Why does appendicitis manifest as diffuse pain in the periumbilical region initially and later as circumscribed pain in the right lower quadrant?
A. Because the appendix swells with appendicitis so that it contacts both the anterior and posterior abdominal walls. B. Because the pain is first conveyed via vagal parasympathetic fibers and then by somatic fibers in the parietal peritoneum of the abdominal wall. C. Because the pain is first conveyed via sympathetic fibers that enter the spinal cord at the T10 level and then by somatic fibers in the parietal peritoneum of the abdominal wall. D. Because the appendix first irritates the subcostal nerve and then the ilioinguinal nerve. E. Because the most sensitive afferents of the appendix are those that are associated with the sympathetic fibers that enter the T10 level of the spinal cord, but later less sensitive afferents associated with the lower quadrant become activated.
Appendicitis is an infection that is a medical emergency that almost always requires prompt surgery to remove the appendix. Symptoms can be abdominal pain, nausea, vomiting, lack of appetite and fever. The first hint of pain is periumbilical, which is below the navel. Referred pain is due to the nerves running through the abdomen that will cause a pain signal from the lower right quadrant to the navel area.
There is a membrane that forms the lining of the abdominal cavity and some invertebrates, such as annelids. It covers most of the intra-abdominal organs and is composed of a layer of the mesothelium, which is supported by a thin layer of connective tissue.