Surgical Anatomy & Reconstructive Techniques Flashcards

Which nerve is at greatest risk during elevation of a radial forearm free flap?

Answer: Radial nerve superficial branch

The superficial branch of the radial nerve runs in proximity to the radial artery and is at risk when elevating the radial forearm flap.

The deep inferior epigastric artery (DIEA) originates from which vessel?

Answer: External iliac artery

The deep inferior epigastric artery arises from the external iliac artery just above the inguinal ligament.

In a TRAM flap reconstruction, Zone IV refers to which area of the flap?

Answer: Contralateral zone farthest from the pedicle with least reliable perfusion

Zone IV of the TRAM flap is the contralateral lateral zone, most distant from the pedicle and least reliably perfused, often discarded.

The thoracodorsal nerve innervates which muscle used in reconstructive surgery?

Answer: Latissimus dorsi

The thoracodorsal nerve, a branch of the posterior cord of the brachial plexus, innervates the latissimus dorsi muscle.

Which anatomical landmark defines the superior border of the femoral triangle?

Answer: Inguinal ligament

The inguinal ligament forms the superior border of the femoral triangle, with sartorius laterally and adductor longus medially.

In V-Y advancement flap design, tissue movement is primarily achieved by which mechanism?

Answer: Secondary movement of surrounding skin after flap advancement

V-Y advancement relies on secondary movement of the surrounding skin, which advances into the defect as the triangular flap is advanced.

The sentinel lymph node in melanoma of the upper extremity typically drains to which basin first?

Answer: Axillary nodes

Melanoma of the upper extremity drains primarily to the axillary lymph node basin as the first echelon of lymphatic drainage.