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

Which anatomical structure is NOT located in Zone 1 of the neck?

1. Trachea

2. Lung

3. Esophagus

4. Jugular vein

The correct answer is: Jugular vein

In the anatomical classification of the neck, Zone 1 is defined as the area that extends from the clavicles superiorly to the level of the sternal notch, and it includes vital structures that are crucial for respiration, swallowing, and vascular supply. The jugular vein, while important in the venous drainage of the head and neck, is situated more laterally and posteriorly in the neck, primarily classified within Zone 2, which encompasses the area from the sternal notch to the angle of the mandible. This zone contains important structures such as the carotid arteries and internal jugular vein. Conversely, structures such as the trachea, esophagus, and lungs (in terms of the mediastinum above the thoracic inlet) are located within Zone 1. The trachea is essential for air passage and lies anteriorly, while the esophagus is positioned posteriorly to the trachea. The lungs, although primarily contained within the thoracic cavity, can be associated with Zone 1 when considering the region around the thoracic inlet. Thus, the jugular vein is accurately identified as the structure not located in Zone 1 of the neck due to its anatomical positioning within Zone 2 and beyond.