A 33-year-old woman was jogging across the park at 11 PM when she was attacked by a gang of youths. After she was brutally mugged and raped, one of the youths decided to stab her in the heart to keep her silent. Later in the emergency department she was unconscious and in extremely poor shape. A small wound about . in diameter was present in the left fifth intercostal space about 0.5 in. from the lateral sternal margin. Her carotid pulse was rapid and weak, and her neck veins were distended. No evidence of a left-sided pneumothorax existed. A diagnosis of cardiac tamponade was made.
-The following observations are in agreement with the diagnosis except which?
A) The tip of the knife had pierced the pericardium.
B) The knife had pierced the anterior wall of the left ventricle.
C) The blood in the pericardial cavity was under right ventricular pressure.
D) The blood in the pericardial cavity pressed on the thin-walled atria and large veins as they traversed the pericardium to enter the heart.
E) The backed-up venous blood caused congestion of the veins seen in the neck.
F) The poor venous return severely compromised the cardiac output.
G) A left-sided pneumothorax did not occur because the knife passed through the cardiac notch.
Correct Answer:
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