外科：整外

19 flashcards · Other · by Wanying Koh

1. fibroblasts appear post-injury day 2 onwards

2. Wound healing process duration and involved cells? 1) inflammation 2) proliferation + wound contracture 3) maturation

   1) <3 days [neutrophils, monocytes, macrophages, fibroblasts] 2) 3 days - 4wk [fibroblasts, collagen] - granulation tissue [myofibroblasts --> wound contracture] 3) 1mo - 6mo [collagen 重新排列]

3. Which factors that are involved in angiogenesis: TNFa, TGFb, platelet derived growth factor, leukocyte derived growth factor

   leukocyte derived growth factor 無！

4. blood supply of random flap

   dermal & subdermal plexus

5. No reflow phenomenon 時受損的細胞？

   BV endothelial cells

6. 水泥灼傷 acidic or basic

   basic (pH 12-13) contains CaO

7. de Quervain syndrome - which compartment

   Compartment 1

8. plasmatic circulation define

   within 48hr, where graft has no blood supply yet hence receives nutrients from the recipient site plasma

9. graft healing hours: plasmatic circulation inosculation and capillary in growth (organization) revascularization

   <48h (2d) 48-72h (2-3d) 4-7d

10. primary contracture vs. secondary contracture FTSG / STSG 哪個多

    primary contracture: due to dermis elastin 的 contracture FTGS 多 cuz thicker layer STSG 少 secondary contracture: due to myofibroblasts 之後的 contracture FTGS 少 STSG 多 as graft shrink overtime

11. septal hematoma conservative tx or emergent tx

    emergent - drainage of hematoma septum receives nutrients via nasal mucosal diffusion hematoma if not cleared will obstruct diffusion --> avascular necrosis --> saddle nose deformity

12. microscopic surgery 可以/不可以修補 peripheral n.? 修補大/小面積的缺損？

    可以 大面積

13. diabetic foot 的 osteomyelitis dx

    Xray (初步檢查） MRI (進階首選 -- better than bone scan) bone scan imaging 可能會比clinical s/s 出現 earlier

14. primary contracture 多 secondary contracture 多 FTSG STSG

    primary full split secondary

15. granulation tissue

    macrophage+ fibroblast + endothelial cells during proliferation phase

16. flap embolism occurs mostly during

    first 48hrs after surgery closely monitor and flap savage within this period, high success rates for flap survival

17. tunica media 外露 when bv sewed too loosely causes

    flap embolism

18. port-wine stain tx by what laser

    pulsed-dye laser Nd:YAG laser: removal of tattoos, removal of hair, vascular lesions ruby laser: removal of tattoos, removal of hair CO2 laser: superficial lesions

19. cleft lip and palate repair timings lip adhesion lip and primary nose repair palate repair lip or nose revision

    2-3mo 3-6mo 10-12mo >5yo