Plastic Surgery Question Bank

Read the Plastic Surgery Question Bank sample questions

1. 1.Which of the following muscle that exerts a force on the mandible is considered a depressorretractor?

   • A.Temporalis
   • B.Masseter
   • C.Median pterygoid
   • D.Lateral pterygoidCorrect

   Why: The lateral pterygoid is the principal depressor and protruder/retractor that, with the suprahyoid muscles, opens the jaw and translates the condyle; its lower head pulls the condyle and disc forward and, because it draws the mandible down and back during opening, it functions in the depressor-retractor group. The temporalis (posterior fibers retract but mainly elevate), masseter, and medial pterygoid are all elevators/closers, not depressors.

2. 2.Which of the following muscle that exerts a force on the mandible is considered a depressorretractor?

   • A.Temporalis
   • B.Masseter
   • C.Median pterygoid
   • D.Lateral pterygoidCorrect

   Why: The lateral pterygoid is the principal depressor and protruder/retractor that, with the suprahyoid muscles, opens the jaw and translates the condyle; its lower head pulls the condyle and disc forward and, because it draws the mandible down and back during opening, it functions in the depressor-retractor group. The temporalis (posterior fibers retract but mainly elevate), masseter, and medial pterygoid are all elevators/closers, not depressors.

3. 3.Proper reduction of an isolated zygoma fracture requires reduction and realignment of which of the following?

   • A.A ) Zygomaticofrontal suture, zygomaticomaxillary buttress, and infraorbital rimCorrect
   • B.B ) Zygomaticofrontal suture, zygomaticomaxillary buttress, and orbital floo
   • C.C ) Zygomaticofrontal suture, zygomaticonasal suture, and infraorbital rim
   • D.D ) Zygomaticomaxillary buttress, infraorbital rim, and nasomaxillary buttress

   Why: Accurate reduction of an isolated (tripod/ZMC) zygoma fracture is judged at the points of articulation: the zygomaticofrontal suture, the zygomaticomaxillary buttress, and the infraorbital rim. Aligning these three external/palpable landmarks confirms the zygoma has been derotated and seated correctly, which is more reliable than judging the orbital floor alone.

4. 4.Which of the following statements regarding the anatomy of the platysma muscle is FALSE?

   • A.It is a paired muscle innervated by the external laryngeal branch of the superior laryngeal nerveCorrect
   • B.It originates from the fascia of the pectoralis major and deltoid muscles
   • C.It ascends in the neck to insert on the inferior border of the mandible
   • D.Its posterior third of the platysma passes over the mandible and fuse with the SMAS.

   Why: The statement is false because the platysma is a muscle of facial expression and is innervated by the cervical branch of the facial nerve (CN VII), not the external laryngeal branch of the superior laryngeal nerve (which supplies the cricothyroid). The other statements correctly describe its origin from pectoral/deltoid fascia, insertion at the inferior mandibular border, and continuity of its posterior fibers with the SMAS.

5. 5.It is a connective tissue structure that attaches peripherally at the periosteum of the orbital margin, lies just deep to the orbicularis oculi muscle and centrally fuses with the lid retractor structures near the lid margins. Which of the following best described the eyelid structure presented previously?

   • A.The tarsal plate
   • B.The medial palpebral ligament
   • C.The medial palpebral ligament
   • D.The orbicularis retaining ligamentCorrect

   Why: The orbicularis retaining ligament (orbitomalar ligament) is the connective-tissue septum that attaches peripherally to the periosteum of the orbital rim, lies deep to the orbicularis oculi, and contributes to the lid-cheek junction by tethering near the retractor structures. The tarsal plate and medial palpebral ligament are distinct structural elements that do not match this description.

6. 6.Which of the following branches supply the sensory innervation of the tip of the nose?

   • A.Supraorbital nerve
   • B.Infraorbital nerve
   • C.Supratrochlear branch of the ophthalmic nerve
   • D.External nasal branch of the anterior ethmoidal nerveCorrect

   Why: Sensation to the nasal tip (and the lower dorsum/supratip skin) is supplied by the external nasal branch of the anterior ethmoidal nerve, which emerges between the nasal bone and the upper lateral cartilage. The supraorbital and supratrochlear nerves supply the forehead/upper nasal root, and the infraorbital nerve supplies the lateral lower nose and ala, not the tip.

7. 7.Which of the following eyelid topography is related to the orbicularis oculi muscle of Riolan?

   • A.Meibomian gland orificies
   • B.Gray lineCorrect
   • C.Tarsus
   • D.Eyelash follicles

   Why: The gray line (Riolan's muscle, the most superficial pretarsal fibers of the orbicularis oculi at the lid margin) corresponds to that surface landmark. It is the key dividing surgical landmark between the anterior lamella (skin/orbicularis) and posterior lamella (tarsus/conjunctiva), located just anterior to the meibomian orifices.

8. 8.Which of the following statements related to the anatomy of the orbit is FALSE?

   • A.The optic foramen is located in the lesser wing of the sphenoid bone.
   • B.The optic foramen is located in the lesser wing of the sphenoid bone.
   • C.Lateral to the superior orbital fissure is located the optic foramen.Correct
   • D.The medial wall of the orbit is formed by the lacrimal bone, the ethmoid bone and the lesser wing of the sphenoid bone

   Why: The statement is false: the optic foramen (optic canal) lies medial, not lateral, to the superior orbital fissure, within the lesser wing of the sphenoid. The superior orbital fissure is positioned lateral and slightly inferior, so describing the optic foramen as lateral to it is incorrect.

9. 9.Which of the following is considered a MINOR TIP SUPPORT mechanism of the nose?

   • A.Medial crural footplate attachment to the caudal septum
   • B.Nasal septum
   • C.Attachment of the caudal border of the upper lateral cartilages to the cephalic border of the lower lateral cartilages
   • D.Nasal spineCorrect

   Why: The nasal spine is a minor tip-support mechanism. The major tip-support mechanisms are the size/shape/strength of the lower lateral cartilages, the medial crural footplate attachment to the caudal septum, and the attachment of the upper lateral cartilages to the lower lateral cartilages; the nasal septum's dorsal/caudal support is major, whereas the bony nasal spine is a contributing minor support.

10. 10.Which of the following muscles is considered the MAIN elevator of the brow?

    • A.Lateral orbicularis oculi
    • B.Procerus
    • C.Corrugator
    • D.FrontalisCorrect

    Why: The frontalis is the only true brow elevator; its vertical fibers raise the eyebrows and produce transverse forehead rhytids. The corrugator, procerus, and the orbicularis oculi are all brow depressors, so frontalis is the main elevator.