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Chapter 37. Airway Management in Penetrating Neck Injury

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Penetrating neck injury classification has divided the neck into three anatomic zones. Zone III extends from

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A. the level of the clavicles and the sternal notch to the cricoid cartilage

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B. the level of the clavicles and the sternal notch to the thyroid cartilage

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C. the cricoid cartilage to the angle of the mandible

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D. the thyroid cartilage to the angle of the mandible

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E. the angle of the mandible to the base of the skull

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(E) Zone I extends from the level of the clavicles and sternal notch to the cricoid cartilage, Zone II extends from the level of the cricoid cartilage to the angle of the mandible, and Zone III extends from the angle of the mandible to the base of the skull.

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The only hard clinical sign diagnostic of laryngotracheal injury in penetrating trauma is

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A. subcutaneous emphysema

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B. air escaping from the neck wound

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C. hoarseness

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D. hemoptysis

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E. stridor

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(B) The signs and symptoms of aerodigestive injury include hoarseness or dysphonia, stridor, subcutaneous emphysema or crepitance, dyspnea, dysphagia, hemoptysis, tenderness on palpation of the larynx, and air bubbling from the wound. However, the only hard clinical sign of laryngotracheal injury is air escaping from the neck wound.

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In penetrating neck injury, the investigation of choice for suspected laryngotracheal trauma and vascular injury is

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A. MDCTA

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B. direct laryngoscopy

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C. flexible bronchoscopic endoscopy

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D. duplex ultrasonography

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E. catheter angiography

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(A) MDCTA is the investigation of choice for suspected laryngotracheal trauma and vascular injury in PNI.

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