Name the common sites on the thoracic aorta where damage occurs in blunt trauma. Between 80\% and 90\% of such injuries result in immediate death. Explain in anatomic terms the path commonly taken by the escaping blood in cases of traumatic rupture of the thoracic aorta. Name the tissues that can sometimes temporarily control the leak, thus permitting the patients to be taken to the emergency department alive.

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Quizplus · Accepted Answer

The Answer is Blunt traumatic injury to the thoracic aorta involving horizontal deceleration occurs most commonly just distal to the origin of the left subclavian artery. This site is vulnerable since the heart and the aortic arch are mobile and the descending aorta is fixed. Sudden vertical deceleration, as in a fall, may result in an intimal tear at the root of the ascending aorta; the momentum of the heart filled with blood is sufficient to produce the tear.
Rupture of the ascending aorta occurs into the pericardial cavity, producing immediate cardiac tamponade and death. Rupture of the descending thoracic aorta frequently occurs into the left pleural cavity. The tear initially occurs in the tunica intima; the tunica media and adventitia and the surrounding connective tissue and the pleura may delay the complete rupture or temporarily control the leak. If untreated, delayed rupture and death usually occur in these cases within 2 weeks.

Name the Common Sites on the Thoracic Aorta Where Damage