PRS Quick Hits

Question 1

Mathes & Nahai Type I Flap

Answer 1

Type I- Single Vascular Pedicle

Tongue: Medial and lateral Genioglossus, Hyoglossus, Longitudinalis linguae, Styloglossus, Transversus and verticalis linguae

Hand: Abductor digiti minimi, Abductor pollicis brevis, First dorsal interosseous

Arm: Anconeus

Hip: Deep circumflex iliac artery (DCIA)

Thigh (Lateral): Vastus lateralis, Tensor fascia lata

Leg: Gastrocnemius

+ G.I. (Intestine): Jejunum, Colon

Question 2

Mathes & Nahai Type II Flap

Answer 2

Type II- Dominant Vascular Pedicle and Minor Vascular Pedicle(s); minor pedicles together are not enough to sustain the whole muscle

Neck/Back: Platysma, Sternocleidomastoid, Trapezius

Arm, Forearm: Brachioradialis, Coracobrachialis, Triceps, Flexor carpi ulnaris, Flexor digitorum brevis

Thigh (Antero-medial, Posterior): Rectus femoris, Vastus medialis, Gracilis, Hamstring (biceps femoris)

Leg: Soleus + Lateral compartment (Peroneus brevis, Peroneus longus)

Foot: Abductor digiti minimi, Abductor hallucis

Question 3

Mathes & Nahai Type III Flap

Answer 3

Type III- Two Dominant Pedicles

Head: Temporalis, Orbicularis oris

Thorax: Intercostal, Pectoralis minor, Serratus anterior

Abdomen: Rectus abdominis

Buttock: Gluteus maximus

+ G.I.: Omentum

Question 4

Mathes & Nahai Type IV Flap

Answer 4

Type IV- Segmental Vascular Pedicles

Abdomen: External oblique

Thigh: Sartorius

Leg: Extensor digitorum longus, Extensor hallucis longus, Flexor digitorum longus, Flexor hallucis longus, Tibialis anterior

Question 5

Mathes & Nahai Type V Flap

Answer 5

Type V- Dominant Vascular Pedicle and Secondary Segmental Vascular Pedicles

Thorax: Pectoralis major, Latissimus dorsi

Abdomen: Internal oblique

+ Leg: Fibula [not muscle]

Question 6

Tongue Anatomy & Flap

Answer 6

Intrinsic muscles
-Transverse
-Vertical
-Superior longitudinal*
-Inferior longitudinal*

Extrinsic muscles
-Genioglossus*
-Hypoglossus*
-Styloglossus*
-Palatoglossus (X)

*Type I

Question 7

Vastus lateralis flap

Answer 7

Type I

Question 8

Gastrocnemius

Answer 8

Type I

Question 9

Tensor fascia lata

Answer 9

Type I

Question 10

Trapezius flap

Answer 10

Type II

Question 11

Gracilis

Answer 11

Type II

Question 12

Soleus

Answer 12

Type II

Question 13

Vastus medialis

Answer 13

Type II

Question 14

Pharyngeal Groove/Cleft (Ectoderm) I

Answer 14

External auditory meatus

Question 15

Pharyngeal Groove/Cleft (Ectoderm) II

Answer 15

Where brachial cleft anomalies are most common, run under SCM, over arch III

Question 16

Pharyngeal Groove/Cleft (Ectoderm) III

Answer 16

Brachial cleft anomalies run under ICA & under arch III

Question 17

Pharyngeal arch (mesoderm) I nerve & artery

Answer 17

CN V, maxillary

Question 18

Pharyngeal arch (mesoderm) II nerve & artery

Answer 18

CN VII, stapedial

Question 19

Pharyngeal arch (mesoderm) III nerve & artery

Answer 19

CN IX & CCA, proximal ICA

Question 20

Pharyngeal arch (mesoderm) IV/VI nerve & artery

Answer 20

CNX, aortic arch, R SCA, origin of pulmonary arteries, ductus arteriosus

Question 21

Pharyngeal arch (mesoderm) I bones (7)

Answer 21

Greater wing of sphenoid, maxilla, zygomatic, temporal (squamous), mandible, incus, malleus

Question 22

Pharyngeal arch (mesoderm) II bones (4)

Answer 22

Styloid process, stylohyoid ligament, lesser horn & upper body of hyoid

Question 23

Pharyngeal arch (mesoderm) III bones

Answer 23

Greater horns & lower body of hyoid

Question 24

Pharyngeal arch (mesoderm) IV/VI bones

Answer 24

Laryngeal cartilages

Question 25

Pharyngeal arch (mesoderm) I muscles

Answer 25

Muscles of mastication, anterior digastric, mylohyoid, tensor tympani, TVP

Question 26

Pharyngeal arch (mesoderm) II muscles

Answer 26

Muscles of facial expression, posterior digastric, stylohyoid, stapedius

Question 27

Pharyngeal arch (mesoderm) III muscles

Answer 27

Stylopharyngeus

Question 28

Pharyngeal arch (mesoderm) IV/VI muscles

Answer 28

Pharyngeal constrictors, LVP, palatoglossus, striated upper esophageal muscles, laryngeal muscles

Question 29

Pharyngeal pouch (endoderm) I

Answer 29

Internal auditory meatus

Question 30

Pharyngeal pouch (endoderm) II

Answer 30

Palatine tonsil

Question 31

Pharyngeal pouch (endoderm) III

Answer 31

Inferior parathyroids, thymus

Question 32

Pharyngeal pouch (endoderm) IV

Answer 32

Superior parathyroids

Question 33

Pharyngeal pouch (endoderm) V

Answer 33

Ultimobranchial body (thyroid C cells)

Question 34

Auricle derivatives of 1st pharyngeal arch (mesoderm)

Answer 34

Tragus, helical crus, helix (drain to parotid)

Question 35

Auricle derivatives of 2nd pharyngeal arch (mesoderm)

Answer 35

Antitragus, antihelix, lobule (drain to posterior auricular nodes)