North Carolina EMT State Practice Exam

What are potential causes for distended neck veins?

1. Normal physiological response

2. Tension pneumothorax, cardiac tamponade, right heart failure

3. Allergic reaction

4. Acute respiratory distress

The correct answer is: Tension pneumothorax, cardiac tamponade, right heart failure

Distended neck veins are typically indicative of increased central venous pressure, which can occur due to several medical conditions. The correct answer highlights specific critical conditions that are known to cause this phenomenon. Tension pneumothorax leads to an accumulation of air in the pleural space, which compresses the superior vena cava and impedes venous return to the heart. This results in increased pressure in the veins, causing them to distend. Cardiac tamponade, characterized by fluid accumulation in the pericardial space, exerts pressure on the heart and restricts its ability to fill adequately, also causing elevated central venous pressure and resultant distention of the neck veins. Similarly, right heart failure can result from various underlying issues like myocardial infarction or chronic pulmonary hypertension, where the right side of the heart fails to eject blood effectively, leading to a backup of blood in the venous system, manifesting as distended neck veins. The other options do not have the same direct connection to distended neck veins. A normal physiological response does not typically cause distention; rather, it reflects a condition of normal venous return and pressure. An allergic reaction may lead to edema or hives but does not directly affect central venous pressure.