Neck Trauma/Emergencies

Question 1

What is important to ask in a history of neck trauma?

Answer 1

mechanism of injury
pain
aerodigestive tract - dyspnoea, hoarseness, dysphonia, dysphagia, haemoptysis
CNS problems - paraesthesia, weakness

Question 2

What investigations should be done for neck trauma?

Answer 2

bloods - FBC, G and S, XM
CXR
CT angiogram
MRA (magnetic resonance angiogram)

Question 3

What should you look for on the CXR of someone with neck trauma?

Answer 3

haemo-pneumothorax

emphysema

Question 4

What should you look for on the CT angiogram of someone with neck trauma?

Answer 4

vascular
pseudoaneurysm
laryngeal
aerodigestive tract

Question 5

What is the management o neck trauma?

Answer 5

urgent exploration - expanding haematoma, hypovolaemic shock, airway obstruction, blood in aerodigestive tract 
laryngoscopy 
bronchoscopy 
pharyngoscopy 
oesophagoscopy 
angiography - embolise, occlude

Question 6

What is the pathophysiology of a deep neck space infection?

Answer 6

extension of infection from tonsil or oropharynx into deeper tissues

Question 7

What are the symptoms of a deep space neck infection?

Answer 7

sore throat
unwell
limited neck movement

Question 8

What are the signs of a deep space neck infection?

Answer 8

febrile
trismus
red and/or tender neck

Question 9

What does febrile mean?

Answer 9

having or showing the symptoms of a fever

Question 10

What is trismus?

Answer 10

lock jaw - limited jaw range of motion

Question 11

What is the management of a deep space neck infection?

Answer 11

fluid resuscitation
IV antibiotics - co-amoxiclav (clindamycin if penicillin allergic)
incision and drainage of neck space