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Old 12-28-2015
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Unhappy NBME 7 Help with this question!!!!!

A 47-year-old woman is brought to the emergency department 30 minutes after being involve in a motor vehicle collision. She was the unrestrained driver of a car traveling at 55 MPH that hit a bridge abutment. on arrival she has sever neck pain and mild chest and abdominal pain. Her pulse is 95/min, respiration are 20/min and BP 120/80. Examination show severe tenderness over cervical spine at C5. there is a bruise over the sternum and upper abdomen. Neurological examination shows no abnormalities. XR of the chest shows no abnormalities except for slightly widened mediastinum. AN XR of the cervical spine show a C5 facet fracture. An XR of the abdomen shows no abnormalities which of the following is the most likely location of the life-threatening cardiovascular injury:

A) Abdominal Aorta
b) Carotid Artery
c)Heart
d) inferior vena Cava
e)innominate artery
f)Innominate Vein
g) Jugular Vein
H) Pulmonary artery
I)Pulmonary vein
J)Subclavian artery
K) Superior vena cava
L) Thoracic aorta

Please can someone explain!!!! i am very confused in this one!
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Old 12-28-2015
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could it be thoracic aorta ... cuz she is an unrestrained passenger.
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Originally Posted by SRI101 View Post
could it be thoracic aorta ... cuz she is an unrestrained passenger.
Can you explain why you think is thoracic aorta, i found same answer in other thread but no explanation, is it aortic coartation?
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Old 12-29-2015
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Can you explain why you think is thoracic aorta, i found same answer in other thread but no explanation, is it aortic coartation?
its not aortic coarctation.... its injury to the thoracic aorta...

its like rupture of the urethra of males during saddle injuries ... use the same principle and apply it here. its a arch, 2 ends of the arch are attached to each something, but the middle is not.
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Old 12-30-2015
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Originally Posted by SRI101 View Post
its not aortic coarctation.... its injury to the thoracic aorta...

its like rupture of the urethra of males during saddle injuries ... use the same principle and apply it here. its a arch, 2 ends of the arch are attached to each something, but the middle is not.
Y cant it be abdominal aorta?
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Old 12-30-2015
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But she has widened mediastinum and a bening abdominal physical exam. Another thing is that this patient's vital sings are normal if there is rupture of a great vessel like the aorta, wouldn't she has low BP and high Pulse???
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But she has widened mediastinum and a bening abdominal physical exam. Another thing is that this patient's vital sings are normal if there is rupture of a great vessel like the aorta, wouldn't she has low BP and high Pulse???
the body protect it self as much as it can. So when you have a leak or break in the a vessel it causes a hematoma formation so that why this patients bp isnt falling like crazy.
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