Pain Syndromes

sites of referred pain from specific organs

Ascending aorta (T2-T3)

Gall bladder (T7-T8)

Appendix --(T11-T12)

Colon (T11-L1)

Hollow viscus

Kidney (T10-L1)

sites of referred pain from specific organs

VISCERAL AND REFERRED PAIN

Deep visceral pain is dull and boring; it is the consequence of distension or traction on free nerve endings.

Referred pain of a dull quality relates to a specific area of the body surface - often hypersensitive to touch.

The basis of referred pain

The visceral afferents converge upon the same cells in the posterior horns as the somatic efferents. The patient 'projects' pain from the viscera to the area supplied by corresponding somatic afferent fibres.

A knowledge of the source of referred pain is important in diagnosis and treatment.

Hollow viscus

Ascending aorta (T2-T3)

PHANTOM LIMB PAIN

Following amputation of a limb, 10% of patients develop pain with a continuous persistent burning quality, caused by neuroma formation in the stump. The patient 'feels' the pain arising from some point on the missing limb (the pain input projects through pathways which retain the topographical image of the absent limb).

Treatment: no specific treatment.

Gall bladder (T7-T8)

Appendix --(T11-T12)

Pancreas (T7-T8)

Testis (T10-T11) Ureter (T10-L1)

Kidney (T10-L1)

Topographical arrangement extends up to the sensory cortex

Colon (T11-L1)

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