American Board of Surgery Qualifying Exam (ABS QE) Practice Test

What common injury may result from frontal impact during a car accident?

1. Aortic transection

2. Cardiac contusion

3. Pulmonary contusion

4. Cervical spine fracture

The correct answer is: Aortic transection

Aortic transection is a significant and common injury that can occur as a result of frontal impact during a car accident. The mechanism involves a sudden deceleration, which can lead to tearing or rupture of the aorta, particularly at its weakest point near the aortic isthmus, just distal to the left subclavian artery. This area is especially vulnerable during high-energy impacts, as the chest experiences rapid forward motion while the aorta, anchored at both ends, remains fixed, creating shear stress that can lead to transection. Given the high fatality rate associated with this injury, immediate recognition and intervention are critical. In contrast, while cardiac contusion, pulmonary contusion, and cervical spine fractures can also be associated with such accidents, they are less directly tied to the mechanism of frontal impact compared to aortic transection. Cardiac contusion typically occurs from direct trauma to the heart and may not always present immediately. Pulmonary contusions are related to chest impacts but are less specific to frontal collisions. Cervical spine fractures can result from the whiplash effect during a crash but are less common compared to aortic injuries stemming from high-decibel deceleration forces. Understanding the dynamics of high-energy trauma helps in recognizing why aortic tran