Visceral/Pain Referral Patterns Flashcards
Heart referral pattern
upper quadrant
epigastrium
Spleen referral pattern
left chest
Lung and pleura referral pattern
abdomen
Appendix and pancreas referral pattern
umbilicus
Gallbladder referral pattern
shoulder blade
RUQ pain
- Gallbladder
- duodenum
- pancreas
- kidney
- hepatic fissure
LUQ pain
- stomach
- spleen
- kidney
- pancreas
- splenic fissure
RLQ pain
- cecum
- appendix
- ovary and tube
LLQ pain
- sigmoid
- ovary and tube
Vascular pain
tearing pain in sternum or chest
Neuralgia
- Shingles (sensory nerve root infection)
- Spinal cord
- Pressure from osteophyte
Angina
-Left, right, or B jaw, neck, shoulder girdle, medial border of upper limb
Lung: pancost’s tumor
Tumor of apical segment can compress lower nerve roots C8-T1
Gallbladder referral pattern
cholecystitis can refer pain to C4 via diaphragm irritation
Spondylogenic pain: Osseus
Infections, neoplasms, metabolic disease, trauma
Spondylogenic pain: soft tissues
Ligaments, muscles
Spondylogenic pain: articular
discs, z-joints, rib joints, nerve root entrapment, stenosis
Spondylogenic pain: structural
Kypohsis, scoliosis
Meadows: summary of serious disease and symptoms:
Neoplasm, osteoporotic/neoplasmic fracture
- Severe root pain
- Wedging/local kyphosis
Meadows: summary of serious disease and symptoms:
Cardiac, Viscera, AS, neoplasm
- Pain related to stress
- Pain = activity
- Reduced SB, full rotation
- Severe chest pain without joint pain
Meadows: summary of serious disease and symptoms:
Neoplasm, cord pressure or ischaemia
-Spinal cord signs
Meadows: summary of serious disease and symptoms:
Viscera
Pain onset with eating
Meadows: summary of serious disease and symptoms:
Aortic Aneurysm
Pulsating abdomen
Dwyer: Z joint referral pattern
- C2/3 = head
- C5/6, 6/7 = shoulder girdle pain
Cloward: anterior cervical disc referral
- C6-7 = inf angle of scap
- C5-6 = spine of scap and superior angle
- C3-4 = C7 SP and posteroir border of trap
MacNab Classification of pain:
Viscerogenic
- Slow pain, hard to localize
- intense, unremitting pain, stabbing
MacNab Classification of pain:
Vasculogenic
Diffuse, aching, poorly localized, may be referred
MacNab Classification of pain:
Neurogenic
Intense pain of neuropathy
pain of stenosis or tumor
MacNab Classification of pain:
Psychogenic
psychogenic
MacNab Classification of pain:
Spondylogenic
Osseous, ligamentous, muscular, zjoint, ujoint.
