Final answer:
In the context of adolescent penetrating trauma, the most significant physiological factor affecting management is the adolescent's systolic blood pressure. It is vital for assessing the extent of shock and determining the need for resuscitation measures.
Step-by-step explanation:
In the evaluation of an adolescent penetrating trauma victim, the physiological difference that affects management to the greatest degree is D - Systolic blood pressure. Adolescents may experience significant changes in systolic blood pressure as a result of trauma. This is a critical consideration for management because it provides insight into the degree of shock and the need for fluid resuscitation or blood products to maintain organ perfusion. Furthermore, the adolescent's circulatory and respiratory systems are undergoing rapid growth; this must be factored into the understanding of their physiological responses and the subsequent management strategies required.