ABPS Surgical Anatomy & Reconstructive Techniques

Question 1

Which artery supplies the majority of blood to the latissimus dorsi muscle?

Accepted Answer

Thoracodorsal artery

Answer

The thoracodorsal artery is the dominant vascular supply to the latissimus dorsi muscle, branching off the subscapular artery. This robust blood supply makes the latissimus dorsi a highly reliable muscle for pedicled or free flap reconstruction in plastic surgery. Its consistent anatomy is crucial for successful tissue transfer.

Question 2

What is the most important landmark when planning a TRAM flap?

Accepted Answer

Rectus abdominis muscle

Answer

When planning a Transverse Rectus Abdominis Myocutaneous (TRAM) flap for breast reconstruction, the rectus abdominis muscle is the most important landmark because the flap is based on perforator vessels that run through this muscle. The integrity and vascular supply of the rectus abdominis are critical for the viability of the transferred tissue. Careful dissection around this muscle ensures adequate blood flow to the flap while minimizing abdominal wall morbidity.

Question 3

What nerve must be preserved during a facelift to prevent lip droop?

Accepted Answer

Marginal mandibular branch

Answer

The marginal mandibular branch of the facial nerve innervates the depressor anguli oris and depressor labii inferioris muscles, which are responsible for depressing the corner of the mouth and the lower lip. Injury to this nerve during a facelift can lead to an asymmetrical smile or lip droop on the affected side. Surgeons must meticulously identify and preserve this nerve to avoid such complications.

Question 4

Which muscle is typically used in pedicled flap breast reconstruction?

Accepted Answer

Latissimus dorsi

Answer

The latissimus dorsi muscle is commonly used in pedicled flap breast reconstruction due to its reliable blood supply (thoracodorsal artery) and sufficient tissue volume. It can be rotated from the back to the chest to create a new breast mound, either alone or in combination with an implant. This flap provides a natural-feeling reconstruction with good aesthetic outcomes.

Question 5

What is the key structural difference between full-thickness and split-thickness skin grafts?

Accepted Answer

Thickness of the dermal component

Answer

The key structural difference between full-thickness and split-thickness skin grafts lies in the amount of dermis included. A split-thickness graft contains the epidermis and only a portion of the dermis, making it thinner and more fragile but easier to harvest and take. A full-thickness graft includes the entire epidermis and dermis, providing better cosmetic results, less contraction, and more durability, but it requires a more precise donor site closure.

(ABPS) Certified American Board of Plastic Surgery Practice Test

(ABPS) Certified American Board of Plastic Surgery Practice Test

ABPS Surgical Anatomy & Reconstructive Techniques