Referred pain Flashcards
Where does the pain from the diaphragm radiate
Pain resulting from diaphragmatic peritoneum- shoulder region (c3-5)
peripheral region of diaphragm- antolateral abdominal wall
What is visceral pain conducted along
Afferent autonomic nerves
characteristics of somatic pain
epitomised by pain arising from skin
Many modalities
Sensitive, well localised, often sharp
Many sensory receptora
Characteristics of visceral pain
Fewer sensory endings in viscera
Often in smooth muscle
Poorly localised
Dull, heavy or gripping
May be referred
What can cause pain in viscera
Excessive stretching/ contraction of their walls or certain pathological conditions can cause pain
What do visceral afferent fibres not have
peripheral synapse (unlike visceral efferent)
What do visceral afferent fibres enter the CNS along
The dorsal nerve root
where is the cell body found
In dorsal root ganglion
What might be the mechanism for referred pain
nerves from an area with high sensory input such as a skin converge to the same area on the spinal cord with the nerves from an area of low sensory input and the brain gets that confused
Where may pain from a heart attack be felt
Base of neck, jaw, shoulder, arm
How can you predict the location of referred pain from a particular organ
Where it’d pain fibres enter the Spinal cord
Where do foregut structures refer to
the epigastrium
Where do midgut structures refer to
Umbilicus
Where do hindgut structures refer to
Hypogastrium (sigmoid and rectum - S2, S3,S4)
Where is the site of pain for the kidneys
T10-L1
Posterior costovertebral angle, radiating forward around flank
Where is the site of pain for the ureters
L1/2
Costovertebral angle, radiating to lower abdomen, testicles, inner thigh
Where is the site of pain for the bladder/upper urethra
S2-S4, T12-L2
Lower abdomen and upper thighs
where is the site of pain for the uterus
T12-L1
Where is the site of pain for the cervix
S2-S4
Where is the site of pain for the intestines
Back (backache or sharp pain in back), umbilicus
Where is the site of pain for the oesophagus
Along sternum, left upper thorax
Where is the site of pain for the liver
Right shoulder
Where is the site of pain for the pancreas
Directly behind the pancreas, lower left quadrant, umbilicus
Where is the site of pain for the spleen
Left shoulder and upper third of arm
