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Neck Trauma, Penetrating, Anterior

Neck Trauma, Penetrating, Anterior is a topic covered in the 5-Minute Emergency Consult.

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  • Wound severity gauged by violation of platysma muscle
  • Neck is divided into 3 zones
    • Zone I: Between clavicles and cricoid cartilage
      • Involves vessels, lungs, trachea, esophagus, thyroid
      • Penetrating trauma in this zone carries highest mortality owing to injury to thoracic structures.
    • Zone II: Between cricoid cartilage and angle of mandible
      • Involves vessels, trachea, esophagus, C-spine, and spinal cord
      • Injuries are most common in this zone due to it being most exposed region.
    • Zone III lies above angle of mandible to base of skull
      • Injuries are difficult to access surgically

Pediatric Considerations
Larynx is located higher in neck and receives better protection from mandible and hyoid bone.


  • Gunshot wounds
  • Stab wounds
  • Miscellaneous (e.g., glass shards, metal fragments, animal bites)

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Rosen, Peter, et al., editors. "Neck Trauma, Penetrating, Anterior." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307534/all/Neck_Trauma__Penetrating__Anterior.
Neck Trauma, Penetrating, Anterior. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307534/all/Neck_Trauma__Penetrating__Anterior. Accessed April 25, 2019.
Neck Trauma, Penetrating, Anterior. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307534/all/Neck_Trauma__Penetrating__Anterior
Neck Trauma, Penetrating, Anterior [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 25]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307534/all/Neck_Trauma__Penetrating__Anterior.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Neck Trauma, Penetrating, Anterior ID - 307534 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307534/all/Neck_Trauma__Penetrating__Anterior PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -