Examination | Finding | Concern |
General appearance | | - Vascular injury or cerebral hypoperfusion (eg, hemorrhage, hypotension)
|
| - Vascular injury; stroke; spinal cord injury
|
- Distress (eg, agitation, respiratory distress)
| - Hypoxia from airway occlusion or tension pneumothorax
|
Oropharyngeal examination | | - Pharyngoesophageal injury
|
- Hemoptysis, hematemesis, dysphagia, odynophagia
| - Pharyngoesophageal or laryngotracheal injury
|
Voice | | - Airway occlusion from multiple sources (expanding hematoma, laryngotracheal injury)
|
| - Laryngotracheal injury
- Laryngeal nerve injury
|
Tracheal position | | - Visceral injury or vascular injury producing mass effect
|
- Tension pneumothorax (most commonly associated with Zone I PNI)
|
Neck appearance, palpation, auscultation | - Expanding hematoma, thrill, or bruit
| |
| - Airway leak, pneumothorax, laryngotracheal or pharyngoesophageal injury
|
| |
Neurologic examination | | - Spinal nerve or cranial nerve injury (neuropraxia versus nerve transection)
|
- Horner's syndrome (miosis, ptosis, anhidrosis)
| - Sympathetic chain injury (consider adjacent vascular injury due to proximity)
|