Abdominal PainAbdominal Pain Pathways 2 innervations:1. Somatic(Peripheral nerves e.g. skin and parietal peritoneum lining abdominal wall)2. Visceral

If pain from abdominal organs travels with sympathetics Visceral Pathway Cell bodies are in the dorsal root ganglia Pass through sympathetic paravertebral ganglia without synapsing Neurone decussates at this level & then ascends in the lateral spinothalamic tract and on to the thalamus

If pain from thoracic and pelvic organs travel with parasympathetics Visceral pathway

If pain from abdominal wall is via the peripheral cutaneous nerves Somatic pathway A initial shart pain (myelinated pain sensation travels quickly) C longer diffuse pain (unmyelinatedpain sensation travels slowly)Visceral vs Somatic Painful stimuli are appropriate to the organs function

Basically, pain referred back to level of embryological origin!

Level Pain Referred to:Structure:Embryological Origin:Pain fibres travel back w/:

All intestinal pain classified as midline! Everything elsepain localizes to one side

Includes all gut structures from lower oesophagus upper anus Also includes spleen, liver, gallbladder, pancreas

Pancreas 2nd-4th parts duodenum Lower rectum Aorta Kidneys Ureters

Oesophagus

Uterus Ovaries Fallopian tubes

CHECK SHEET FOR PAIN PATTERNSLOOK @ LEARNING OBJECTIVES AS THE LECTURER SAID WE DONT NEED TO KNOW CLINICAL STUFF!