Visceral pain

Question 1

What does visceral pain result from?

Answer 1

Visceral stretching
Visceral inflammation
Visceral ischaemia

Question 2

Characteristics of visceral pain

Answer 2

Diffuse/poorly defined
Midline

Question 3

What symptoms often accompany visceral pain?

Answer 3

Nausea
Vomiting
Sweating

Question 4

Explain sympathetic outflow to gut

Answer 4

T5-L2
Pass through sympathetic chain without synapsing
Form abdominopelvic splanchnic nerves by synapsing after
Form greater (T5-T9), lesser (T10-T11) and least (T12) splanchnic nerves
These synapse with prevertebral ganglia - coeliac/renal/S and I mesenteric
Extend from prevertebral ganglia to viscera (now post ganglionic)

Question 5

What path does visceral pain follow?

Answer 5

Path of sympathetic outflow but in reverse

Question 6

Where do you feel pain from sensory greater, lesser and least nerves?

Answer 6

Greater - epigastric (T5-T9 dermatomes)
Lesser - umbilicus (T10 dermatome)
Least - Suprapubic region (T12 dermatome)

Question 7

what is a caecal volvulus?

Answer 7

Intestinal obstruction. cecum, which is between the small bowel and colon, detaches from the abdominal wall and twists on itself.

Question 8

Describe visceral pain pathway for caecal volvulus

Answer 8

Distended small bowel = general viscera afferents activated
Afferent impulse goes to superior mesenteric ganglia (prevertebral)
Continues along lesser splanchnic nerve (T10-T11)
Passes through sympathetic chain
Intro dorsal horn of spine
Converge with somatic afferents at this level (T10-T11)
Brain perceives pain coming from dermatome - peri-umbilical pain