Injuries and wounds: aortic rupture in deceleration: practice question

A Forensic Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Forensic Medicine · Injuries and wounds: aortic rupture in deceleration

Sample item

A driver is thrown forward in a high-speed head-on collision and dies at the scene. There is no external chest wound, but autopsy shows a transverse tear in the thoracic aorta with blood in the left pleural cavity. Which is the typical site of this tear?

AThe aortic root just above the valveBThe pulmonary trunk at its bifurcationCThe aortic isthmus just beyond the left subclavian originDThe abdominal aorta at the origin of the renal arteries

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. The aortic isthmus just beyond the left subclavian origin

In sudden deceleration the mobile aortic arch continues forward while the descending aorta is held fixed by the ligamentum arteriosum and intercostal arteries. The shear force tears the aorta at the isthmus. Radiologically this can present as a widened mediastinum.

Option by option

A. The aortic root just above the valve
Tears of the aortic root occur in blunt chest trauma but are far less common than isthmic tears.
B. The pulmonary trunk at its bifurcation
The pulmonary trunk is not the usual site of fatal vascular tearing in deceleration.
C. The aortic isthmus just beyond the left subclavian origin (correct)
Correct. The isthmus is the junction between the mobile arch and the fixed descending aorta.
D. The abdominal aorta at the origin of the renal arteries
The abdominal aorta is rarely torn by deceleration.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is C, The aortic isthmus just beyond the left subclavian origin. In sudden deceleration the mobile aortic arch continues forward while the descending aorta is held fixed by the ligamentum arteriosum and intercostal arteries.

Why is "The aortic root just above the valve" not the answer?

Tears of the aortic root occur in blunt chest trauma but are far less common than isthmic tears.

Why is "The pulmonary trunk at its bifurcation" not the answer?

The pulmonary trunk is not the usual site of fatal vascular tearing in deceleration.

Why is "The abdominal aorta at the origin of the renal arteries" not the answer?

The abdominal aorta is rarely torn by deceleration.

What concept does this question test?

It tests Injuries and wounds: aortic rupture in deceleration in Forensic Medicine. The shear force tears the aorta at the isthmus. Radiologically this can present as a widened mediastinum.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Injuries and wounds: aortic rupture in deceleration?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.