Referred pain
Summary
Definition
- Referred pain is the physiologic process whereby internal organs manifest with body surface pain.
DIAPHRAGM
- C3, C4, and C5 innervate the diaphragm (C3, C4, C5 keep the diaphragm alive!)
- The diaphragm refers sensation to the C3, C4, C5 dermatomes: the neck, shoulders, and upper lateral arm.
HEART
- T1 to T5 innervate the heart.
- The T1 to T5 dermatomes cover the chest and medial upper arm and forearm, so myocardial ischemia (heart pain) is felt along the left side of the chest and inside of the left arm. Note that cardiac pain does not extend into the fingers (supplied by C6 to C8).
UMBILICUS
- T10 dermatome covers the umbilicus (T10 innervates the appendix), and thus, appendicitis is first felt at the umbilicus.
When the appendicitis becomes somatic and moves to the right lower quadrant.