Omssat 2008

Front 1

What percentage of cases does the marginal mandibular nerve run below the inferior border of the mandible?

Back 1

19% of cases, but only of those cases where the nerve is found posterior to the facial artery and vein

Front 2

The Keen technique is used to reduce fracture of what structure?

Back 2

Zygomatic arch (through a buccal vestibule approach)

Front 3

What is the most important bony suture for future growth when treating a NASO-Septal fracture in the pediatric patient?

Back 3

The Septovomerine (it is considered a growth center)

Front 4

What is the most important factor in re-establishing the vertical facial height in pan-facial fractures?

Back 4

Reduction of mandibular condyle fractures

Front 5

Between which two anatomic layers is the safest plane of dissection during the initial elevation of a coronal flap?

Back 5

Between the galea (aponeurosis) and pericranium because at this level the frontal branch is superior to the level of dissection, less likely to be damaged

Front 6

What is the most frequently fractured area of the edentulous mandible?

Back 6

The mandibular body

Front 7

How do you differentiate between superior orbital fissure syndrom and orbital apex syndrom?

Back 7

Loss of vision. Both conditions involve opthalmoplegia due to involvement of II, IV, VI. Anesthesia due to V1. Ptosis due to loss of sympathetic tone to Mullers muscle

Front 8

What is a common cause of Binocular diplopia (as opposed to monocular!)?

Back 8

Alteration in globe position. Monocular can be caused by retinal detachment, lens dislocation, corneal scarring, or other traumatic insult to the globe

Front 9

What is the mean distance of the optic canal from the posterior ethmoidal foramen?

Back 9

5mm. This is about knowing that the optic canal is about 42 mm when measured from the rim, the PEF is ~36mm, and the Anterior EF ~24mm

Front 10

What is the greatest width of an upper eyelid defect that can be repaired by primary closure without compromising function?

Back 10

25%

Front 11

What are the classes of hemorrhage?

Back 11

Class I: Up to 15% volume loss (no changes)
Class II: 15-30% volume loss; tachypnea, tachycardia, decreased pulse pressure. Resuscitate with crystalloids
Class III: 30-40% loss. Tachycardia, BP drops. Blood and crystalloid resuscitation
Class IV: >40% loss. hero tactics

Front 12

How to calculate Cerebral Perfusion Pressure?

Back 12

Subtract the Intracranial Pressure from the Mean Arterial Pressure -->((Systolic*1)+(Diastolic*2))/3

Front 13

What percentage of the total body surface is an Infant's head as compared to an adult's?

Back 13

Twice the percentage

Front 14

What is Beck's triad?

Back 14

A diagnosis for cardiac tamponade
1. Venous pressure elevation
2. Decline is arterial pressure
3. Muffled heart tones

Front 15

What is the most common MID-facial fracture in pediatric patients?

Back 15

The nose

Front 16

What is the most common MANDIBLE fracture in pediatric patients?

Back 16

The condyles. According to this test, the angle occurs more commonly as the population ages

Front 17

What explains the relative lack of pediatric MID-facial trauma compared to adults?

Back 17

Big ol' craniums offers some protection to the midface

Front 18

What is a consideration for ORIF of condyle fractures in pediatric patients?

Back 18

Persistent malocclusion in the permanent dentition

Front 19

When do you give a patient Tetanus booster AND tetanus immunoglobulin?

Back 19

Never. The booster is if the patient received the shot 10 years ago, or 5 years ago and has a contaminated wound. The Ig is given with the tetanus series if the patient does not know when or if they ever had the tetanus shot.

Front 20

What are the indications for removal of teeth in the line of mandibular fractures?

Back 20

1. Obvious pathology (caries, perio)
2. Mobility of involved teeth
3. Teeth preventing fx reduction
4. Fractured roots
5. Exposed root apices

Front 21

What is the recommended course of treatment for a patient with an intracapsular fx and normal occlusion?

Back 21

Observation. You don't need to do CRIMF if the occlusion is unchanged.

Front 22

What eye condition is a contraindication for exploration of an orbital floor fracture?

Back 22

Hyphema, due to the possibility of re-bleeding into the anterior chamber.

Front 23

Is chemosis likely to be the cause of diplopia?

Back 23

No. Chemosis is edema of the palpebral and bulbar conjunctiva.

Front 24

What anatomical landmark denotes where it becomes impractical to attempt repair of laceration to the facial nerves?

Back 24

Anterior to a vertical line from the lateral canthus. At this point, the branches are too small for repair to be practical

Front 25

Which sequelae of craniofacial trauma is accompanied by a strange buzzing sound?

Back 25

Carotid-Cavernous fistula.
Caused by abnormal flow of blood from a high flow (internal carotid) to a low flow system (cavernous sinus)

Front 26

Injury to which zone of the neck is most amenable to physical examination?

Back 26

Zone 2: extends from the cricoid to the inferior border of the mandible

Front 27

What are the zones of the neck?

Back 27

Zone 1: from the clavicle to the cricoid
Zone 2: from the cridoid to the mandibular angle
Zone 3: from mandibular angle to the base of the skull

Front 28

Which muscle causes the mandibular condyle to frequently be displaced anterior and medial when fractured?

Back 28

The lateral pterygoid

Front 29

Formation of a cartilaginous callus following an initial formation of a hematoma is what type of bone healing?

Back 29

Secondary. Primary does NOT go thru a callus formation

Front 30

An MIO of 5mm immediately following 3 weeks of IMF is best explained by what process?

Back 30

Muscle splinting (and guarding)

Front 31

What is the main sensory innervation of the auricle?

Back 31

The greater auricular nerve, originates from the 2nd and 3rd cervical nerves

Front 32

Which drugs should be avoided in patient with hypertrophic cardiomyopathy

Back 32

Definitely diuretics; dehydration exacerbates symptoms. But also, digitalis, nitrates, vasodilators, and beta-adrenergic agonists should also be avoided

Front 33

Which type of cardiomyopathy is most often associated with high outflow tract pressures?

Back 33

Hypertrophic.

Front 34

Caution should be given to administering local anesthetics containing vasoconstrictor to hypertensive patient treated with which medication?

Back 34

Non-selective beta blockers

Front 35

Which type of heart block is associated with increasing PR intervals?

Back 35

Mobitz Type I second degree heart block

Front 36

What is the relevance of the acronym MONA?

Back 36

Morrphine, Oxygen, Nitroglycerin, Aspirin for a patient with chest pain. Start with oxygen first!

Front 37

What are the beneficial effects of using ACE inhibitors and diuretics for treatment of CHF?

Back 37

Decrease preload and afterload

Front 38

Which type of regurgitation uccurs only during the diastolic phase of heart function?

Back 38

Aortic regurgitation

Front 39

What is the risk of sudden cardiac death in a patient with aortic stenosis?

Back 39

5%

Front 40

Wenkeback block is also known as?

Back 40

Mobitz Type I

Front 41

What factors allow you to discern between respiratory and metabolic acidosis or alkalosis?

Back 41

Simple! Respiratory you check pH and pCO2
Alkalosis you check pH and HCO3.

Front 42

What is one of the most important causes of nosocomial pneumonia?

Back 42

mechanical ventilation