52yo man is brought to the ed b/c of respiratory distress after hitting his chest on the steering wheel in a motor vehicle collision. on arrival, his pulse is 110, rr 32, and bp 110/80. there is tenderness to palpation over the 3rd, 4th, and 5th ribs. x-rays show fractures of these ribs both anteriorly and laterally and an infiltrate in an underlying area suggestive of alveolar and insteritial edema. which of the following is the most likely diagnosis?
a. cardiac tamponade
b. hemothorax
c. open pneumothorax
d. pulmonary contusion
e. tension pneumothorax
f. traumatic diaphragmatic hernia.