Trauma - Spinal, Thoracic and Abdominal Injuries MCQs

The inferior thyroid artery (ITA) is considered the principal blood supplier of the thyroid gland . The ITA gives rise to the ascending cervical artery, the inferior laryngeal artery, and also gives pharyngeal, tracheal , and esophageal ITA also supplies the four parathyroid glands . Blood supply of esophagus: Cricopharyngeal muscle (inlet of esophagus) is supplied by superior thyroid artery Cervical esophagus: predominantly by inferior thyroid artery Thoracic esophagus: aorta, both right and left bronchial artery, along with descending branch from inferior thyroid artery, intercostal artery and ascending branch from inferior phrenic artery Abdominal esophagus: left gastric artery and inferior phrenic artery Blood supply to the thymus comes from the internal thoracic artery .

Explanation: Whole-Body CT (WBCT) in Severe Blunt Trauma WBCT (head-to-pelvis with IV contrast) is the gold standard for evaluating the severely injured adult with blunt trauma. Selective (region-specific) imaging has no role in these patients due to the high likelihood of multisystem injury and the need for comprehensive assessment. WBCT is time-critical and should be performed as early as possible during resuscitation to guide timely interventions. If a patient requires immediate trauma laparotomy without prior WBCT , Apply a pelvic binder and do not remove it until a pelvic fracture is excluded. Obtain an immediate pelvic X-ray , either in the emergency department or on arrival to the operating theatre. Key Takeaways: Whole-body CT is the preferred investigation when there are signs of multiple injuries or deranged physiology.

Thoracic MDCTA has become the standard approach to evaluation of the chest and provides superior visualization of the chest wall, vasculature, pleural spaces, and lung parenchyma. Option A : Chest radiography is almost universally performed during the initial assessment on patients at risk for thoracic injuries. Option B : Deviation of the trachea at the sternal notch may reveal intrathoracic tension on the side opposite the trachea. Option C: Thoracic MDCTA is unreliable for evaluation of pericardium, given cardiac motion degradation. Reference : Sabiston textbook of Surgery, chapter: 17, Edition: 21st, Pg: 405

For cardiac injuries that cause cardiovascular collapse, a left anterolateral thoracotomy is performed in the emergency department and may be extended to a contralateral (“clamshell”) incision if needed. When time permits, most cardiac injuries are best approached through a median sternotomy. Reference : Sabiston textbook of Surgery, chapter: 17, Edition: 21st, Pg: 409