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An 18-Year-Old Woman Was Thrown from a Horse While Attempting

Question 6

Multiple Choice

An 18-year-old woman was thrown from a horse while attempting to jump a fence. She landed heavily on the ground, striking the lower part of her chest on the left side. On examination in the emergency department she was conscious but breathless. The lower left side of her chest was badly bruised, and the ninth and tenth ribs were extremely tender to touch. She had severe tachycardia, and her systolic blood pressure was low.
-The following statements are possibly correct except which?


A) There was evidence of tenderness and muscle spasm in the left upper quadrant of the anterior abdominal wall.
B) A posteroanterior radiograph of the chest revealed fractures of the left ninth and tenth ribs near their angles.
C) The blunt trauma to the ribs could not result in injury to the underlying spleen.
D) The presence of blood in the peritoneal cavity had irritated the parietal peritoneum, producing reflex spasm of the upper abdominal muscles.
E) The muscles of the anterior abdominal wall are supplied by thoracic spinal nerves.

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