Emergency Medical Technician (EMT) Intermediate Practice Exam

Which of the following chest injuries would be the least likely to present with jugular venous distention?

1. Massive hemothorax

2. Simple pneumothorax

3. Tension pneumothorax

4. Cardiac tamponade

The correct answer is: Massive hemothorax

Jugular venous distention (JVD) occurs when there is increased pressure in the venous system, often due to conditions that impair the heart's ability to pump effectively or create significant changes in thoracic pressure. Understanding the chest injuries associated with JVD is crucial for EMTs. A massive hemothorax involves a significant accumulation of blood in the pleural space, which can compress the lungs and potentially shift the mediastinum. However, in the case of a massive hemothorax, the primary concern is typically the volume of blood lost and its impact on the lungs and overall circulation rather than changes in venous pressure. As such, jugular venous distention is not a common presentation unless there is significant cardiac compromise or hypovolemia. In contrast, conditions like tension pneumothorax, which involves air accumulation in the pleural space, can increase intrathoracic pressure to the point of collapsing major veins and impeding blood return to the heart, leading to noticeable JVD. Cardiac tamponade similarly results in increased intrathoracic pressure due to fluid accumulation around the heart, causing JVD as the heart struggles to fill properly. Simple pneumothorax, although it can lead to some