QuestionSBA
QuestionChoice
This is a description of the pain in pancreatitis. In terms of anatomy, the epigastric region is roughly where the pancreas is located. However, the appendix is in the right lower quadrant.
10027895
e
Epigastric pain which radiates to the back
QuestionChoice
This is a description of the pain caused by renal stones. The pain follows this pattern because of where the kidneys are and how the ureters descend to enter the pelvis.
10027892
b
Severe back or loin pain which radiates to the lower abdomen
QuestionChoice
Suprapubic pain is a common symptom of urinary tract infections or cystitis. This is because of where the bladder is located anatomically. During the first part of appendicitis, patients may complain of suprapubic pain as part of the generalised pain they are feeling.
10027893
c
Suprapubic pain
QuestionChoice
Correct, this change in pain sensation is due to the afferent nerve fibres from the visceral and parietal peritoneum surrounding the appendix. When the appendix is first inflamed only the visceral peritoneum is irritated which is innervated by nerve fibres from T8-T10. Once the appendix is more inflamed, the parietal peritoneum is also involved which is innervated by the somatic nerve fibres from T10-L1. As these fibres are somatic the pain is more accurately localised to where the appendix is anatomically located.
10027891
a
Generalised or central abdominal discomfort which progresses to localised pain in the right iliac fossa
QuestionChoice
This is a description of the pain felt in cholecystitis (inflammation of the gallbladder). The right side of the body is correct for the appendix but it is in the lower quadrant rather than the upper. The pain radiates to the shoulder tip due to the involvement of the phrenic nerve. This could also happen in appendicitis if the appendix ruptures causing peritonitis.
10027894
d
Right upper quadrant pain which radiates to the shoulder tip
Concept
Chapter
2693
4486
Appendicitis
Topic
135
General surgery
17976
In appendicitis, what is the most common description of the pain?
a