Neck trauma: Clinical (To be retired)


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Neck trauma: Clinical (To be retired)

Medical and surgical emergencies

Cardiology, cardiac surgery and vascular surgery

Advanced cardiac life support (ACLS): Clinical (To be retired)

Supraventricular arrhythmias: Pathology review

Ventricular arrhythmias: Pathology review

Heart blocks: Pathology review

Coronary artery disease: Clinical (To be retired)

Heart failure: Clinical (To be retired)

Syncope: Clinical (To be retired)

Pericardial disease: Clinical (To be retired)

Valvular heart disease: Clinical (To be retired)

Chest trauma: Clinical (To be retired)

Shock: Clinical (To be retired)

Peripheral vascular disease: Clinical (To be retired)

Leg ulcers: Clinical (To be retired)

Aortic aneurysms and dissections: Clinical (To be retired)

Cholinomimetics: Direct agonists

Cholinomimetics: Indirect agonists (anticholinesterases)

Muscarinic antagonists

Sympathomimetics: Direct agonists

Sympatholytics: Alpha-2 agonists

Adrenergic antagonists: Presynaptic

Adrenergic antagonists: Alpha blockers

Adrenergic antagonists: Beta blockers

ACE inhibitors, ARBs and direct renin inhibitors

Loop diuretics

Thiazide and thiazide-like diuretics

Calcium channel blockers

cGMP mediated smooth muscle vasodilators

Class I antiarrhythmics: Sodium channel blockers

Class II antiarrhythmics: Beta blockers

Class III antiarrhythmics: Potassium channel blockers

Class IV antiarrhythmics: Calcium channel blockers and others

Positive inotropic medications

Antiplatelet medications

Dermatology and plastic surgery

Blistering skin disorders: Clinical (To be retired)

Bites and stings: Clinical (To be retired)

Burns: Clinical (To be retired)

Endocrinology and ENT (Otolaryngology)

Diabetes mellitus: Clinical (To be retired)

Hyperthyroidism: Clinical (To be retired)

Hypothyroidism and thyroiditis: Clinical (To be retired)

Parathyroid conditions and calcium imbalance: Clinical (To be retired)

Adrenal insufficiency: Clinical (To be retired)

Neck trauma: Clinical (To be retired)


Mineralocorticoids and mineralocorticoid antagonists


Gastroenterology and general surgery

Abdominal pain: Clinical (To be retired)

Appendicitis: Clinical (To be retired)

Gastrointestinal bleeding: Clinical (To be retired)

Peptic ulcers and stomach cancer: Clinical (To be retired)

Inflammatory bowel disease: Clinical (To be retired)

Diverticular disease: Clinical (To be retired)

Gallbladder disorders: Clinical (To be retired)

Pancreatitis: Clinical (To be retired)

Cirrhosis: Clinical (To be retired)

Hernias: Clinical (To be retired)

Bowel obstruction: Clinical (To be retired)

Abdominal trauma: Clinical (To be retired)

Laxatives and cathartics


Acid reducing medications

Hematology and oncology

Blood products and transfusion: Clinical (To be retired)

Venous thromboembolism: Clinical (To be retired)

Anticoagulants: Heparin

Anticoagulants: Warfarin

Anticoagulants: Direct factor inhibitors

Antiplatelet medications


Infectious diseases

Fever of unknown origin: Clinical (To be retired)

Infective endocarditis: Clinical (To be retired)

Pneumonia: Clinical (To be retired)

Tuberculosis: Pathology review

Diarrhea: Clinical (To be retired)

Urinary tract infections: Clinical (To be retired)

Meningitis, encephalitis and brain abscesses: Clinical (To be retired)

Bites and stings: Clinical (To be retired)

Skin and soft tissue infections: Clinical (To be retired)

Protein synthesis inhibitors: Aminoglycosides

Antimetabolites: Sulfonamides and trimethoprim

Antituberculosis medications

Miscellaneous cell wall synthesis inhibitors

Protein synthesis inhibitors: Tetracyclines

Cell wall synthesis inhibitors: Penicillins

Miscellaneous protein synthesis inhibitors

Cell wall synthesis inhibitors: Cephalosporins

DNA synthesis inhibitors: Metronidazole

DNA synthesis inhibitors: Fluoroquinolones

Herpesvirus medications



Miscellaneous antifungal medications

Anthelmintic medications


Anti-mite and louse medications

Nephrology and urology

Hypernatremia: Clinical (To be retired)

Hyponatremia: Clinical (To be retired)

Hyperkalemia: Clinical (To be retired)

Hypokalemia: Clinical (To be retired)

Metabolic and respiratory acidosis: Clinical (To be retired)

Metabolic and respiratory alkalosis: Clinical (To be retired)

Toxidromes: Clinical (To be retired)

Medication overdoses and toxicities: Pathology review

Environmental and chemical toxicities: Pathology review

Acute kidney injury: Clinical (To be retired)

Kidney stones: Clinical (To be retired)

Adrenergic antagonists: Alpha blockers

Neurology and neurosurgery

Stroke: Clinical (To be retired)

Seizures: Clinical (To be retired)

Headaches: Clinical (To be retired)

Traumatic brain injury: Clinical (To be retired)

Neck trauma: Clinical (To be retired)

Lower back pain: Clinical (To be retired)

Spinal cord disorders: Pathology review

Anticonvulsants and anxiolytics: Barbiturates

Anticonvulsants and anxiolytics: Benzodiazepines

Nonbenzodiazepine anticonvulsants

Migraine medications

Osmotic diuretics

Antiplatelet medications


Opioid agonists, mixed agonist-antagonists and partial agonists

Opioid antagonists

Pulmonology and thoracic surgery

Asthma: Clinical (To be retired)

Chronic obstructive pulmonary disease (COPD): Clinical (To be retired)

Venous thromboembolism: Clinical (To be retired)

Acute respiratory distress syndrome: Clinical (To be retired)

Pleural effusion: Clinical (To be retired)

Pneumothorax: Clinical (To be retired)

Chest trauma: Clinical (To be retired)

Bronchodilators: Beta 2-agonists and muscarinic antagonists

Pulmonary corticosteroids and mast cell inhibitors

Rheumatology and orthopedic surgery

Joint pain: Clinical (To be retired)

Anatomy clinical correlates: Clavicle and shoulder

Anatomy clinical correlates: Axilla

Anatomy clinical correlates: Arm, elbow and forearm

Anatomy clinical correlates: Wrist and hand

Anatomy clinical correlates: Median, ulnar and radial nerves

Anatomy clinical correlates: Bones, joints and muscles of the back

Anatomy clinical correlates: Hip, gluteal region and thigh

Anatomy clinical correlates: Knee

Anatomy clinical correlates: Leg and ankle

Anatomy clinical correlates: Foot

Acetaminophen (Paracetamol)

Non-steroidal anti-inflammatory drugs


Opioid agonists, mixed agonist-antagonists and partial agonists

Antigout medications


Neck trauma: Clinical (To be retired)

USMLE® Step 2 questions

0 / 1 complete


USMLE® Step 2 style questions USMLE

of complete

A 66-year-old woman comes to the Emergency Department because of a decelerating motor vehicle accident that resulted in injury to her neck. Her temperature is 37.1°C (98.8°F), pulse is 90/min, respirations are 20/min, and blood pressure is 130/85 mm Hg. Physical examination shows bilateral loss of pain and temperature sensation in her upper extremities with triceps and biceps reflexes are weak bilaterally and strength 2/5. Lower extremity reflexes are present, with 4/5 muscle strength. Which of the following is a risk factor for the most likely diagnosis?


Content Reviewers


Sam Gillespie, BSc

Rishi Desai, MD, MPH

The neck is a compact tube packed with many vital structures including blood vessels like the carotid artery and internal jugular vein, nerves like the brachial plexus, parts of the airway like the larynx and trachea, and parts of the digestive tract, such as the pharynx and esophagus. As a result, even seemingly innocuous traumatic injury can be lethal. The cervical spine is the most flexible and mobile part of the vertebral column.

But, that flexibility comes with a price, making the cervical spine the most vulnerable part of the vertebral column to trauma. Now, neck trauma can be classified into penetrating neck injury, like that from a knife stab, and blunt neck injury, like that from a car crash.

Before delving into penetrating neck injuries, it’s crucial to review the anatomy. The neck is anatomically divided into three zones. From bottom to top, zone I, or the lower zone, is from the clavicles to the cricoid cartilage, zone II, or the middle zone, is from the cricoid cartilage to the angle of the mandible, and zone III, or the upper zone, is from the angle of the mandible to the base of the skull. To help you remember the order of the zones, think of going up an elevator, so zones I, II, III from bottom to top. The neck is enveloped by the superficial and deep cervical fascia, and sandwiched between them is the platysma muscle.

Anatomically, the neck can also be described in triangles. The sternocleidomastoid muscle separates the neck into two triangles. The anterior triangle contains most of the major anatomic structures, including the larynx, trachea, pharynx, esophagus and major vascular structures; while the posterior triangle contains muscles, the spinal accessory nerve, and the spinal column.


Neck trauma refers to any type of injury to the neck, which is the area of the body between the head and the shoulders. It is classified into blunt neck trauma (e.g. injuries caused by motor vehicle accidents), and penetrating trauma (e.g. neck stab injuries). It is a penetrating neck injury if the platysma muscle is torn.

The management of blunt neck trauma follows ABCDEs (airway, breathing, circulation, disability, and exposure) sequence. Intubation should be done quickly to clear the airway (if not clear, and the cervical spine immobilized with a cervical collar. Next, reference to clinical decision tools such as the NEXUS or Canadian C-spine rule is necessary to determine if the C-spine is “cleared”, or if CT imaging is necessary to decide surgical vs non-surgical definitive management.

ABCDEs sequence also applies to penetrating neck injury. Securing the airway may require orotracheal intubation, or emergent cricothyrotomy if necessary. Hemorrhage control is done by direct pressure on the wound, and if that doesn't suffice, a Foley catheter is inflated in the wound to occlude it. For hemodynamically unstable individuals, emergency surgery is required. With penetrating neck injuries cervical collars are usually not necessary unless they are associated with a neurological deficit or a suspected concomitant blunt neck injury.


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