American Board of Surgery Qualifying Exam (ABS QE) Practice Test

In trauma to the neck, what is a common approach for zone 1 injuries?

1. Medial sternotomy with neck incision

2. Direct cervical approach

3. Right thoracotomy

4. Endovascular repair

The correct answer is: Medial sternotomy with neck incision

In managing trauma to the neck, especially in zone 1 injuries, a medial sternotomy combined with a neck incision is commonly employed. Zone 1 injuries encompass areas of the neck that extend from the clavicles to the cricoid cartilage, often involving critical vascular structures such as the great vessels and the trachea. The medial sternotomy provides a direct route to assess and control the thoracic inlet and any potential vascular injury. This approach not only allows for better access to major structures in this area but also facilitates necessary intervention to control bleeding and repair damaged vessels. The neck incision is necessary to fully expose the extent of the injury and to allow for simultaneous exploration and intervention if needed. This dual approach maximizes both visualization and access to manage the complexities that often accompany zone 1 injuries. Other methods, while potentially applicable in different contexts, do not provide the same breadth of access and control needed for these critical injuries.