A patient was brought to the Emergency Department by ambulance with two arrow wo

Question

A patient was brought to the Emergency Department by ambulance with two arrow wounds. One arrow is still in the patient on the left side; entering anteriorly between the 7th and 8th ribs in a 15 degree angle, the arrow head protruding posteriorly. The second wound is located in the posterior cervical triangle

Describe the trajectory of the first arrow using directional terms and anatomical planes.

Identify and describe the organs and any other membranes that may have been affected by the first

arrow.

Explanation / Answer

The trajectory of the first arrow will be posterosuperiorly along the axial plane. From anterior to posterior the affected organs will be anterior skin, anterior superficial fascia, anterior intercostal muscles, anterior deep fascia,anterior peritoneal membrane, pleural cavity, lung, heart, posterior peritoneal membrane, posterior intercostal muscles, posterior deep fascia, posterior superficial fascia, posterior skin. The heart and lungs are the vital organs being affected by the arrow. The wound of the heart and lung can be life threatening. Since the second wound is present in the posterior triangle of the neck so the contents of the posterior triangle of the neck will also be affected. Some of the contents are as follows :- spinal accessory nerve, cervical plexus, brachial plexus, omohyoid muscles, scalene muscles, levator scapulae muscles, occipital lymph node and supraclavicular lymph nodes.

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