Referred pain from the diaphragm to the shoulder tip is mediated via which nerve?

• A Intercostal nerves (T6–T12)
• B Vagus nerve
• C Greater auricular nerve
• D Phrenic nerve (C3–C5) ✓

Explanation

The phrenic nerve (C3–C5) supplies the central part of the diaphragm. When irritated (e.g., by sub-diaphragmatic blood, pus, or a ruptured ectopic pregnancy), pain is referred to the shoulder tip (C4 dermatome) because the phrenic nerve shares the same spinal segments as the supraclavicular nerves supplying the shoulder. The peripheral diaphragm is supplied by intercostal nerves and refers pain to the chest wall/abdomen.

Reference: BD Chaurasia's Human Anatomy, 8th ed.

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Written and medically reviewed by the StethoPrep medical team.