Neurology- Referred Pain

Revision Note s- Refer

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Definition for referred pain
Referred pain occurs in a different region from the origin of the source of pain
Hetertopic pain
Is used to decribe pain that arise in one structure and felt in a region which is different from the site of pathology. it is the word use to describe visceral or vascular pain.
Somatic referred pain
Used to describe pain that has a skeletal origin.
What can you used to determine that pain is referred pain
The pain would not increased if the site of pain is palpated.
Referred pain cannot be eliminated
Unless the analgesic agent is administered to the primary pain site
Definition of Convergence
Meeting point of two or more objects at a common point.
Definition of projection
Is the process by which the brain refers sensation to their USUAL point of stimulation.
What is the Convergence- Projection theory
This theory acknowledges that there are more 1st order neurons than second neurons in the body as a result many first order neurons converge on the same 2nd order neuron. this confuses the brain as such the brain projects the sensation in the usual place.
Pain from deep structures are felt as more diffuse pain and less localized because
Afferent input from deep structures converges to a great degree than superficial structures.
Why Gall Bladder problem converge at the same site as pain from the right shoulder
Converge at the same point c3-5 which is innervated by the phrenic nerve
diaphragm problems can also refer pain to
Upper trapezius, supraclavicular fossa

The pain Pattern for referred pain is occurs at
Ipsilateral side of the body
Myocardial pain
chest left shoulder and down the arm and jaw
Examples of referred pain patterns
Stomach- spine between the shoulder blades kidney pain- groin area throat- to the ear intestinal dysfunction- middle or low back spleen injuries- left shoulder, lateral end damaged appendix- either side of the abdomen
Why there is confustion between heart attack pain and ingestion pain
Nociceptors from the heart, lungs, esophagus aorta & stomach share the same spinal cord segments. these afferents has connections via lissauers tract