Blunt Injury with labeled CT Scan! - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 09-02-2011
USMLE Forums Master
 
Steps History: Not yet
Posts: 674
Threads: 264
Thanked 959 Times in 393 Posts
Reputation: 969
Send a message via Yahoo to ricko335
CT Scan Blunt Injury with labeled CT Scan!

A 25-year-old male who has been assaulted with a baseball bat is examined in the trauma bay. He complains of abdominal discomfort and shortness of breath. A CT of his torso suggests injury at the site indicated by the yellow arrow. Given this location, you should be concerned with an injury to what major structure?
  • A. Esophagus
  • B. Aorta
  • C. Stomach
  • D. IVC
  • E. Kidney
Blunt Injury with labeled CT Scan!-slide1.jpg
click image to enlarge
Reply With Quote Quick reply to this message
The above post was thanked by:
aknz (09-02-2011), Amenah (09-03-2011), cerebrum85 (09-02-2011), drnrpatel (09-05-2011), MANIAKOS (09-02-2011), ndefusco604 (09-03-2011), usluipek (09-03-2011), usmle2011 (09-02-2011)



  #2  
Old 09-02-2011
USMLE Forums Master
 
Steps History: Step 1 Only
Posts: 512
Threads: 57
Thanked 318 Times in 163 Posts
Reputation: 328
Default

I think its IVC
Reply With Quote Quick reply to this message
  #3  
Old 09-02-2011
drnirajmavani's Avatar
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 268
Threads: 14
Thanked 103 Times in 69 Posts
Reputation: 113
Default

i m between IVC and stomach...

Esophagus is way high, aorta-->pt would be in shock and severe pain, kidney--> is mor lateral on the flanks rather then in center
Reply With Quote Quick reply to this message
 
  #4  
Old 09-02-2011
val7's Avatar
USMLE Forums Master
 
Steps History: CS Only
Posts: 557
Threads: 29
Thanked 296 Times in 186 Posts
Reputation: 316
Default

I think it has to be IVC, it fits the best
Reply With Quote Quick reply to this message
  #5  
Old 09-03-2011
yasirsattar75's Avatar
USMLE Forums Guru
 
Steps History: Not yet
Posts: 395
Threads: 51
Thanked 292 Times in 111 Posts
Reputation: 302
Default

Quote:
Originally Posted by ricko335 View Post
A 25-year-old male who has been assaulted with a baseball bat is examined in the trauma bay. He complains of abdominal discomfort and shortness of breath. A CT of his torso suggests injury at the site indicated by the yellow arrow. Given this location, you should be concerned with an injury to what major structure?
  • A. Esophagus
  • B. Aorta
  • C. Stomach
  • D. IVC
  • E. Kidney
Attachment 1901
click image to enlarge
its D inferior vena cava pretty sureee ..... and shortness of breath becauseee of injury to phrenic nerve also .. phrenic nerve passes alongwith inferior vena cava at region on T10 level ... .... and i have seen the same question kaplan q bank .. patient can present with condition like when he inspires his abdomen moves inward rather than outward its becausee of diaphragm paralysis and that causes shortness of breath because he has difficulty in inspiration ...
__________________
study study till ur brain is saturated
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message
The above post was thanked by:
aknz (09-03-2011), star123 (09-03-2011), usmle2011 (09-03-2011), zohra (09-03-2011)
  #6  
Old 09-03-2011
USMLE Forums Veteran
 
Steps History: ---
Posts: 253
Threads: 20
Thanked 43 Times in 39 Posts
Reputation: 53
Default

agree its ivc
Reply With Quote Quick reply to this message
  #7  
Old 09-05-2011
USMLE Forums Master
 
Steps History: Not yet
Posts: 674
Threads: 264
Thanked 959 Times in 393 Posts
Reputation: 969
Send a message via Yahoo to ricko335
Default

The correct answer is B.
Traumatic diaphragmatic injuries occur in 0.8-8% of patients with blunt trauma. The high energy levels required to injure the diaphragm puts the patient at high risk for injuries to other surrounding structures. These injuries can be fatal.

The diaphragm has 3 main openings:
1) The aortic opening is at the level of the T12 vertebra and transmits the aorta, the thoracic duct, and often the azygous vein.
2) The esophageal opening is between the muscular fibers of the right diaphragmatic crus, usually at the level of the T10 vertebra. This opening transmits the esophagus and the branches of the left gastric artery and vein.
3) The opening of the inferior vena cava (IVC) is in the T8 or T9 vertebra and transmits the IVC and the right phrenic nerve.

The arrow is pointing towards the 12th rib, thus it can be inferred that injury has occurred at T12. Given this information, the correct answer should involve the aorta, thoracic duct or azygous vein.
Reply With Quote Quick reply to this message
The above post was thanked by:
dr_lizard (09-05-2011)
  #8  
Old 09-07-2011
USMLE Forums Guru
 
Steps History: Not yet
Posts: 417
Threads: 74
Thanked 131 Times in 94 Posts
Reputation: 141
Default

i also thought it was IVC cuz IVC is more towards right and aorta is more towards left. and also how did u find out that its T12?
why is it not t8?
Reply With Quote Quick reply to this message
  #9  
Old 09-07-2011
USMLE Forums Scout
 
Steps History: Step 1 Only
Posts: 31
Threads: 0
Thanked 28 Times in 16 Posts
Reputation: 38
Default

Hate seemingly confusing questions. On one hand, an injury to the right phrenic nerve (which is closely related to the IVC and to the right of the midline) is a possibility, answer choice B is also a possibility considering that the arrow points to T12, where aorta crosses the thoracic diaphragm.

Would probably go with D on the exam...
Reply With Quote Quick reply to this message



Reply

Tags
Anatomy-, CT-Images, Gastrointestinal-Tract-, Step-1-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Abdominal CT Scan Diagnosis! USMLE-Syndrome USMLE Step 2 CK Forum 16 06-26-2011 01:12 PM
Where is the lesion CT Scan question? bebix USMLE Step 1 Forum 8 06-07-2011 12:26 PM
CT scan pratice for step 1 chulady USMLE Step 1 Forum 3 01-16-2011 10:39 PM
Captopril Renal Scan! Farqad USMLE Step 2 CK Forum 1 05-08-2010 03:45 PM
Sestamibi Scan lee-usmle USMLE Step 2 CK Buzzwords 0 05-06-2010 07:30 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)