121 Penetrating and Blunt Trauma to the Neck

Question 1

Impact velocity of ___ m/s: penetrates skin

_____ m/s: fractures bone

Answer 1

50 m/s skin

65m/s bone

Question 2

High velocty m/s

Answer 2

High: Faster than 610 m/s

Question 3

Higher incidence of this type of injury in cervical stab wounds.

Why?

Answer 3

Sublavian Vessel laceration.

Stabbings to the neck often occur in a downward direction, with the knife slipping over the clavicle and into the subclavian vessels.

Question 4

Signs of immediate life - threatening injuries:

Answer 4

Massive bleeding
Expanding hematoma
Non - expanding hematoma with hemodynamic instability
Hypovolemic shock
Hemothorax
Hemomediastinum

Immediate surgical exploration is mandatory.

Question 5

For penetrating neck injuries, mortality remains high if these structures are injured:

Answer 5

Major vascular structures (carotid or subclavian)

Cervical spinal cord

Question 6

Initial Management for zone I and Zone III patients who are stable:

Answer 6

Angiography

Question 7

Delineation between zones:

Answer 7

Zone I: below cricoid
Zone III: above angle of mandible
Zone II: in between

Question 8

Laryngeal mucosa lacerations should be considered for early repair: _________ (time frame)

Why?

Answer 8

24 hrs.

Time elapsed before repair can affect airway scarring and voice

Question 9

Simple tracheal laceration vs. Severe disruption (gunshot to trachea) management

Answer 9

6 - week tracheostomy below or through the tracheal injury

Question 10

Management options of tracheal stenosis post tracheal injury:

Answer 10

Sleeve resection

T tube trache if stenosis is sofr

Question 11

Leading cause of death for penetrating neck injuries:

Answer 11

Hemorrhage