller well vascularised defects, most often in the face+

Front 5

Skin grafts are harvested:
- by special knives
- only by a scalpel
- by dermatomes
- only by dermatomes

Back 5

Skin grafts are harvested:
- by special knives+
- by dermatomes+

Front 6

Skin mesh graft:
- survive transplantation less well
- is full thickness skin graft
- due to mesh increase its surface
- allow drainage of secretions

Back 6

Skin mesh graft:
- due to mesh increase its surface+
- allow drainage of secretions+

Front 7

Flaps:
- are segments of tissue
- consist only of the skin and subcutaneous tissue
- consist only of the muscles
- can be classified according vascular supply

Back 7

Flaps:
- are segments of tissue+
- can be classified according vascular supply+

Front 8

Axial pattern flaps:
- have random blood supply
- have a well-defined vascular supply
- may be used as a free flaps
- have not a better blood supply than other flaps

Back 8

Axial pattern flaps:
- have a well-defined vascular supply+
- may be used as a free flaps+

Front 9

Among random skin flaps belong:
- Indian flap
- Z-plasty
- axial groin flap
- door flap

Back 9

Among random skin flaps belong:
- Z-plasty+
- door flap+

Front 10

Muscle and musculocutaneous flaps:
- have random pattern flaps
- are flaps on the trunk
- are special types of axial pattern flaps
- depending on the type of blood supply can be divided into 5 groups

Back 10

Muscle and musculocutaneous flaps:
- are special types of axial pattern flaps+
- depending on the type of blood supply can be divided into 5 groups+

Front 11

Muscle and musculocutaneous flaps:
- has worse vascular suply than skin flaps
- preferably are used for chronic infected defects
- are not resistant to infection
- are usually rotated around the site of entrance of vascular pedicle

Back 11

Muscle and musculocutaneous flaps:
- preferably are used for chronic infected defects+
- are usually rotated around the site of entrance of vascular pedicle+

Front 12

Free flap trasnfer:
- mean tissue transfer from distant parts of the body using microsurgery+
- is the transfer of axial flaps+
- is always used as the first method of choice
- do not allow reconstruction of complicated defects, where is the loss of several types of tissues

Back 12

Free flap trasnfer:
- mean tissue transfer from distant parts of the body using microsurgery+
- is the transfer of axial flaps+

Front 13

Free flaps:
- can be harvested anywhere on the body
- have a well-defined vascular pedicle
- the vessels nourishing the flap are isolated, detached and than reatached to suitable distant recipient vessels
- can be used at any time

Back 13

Free flaps:
- have a well-defined vascular pedicle+
- the vessels nourishing the flap are isolated, detached and than reatached to suitable distant recipient vessels+

Front 14

Free flaps:
- are only skin flaps
- are only muscle flaps
- are also toe transfers
- are also omental or intestinal flaps

Back 14

Free flaps:
- are also toe transfers+
- are also omental or intestinal flaps+

Front 15

Superficial flexor:
- controls the last phalanx of the finger
- bends the middle phalanx of the finger
- inserts itself on the basis of the middle phalanx
- controls the movement only at the proximal joint

Back 15

Superficial flexor:
- bends the middle phalanx of the finger+
- inserts itself on the basis of the middle phalanx+

Front 16

The nutrition of tendon is maintained by:
- tiny vessels within the tendon
- synovial fluid and peritenonium
- vessels at the point of insertion to the bone and in the area of transition to the muscle belly
- is without nutrition

Back 16

The nutrition of tendon is maintained by:
- synovial fluid and peritenonium+
- vessels at the point of insertion to the bone and in the area of transition to the muscle belly+

Front 17

Middle joint of the finger is called:
- MP joint
- DIP joint
- PIP join
- interphalangeal joint

Back 17

Middle joint of the finger is called:
- PIP join+
- interphalangeal joint+

Front 18

Muscle bellies of finger flexors lies at:
- the palm
- the forearm on the volar side
- the forearm on the dorsal side
- proximally from the wrist

Back 18

Muscle bellies of finger flexors lies at:
- the forearm on the volar side+
- proximally from the wrist+

Front 19

Extensors of fingers on the hand:
- are superficial and deep
- go to the dorsal aponeurosis
- are on fingers flat
- are on fingers elliptical

Back 19

Extensors of fingers on the hand:
- go to the dorsal aponeurosis+
- are on fingers flat+

Front 20

Second zone of flexors:
- lies in the palm
- lies above proximal phalanges of fingers
- consists of tendon crossing (chiasma tendineum)
- is in the area of middle phalanges of fingers

Back 20

Second zone of flexors:
- lies above proximal phalanges of fingers+
- consists of tendon crossing (chiasma tendineum)+

Front 21

As a zone of no-mans land is called:
- the area of chiasma tendineum
- zone 2
- zone 3
- the insertion of the tendon to the bone

Back 21

As a zone of no-mans land is called:
- the area of chiasma tendineum+
- zone 2 +

Front 22

After an injury in the hand area:
- we always apply the tourniquet
- we use compression bandage
- we stabilize the limb on the splint
- we do not stop the bleeding to prevent the worsening of fingers nutrition

Back 22

After an injury in the hand area:
- we use compression bandage+
- we stabilize the limb on the splint+

Front 23

Injured hand is treated by:
- usually under local anaesthesia
- on principle of nerve blockage
- on principle of general anaesthesia
- nerve blockage is indicated in more extensive procedures

Back 23

Injured hand is treated by:
- usually under local anaesthesia+
- nerve blockage is indicated in more extensive procedures+

Front 24

Flexor tendons are sutured:
- always with resorbable stitches
- with monofilament suture fibre
- only with braided non resorbable fibres
- with fixation stitches and with the suture around the tendon on its circumference

Back 24

Flexor tendons are sutured:
- with monofilament suture fibre+
- with fixation stitches and with the suture around the tendon on its circumference+

Front 25

Cutted extensors tendons:
- we usually suture with mattress stitches
- we do not suture, they are treated only by fixation
- we fixate without suture and we use it in cases of insertion at the distal phalanges
- we connect them with wire cerclage

Back 25

Cutted extensors tendons:
- we usually suture with mattress stitches+
- we fixate without suture and we use it in cases of insertion at the distal phalanges+

Front 26

Treatment of a hand after suture of flexor tendons involves:
- fixation with plaster of Cramer splint
- fixation in plaster for the period at least of 6 weeks
- does not include fixation to enable the movement of fingers
- exercise with passive and active physiotherapy

Back 26

Treatment of a hand after suture of flexor tendons involves:
- fixation with plaster of Cramer splint+
- exercise with passive and active physiotherapy+

Front 27

An injury of the middle band of extensor above PIP joint:
- presents as the buttonwhole deformity
- presents as the Boutonniere deformity
- presents by an inability of finger flexion
- does not present, it is difficult to find out

Back 27

An injury of the middle band of extensor above PIP joint:
- presents as the buttonwhole deformity+
- presents as the Boutonniere deformity+

Front 28

Physiotherapy after an injury of hand tendons is:
- possible after the complete healing of tendons which means at least after 5-6 weeks
- only passive, exercise without tendon load
- the combination of passive, semi active and active physiotherapy
- absolutely necessary for the renewal of hand function

Back 28

Physiotherapy after an injury of hand tendons is:
- the combination of passive, semi active and active physiotherapy+
- absolutely necessary for the renewal of hand function+

Front 29

Nerve supply of finger is maintained by:
- n. medianus
- only n. ulnaris
- only n. radialis
- all mentioned nerves

Back 29

Nerve supply of finger is maintained by:
- n. medianus+
- all mentioned nerves+

Front 30

N. medianus innervates:
- thenar
- antithenar
- the majority of the thumb, 2nd and 3rd digit
- dorsum of the hand

Back 30

N. medianus innervates:
- thenar+
- the majority of the thumb, 2nd and 3rd digit+

Front 31

Each finger innervates:
- one digital nerve
- two digital nerves
- four digital nerves
- has individual inervation

Back 31

Each finger innervates:
- two digital nerves+
- has individual inervation+

Front 32

Injured interrupted peripheral nerves:
- we always suture with very delicate stitches
- we only move them closer and do not suture
- we suture every single axon
- we suture every single bundles under the microscope

Back 32

Injured interrupted peripheral nerves:
- we always suture with very delicate stitches+
- we suture every single bundles under the microscope+

Front 33

For the reconstruction of nerves we use the suture of:
- myelin sheaths
- every single nerve fibres
- perineurium
- epineurium

Back 33

For the reconstruction of nerves we use the suture of:
- perineurium+
- epineurium+

Front 34

The recovery of nerve conduction following the suture is:
- immediate
- long term
- depends on the intergrowth of axons
- in sensitive fibres quick, in motoric slow

Back 34

The recovery of nerve conduction following the suture is:
- long term+
- depends on the intergrowth of axons+

Front 35

Vascular hand supply is maintained by:
- arteria radialis
- arteria ulnaris
- arteria mediana
- arteria palmaris

Back 35

Vascular hand supply is maintained by:
- arteria radialis+
- arteria ulnaris+

Front 36

Radial and ulnar arteries:
- send direct branches to every single finger
- end at the wrist area
- create arcus palmaris superficialis
- create arcus palmaris profundus

Back 36

Radial and ulnar arteries:
- create arcus palmaris superficialis+
- create arcus palmaris profundus+

Front 37

Digital arteries are:
- at the ulnar side of fingers
- at the radial side of fingers
- at the dorsal area of fingers
- in the middle of the finger

Back 37

Digital arteries are:
- at the ulnar side of fingers+
- at the radial side of fingers+

Front 38

When treating injured arteries on the hand:
- we always ligate to prevent an extensive bleeding
- we suture in case of worsened perfusion of periphery
- we suture only thicker vessels
- we do not suture while persisting perfusion

Back 38

When treating injured arteries on the hand:
- we suture in case of worsened perfusion of periphery+
- we do not suture while persisting perfusion+

Front 39

Fractures of bones on the hand:
- we treat by physiotherapy
- we treat by the splint fixation
- we performe the osteosynthesis
- we reposition but do not fixate to preserve the movement

Back 39

Fractures of bones on the hand:
- we treat by the splint fixation+
- we performe the osteosynthesis+

Front 40

For the ostheosyntesis of hand bones we use:
- Kirschner wires
- splints and screws
- silicon plates
- ceramic plates

Back 40

For the ostheosyntesis of hand bones we use:
- Kirschner wires+
- splints and screws+

Front 41

Replantation is a surgical procedure in which:
- all important functional structures including restoration of blood circulation are reconstructed
- all functional units are reconstructed
- the continuity of amputated part of the human body is restored including its function
- the continuity of amputated part of the human body is restored

Back 41

Replantation is a surgical procedure in which:
- all important functional structures including restoration of blood circulation are reconstructed+
- the continuity of amputated part of the human body is restored including its function+

Front 42

Revascularisation involves:
- sufficient restoration of blood supply interrupted by trauma
- treatment of subtotal amputation
- the restoration of blood supply in subtotal ischemic amputation
- vessel anastomosis

Back 42

Revascularisation involves:
- sufficient restoration of blood supply interrupted by trauma+
- the restoration of blood supply in subtotal ischemic amputation+

Front 43

Amputated part is:
- cooled to a temperature of 4 C
- cooled to temperature of 10 C
- is kept frozen
- must not freeze

Back 43

Amputated part is:
- cooled to a temperature of 4 C +
- must not freeze+

Front 44

By primary treatment are tissues rinsed with:
- hydrogen peroxide
- isotonic sterile solution
- isotonic saline solution
- very low concentrated heparin solution

Back 44

By primary treatment are tissues rinsed with:
- isotonic sterile solution+
- isotonic saline solution+

Front 45

Amputated part is cooled during transport to replantation centre:
- in isotonic sterile solution
- in the form of dry cooling
- in the form of dry cooling, just the amputation area is covered by wet gaze
- around amputated part is laid crushed ice

Back 45

Amputated part is cooled during transport to replantation centre:
- in the form of dry cooling+
- in the form of dry cooling, just the amputation area is covered by wet gaze+

Front 46

Definite indication of replantation is:
- amputation of the thumb
- amputation of the index finger
- multiple finger amputation
- amputation of the ring-finger

Back 46

Definite indication of replantation is:
- amputation of the thumb+
- multiple finger amputation+

Front 47

Definite indication of replantation is:
- amputation at the palm level
- amputation of the index finger in proximal phalanx level
- amputation at the wrist level
- amputation of the index finger in MP joint level

Back 47

Definite indication of replantation is:
- amputation at the palm level+
- amputation at the wrist level+

Front 48

Definite indication of replantation is:
- amputation of the big toe
- multiple finger amputations on the leg
- amputation at the distal third of forearm
- amputation of the thumb at thenar level

Back 48

Definite indication of replantation is:
- amputation at the distal third of forearm+
- amputation of the thumb at thenar level+

Front 49

Ischemic period of time for amputated part which involves muscle tissue:
- must not exceed 7 hours
- is the period of time between amputation and the restoration of circulation
- is the period of time between amputation and admission to the replantation centre
- must not exceed 6 hours

Back 49

Ischemic period of time for amputated part which involves muscle tissue:
- is the period of time between amputation and the restoration of circulation+
- must not exceed 6 hours+

Front 50

The most frequent secondary surgeries after replantation are:
- flexor tendon tenolysis
- correction osteotomy
- secondary procedures on flexor tendons
- extensor tendon transposition

Back 50

The most frequent secondary surgeries after replantation are:
- flexor tendon tenolysis+
- secondary procedures on flexor tendons+

Front 51

Dominant indicative criteria for replantation include:
- the manner of cooling of amputated part during the transport to the replantation centre
- general status of the patient after an amputation injury
- the extent of crush zone of the amputated part and the stump
- administration of antibiotics of the patient before his transfer to the replantation centre

Back 51

Dominant indicative criteria for replantation include:
- general status of the patient after an amputation injury+
- the extent of crush zone of the amputated part and the stump+

Front 52

Indications for replantation of the upper limb include:
- amputation of the thumb at the last phalanx level
- single amputation of one of the three phalanx finger
- amputation at the wrist level
- amputation in proximal third of the forearm

Back 52

Indications for replantation of the upper limb include:
- single amputation of one of the three phalanx finger+
- amputation in proximal third of the forearm+

Front 53

To the dominant indicative criteria of replantation belong:
- medical history of the patient
- general status of the patient after an injury
- appearence of the amputated part and the stump
- injury mechanism

Back 53

To the dominant indicative criteria of replantation belong:
- general status of the patient after an injury+
- appearence of the amputated part and the stump+

Front 54

The period of ischemia of amputated part:
- is the period of time between the time of injury and admission to the replantation centre
- is the period of time between the first medical treatment and the restoration of perfusion
- is the period of time between the time of injury and the restoration of perfusion
- is the period of time between the time of injury and release of vascular clamps on performed anastomosis

Back 54

The period of ischemia of amputated part:
- is the period of time between the time of injury and the restoration of perfusion+
- is the period of time between the time of injury and release of vascular clamps on performed anastomosis+

Front 55

The maximal period of ischemia of amputated part:
- is directly given and its limit is 6 hours
- depends on suitable cooling down of amputated part
- varies according to the tissue involved in the amputated part
- depends mainly on the suitable cooling during the transport of the patient

Back 55

The maximal period of ischemia of amputated part:
- depends on suitable cooling down of amputated part+
- varies according to the tissue involved in the amputated part+

Front 56

What are the basic rules for replantation?:
- the possibility to perform an anastomosis and restore perfusion in amputated part
- the repair of structures which are necessary to be performed before the creation of anastomosis
- we should always perform osteosynthesis
- primarily we should do the suture of flexor tendons

Back 56

What are the basic rules for replantation?:
- the possibility to perform an anastomosis and restore perfusion in amputated part+
- the repair of structures which are necessary to be performed before the creation of anastomosis+

Front 57

Replantation:
- belongs to the operations indicated from vital indication
- can be considered in specific cases as the operation indicated from vital indication
- the life saving operations have the priority before replantation
- is not considered to be the part of group of operations indicated from vital indication

Back 57

Replantation:
- the life saving operations have the priority before replantation+
- is not considered to be the part of group of operations indicated from vital indication+

Front 58

The relative indication for replantation associated with the upper limb is:
- amputation in the proximal phalanx
- amputation of the 2nd digit
- amputation at the wrist
- amputation at distal part of humerus

Back 58

The relative indication for replantation associated with the upper limb is:
- amputation of the 2nd digit+
- amputation at distal part of humerus+

Front 59

The clear indication for replantation is:
- amputation in the wrist
- amputation of 2nd digit
- amputation of scalp
- amputation of 4th finger

Back 59

The clear indication for replantation is:
- amputation in the wrist+
- amputation of scalp+

Front 60

On amputation injuries associated with the upper limb in children:
- is necessary always assess the possibility of replantation
- apply the same criteria as in adults
- change the majority of relative indications for replantation to absolute
- is contraindicated the replantation of single finger

Back 60

On amputation injuries associated with the upper limb in children:
- is necessary always assess the possibility of replantation+
- change the majority of relative indications for replantation to absolute+

Front 61

Microsurgical technique:
- is the super speciality within the plastic surgery field
- is the technique which extends possibilities of surgical branches
- in plastic surgery field enabled the performance of replantations
- is the super speciality for surgical branches

Back 61

Microsurgical technique:
- is the technique which extends possibilities of surgical branches+
- in plastic surgery field enabled the performance of replantations+

Front 62

Which of the following is/are suitable for replantation in upper limbs:
- local infiltration anaesthesia
- contact anaesthesia
- general anaesthesia
- blockage of peripheral nerves

Back 62

Which of the following is/are suitable for replantation in upper limbs:
- general anaesthesia+
- blockage of peripheral nerves+

Front 63

As a part of basics in microsurgery technique is:
- operation microscope and special operating stool for hand support
- special operating table with accessories
- enlargement and special instruments
- special instruments and ultra soft atraumatic suture material

Back 63

As a part of basics in microsurgery technique is:
- enlargement and special instruments+
- special instruments and ultra soft atraumatic suture material+

Front 64

During replantation we try to treat:
- all tissue structures cut off by trauma
- all tissue structures which can be treated
- vessels which secure the restoration of perfusion of amputated part
- only those tissue structures which secure the restoration of perfusion and function of amputated part

Back 64

During replantation we try to treat:
- vessels which secure the restoration of perfusion of amputated part+
- only those tissue structures which secure the restoration of perfusion and function of amputated part+

Front 65

We are right to be worried of infection during an amputation injury:
- in amputations caused in the environment where is contact with soil and dung
- in amputations caused in the environment where is contact with meat and fish
- in amputation caused by circular saw on woodworking
- in amputation caused by cropping books in printing factory

Back 65

We are right to be worried of infection during an amputation injury:
- in amputations caused in the environment where is contact with soil and dung+
- in amputations caused in the environment where is contact with meat and fish+