From the Guidelines
The neck is anatomically divided into three distinct zones for the assessment and management of penetrating injuries, specifically Zone I, Zone II, and Zone III, as described in the ACR Appropriateness Criteria for penetrating neck injury 1.
Zones of the Neck
The zones are defined as follows:
- Zone I: Extends from the clavicles and sternal notch to the cricoid cartilage, containing vital structures such as the major vessels, trachea, esophagus, and thoracic duct.
- Zone II: Spans from the cricoid cartilage to the mandibular angle, housing critical structures including the carotid arteries, jugular veins, larynx, and pharynx.
- Zone III: Reaches from the mandibular angle to the skull base, encompassing the distal carotid arteries and salivary glands.
Clinical Significance
Understanding these zones is essential for the proper assessment and management of penetrating neck trauma, as injuries to different zones pose varying risks to vital structures and necessitate different diagnostic and therapeutic approaches, as highlighted in the study published in the Journal of the American College of Radiology 1.
Diagnostic Approaches
The choice of diagnostic imaging depends on the zone of injury, with Zone I and III injuries often requiring advanced imaging like CT angiography due to the complexity and difficulty of surgical access, whereas Zone II injuries may be more amenable to direct surgical exploration, as discussed in the context of penetrating neck injuries 1.
From the Research
Zones of the Neck
The zones of the neck are typically divided into three main areas:
- Zone 1: The area between the clavicle and the cricoid cartilage, which contains vital structures such as the subclavian vessels and the apices of the lungs 2.
- Zone 2: The area between the cricoid cartilage and the angle of the mandible, which contains structures such as the trachea, esophagus, and carotid arteries 2.
- Zone 3: The area between the angle of the mandible and the base of the skull, which contains structures such as the carotid arteries and the jugular veins 2.
Importance of Zones in Trauma Care
Understanding the zones of the neck is crucial in trauma care, as it helps clinicians to quickly assess and manage potential injuries to vital structures in the neck 3. The zones of the neck are used to guide the management of penetrating neck injuries, with different zones requiring different approaches to airway management and surgical intervention 2, 4.