NURS 6501: Week 7 Quiz:
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Question 5
Which of the following best explains the pathophysiological mechanism of referred pain?
Group of answer choices
- Chronic irritation of pain receptors at the injury site
- Localized inflammation spreading to nearby nerves
- Direct injury to adjacent tissues
- Cross-activation of nerve fibers in the spinal cord leading to pain perception in an area distant from the injury
Correct answer:
Cross-activation of nerve fibers in the spinal cord leading to pain perception in an area distant from the injury
Explanation:
Referred pain occurs when pain is felt in an area other than the actual site of injury or pathology. This happens due to convergence of nerve fibers in the spinal cord.
Pathophysiological mechanism:
- Sensory (afferent) fibers from different parts of the body (e.g., skin and internal organs) converge on the same second-order neurons in the spinal cord or brainstem.
- The brain may misinterpret the source of pain because it is more accustomed to receiving sensory input from somatic (surface) structures, rather than from visceral (internal) organs.
For example, cardiac ischemia can present as pain in the left arm or jaw due to this shared neural pathway.
Why the other choices are incorrect:
- Chronic irritation of pain receptors at the injury site
→ Explains localized chronic pain, not referred pain. - Localized inflammation spreading to nearby nerves
→ Could lead to radiating pain, but not true referred pain. - Direct injury to adjacent tissues
→ Causes local pain, not pain perceived in a distant site.