Answer :
Final answer:
In the case of a patient with shortness of breath and left shoulder pain after an MVA, the ER is most likely to order a spleen ultrasound to check for splenic injury, which can present as Kehr's sign.
Explanation:
Appropriate Ultrasound for Shortness of Breath and Left Shoulder Pain Post-MVA
A 20-year-old individual involved in a motor vehicle accident (MVA), presenting with shortness of breath and left shoulder pain, may trigger the concern for potential internal injuries. Given these particular symptoms, an emergency room is likely to order an ultrasound to assess for internal organ damage. The shoulder pain could be indicative of Kehr's sign, a phenomenon associated with splenic injury that refers pain to the left shoulder possibly due to diaphragmatic irritation. As such, the most appropriate ultrasound in this context would be of the spleen to check for any damage or rupture that might explain the presentation.
Owing to the anatomy of the nervous system, damage to the spleen or irritation to the diaphragm can present as referred pain in areas such as the shoulder or neck. This is because the sympathetic fibers connected to the spleen are from the celiac ganglion, which communicates with regions of the spinal cord associated with the shoulder.
