We present deep, high-resolution (0.'' 03, 200 pc) ALMA Band 7 observations covering the dust continuum and [C II] lambda 157.7 mu m emission in four z similar to 4.4-4.8 sub-millimeter galaxies (SMGs) selected from the ALESS and AS2UDS surveys. The data show that the rest-frame 160 mu m (observed 345 GHz) dust emission is consistent with smooth morphologies on kpc scales for three of the sources. One source, UDS 47.0, displays apparent substructure, but this is also consistent with a smooth morphology-as indicated by simulations showing that smooth exponential disks can appear clumpy when observed at the high angular resolution (0.'' 03) and depth of these observations (sigma(345 GHz) similar to 27-47 mu Jy beam(-1)). The four SMGs are bright [C II] emitters. We extract [C II] spectra from the high-resolution data, and recover similar to 20%-100% of the [C II] flux and similar to 40%-80% of the dust continuum emission, compared to the previous lower-resolution observations. When tapered to 0 2 resolution, our maps recover similar to 80%-100% of the continuum emission, indicating that similar to 60% of the emission is resolved out on similar to 200 pc scales. We find that the [C II] emission in high-redshift galaxies is more spatially extended than the rest-frame 160 mu m dust continuum by a factor of 1.6 +/- 0.4. By considering the L-[C II]/L-FIR ratio as a function of the star formation rate surface density (Sigma(SFR)), we revisit the [C II] deficit and suggest that the decline in the L-[C II]/L-FIR ratio as a function of Sigma(SFR) is consistent with local processes. We also explore the physical drivers that may be responsible for these trends and can give rise to the properties found in the densest regions of SMGs.