ASPS Anatomy, Physiology & Surgical Planning 3 — Questions and Answers
Question 1: Which aesthetic facial subunit principle guides incision placement to minimize visible scarring?
- Incisions placed at the center of each subunit
- Incisions placed at the junction between adjacent subunits (Correct answer)
- Incisions placed within areas of maximum skin laxity only
- Incisions placed parallel to relaxed skin tension lines within subunits
Correct answer: Incisions placed at the junction between adjacent subunits
Aesthetic subunit theory holds that scars at the borders between subunits are less visible because the eye perceives boundaries rather than interruptions.
Question 2: A patient undergoes a pedicled latissimus dorsi flap. Postoperatively, which functional deficit is most likely?
- Inability to flex the elbow
- Weakness in shoulder adduction and internal rotation (Correct answer)
- Loss of shoulder abduction beyond 90°
- Decreased grip strength
Correct answer: Weakness in shoulder adduction and internal rotation
Harvest of the latissimus dorsi muscle results in weakness of shoulder adduction, extension, and internal rotation.
Question 3: In cleft lip repair, the orbicularis oris muscle is repaired in which orientation to restore function?
- Vertically, parallel to the philtrum columns
- Horizontally, perpendicular to the vermilion border
- In a layered Z-plasty configuration
- Transversely across the cleft in anatomic continuity (Correct answer)
Correct answer: Transversely across the cleft in anatomic continuity
Restoring the orbicularis oris in transverse continuity across the cleft recreates the muscular ring essential for lip competence and growth.
Question 4: Which structure forms the posterior boundary of the anatomical snuffbox, relevant in radial forearm flap elevation?
- Flexor carpi radialis tendon
- Extensor pollicis brevis tendon
- Extensor pollicis longus tendon (Correct answer)
- Abductor pollicis longus tendon
Correct answer: Extensor pollicis longus tendon
The extensor pollicis longus tendon forms the posterior (ulnar) boundary of the snuffbox, while EPB and APL form the anterior boundary.
Question 5: When planning a transposition flap, the arc of rotation is measured from the:
- Distal tip of the flap to the recipient defect center
- Pivot point to the most distal point of the flap (Correct answer)
- Flap base to the nearest defect margin
- Center of the flap to the pivot point
Correct answer: Pivot point to the most distal point of the flap
The arc of rotation is determined by measuring from the pivot point to the flap's most distal point, which must reach the defect.
Question 6: The angular artery, a terminal branch of which vessel, supplies the nasolabial flap?
- Internal maxillary artery
- Facial artery (Correct answer)
- Transverse facial artery
- Infraorbital artery
Correct answer: Facial artery
The angular artery is the terminal branch of the facial artery and provides the axial blood supply to the nasolabial flap.
Question 7: In brow lift planning, the ideal brow position in women places the peak of the arch above which reference point?
- The medial limbus
- The lateral canthus
- The lateral limbus or lateral corneal margin (Correct answer)
- The mid-pupil
Correct answer: The lateral limbus or lateral corneal margin
The female brow peak ideally lies above the lateral limbus (lateral corneal margin), creating an arched feminine contour.
ASPS Anatomy, Physiology & Surgical Planning 3
Which aesthetic facial subunit principle guides incision placement to minimize visible scarring?