Visceral afferents transmitting pain from the gallbladder travel with sympathetic fibres and enter the spinal cord at which spinal segment, explaining referred pain to the right shoulder tip?
- A T1–T4
- B T10–L1
- C T5–T9 ✓
- D S2–S4
Correct answer: C. T5–T9
Explanation
Visceral pain from the gallbladder is transmitted via the greater splanchnic nerve (T5–T9), which carries the afferent fibres to the T5–T9 dorsal horn segments. Pain converges with somatic afferents from the dermatomes T5–T9, accounting for epigastric and right hypochondrial referred pain. Right shoulder tip pain is mediated by right phrenic nerve irritation (diaphragmatic peritoneum, C3–C5), not directly by T5–T9, but this is the classic segmental referral of biliary pain.
Reference: BD Chaurasia's Human Anatomy, 8th ed.
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