Chest imaging: traumatic aortic injury: practice question

A Radiology 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.

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Radiology · Chest imaging: traumatic aortic injury

Sample item

After a high-speed deceleration accident, a supine chest radiograph shows a widened mediastinum, loss of the aortic knuckle contour and a left apical cap. Where is the aortic tear most likely located?

AAortic isthmus just distal to the left subclavian arteryBAbdominal aorta at the renal arteriesCAortic arch at the brachiocephalic originDAortic root

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

The answer and the reasoning

A. Aortic isthmus just distal to the left subclavian artery

Rapid deceleration injures the aorta at the isthmus, the junction of the mobile arch and fixed descending aorta near the ligamentum arteriosum. CT angiography confirms the injury and guides endovascular repair. Other signs include tracheal deviation to the right and a depressed left main bronchus.

Option by option

A. Aortic isthmus just distal to the left subclavian artery (correct)
Correct. The isthmus is the most common site of traumatic rupture.
B. Abdominal aorta at the renal arteries
The abdominal aorta is not the typical site in deceleration.
C. Aortic arch at the brachiocephalic origin
The brachiocephalic origin is an uncommon site.
D. Aortic root
The root is a less common site of blunt injury.

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 Radiology question

What is the answer to this Radiology question?

The best answer is A, Aortic isthmus just distal to the left subclavian artery. Rapid deceleration injures the aorta at the isthmus, the junction of the mobile arch and fixed descending aorta near the ligamentum arteriosum.

Why is "Abdominal aorta at the renal arteries" not the answer?

The abdominal aorta is not the typical site in deceleration.

Why is "Aortic arch at the brachiocephalic origin" not the answer?

The brachiocephalic origin is an uncommon site.

Why is "Aortic root" not the answer?

The root is a less common site of blunt injury.

What concept does this question test?

It tests Chest imaging: traumatic aortic injury in Radiology. CT angiography confirms the injury and guides endovascular repair. Other signs include tracheal deviation to the right and a depressed left main bronchus.

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 Chest imaging: traumatic aortic injury?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology 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.