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

• A Intercostal nerves T6-T9
• B Axillary nerve
• C Suprascapular nerve
• D Phrenic nerve (C3, C4, C5) ✓

Explanation

The phrenic nerve (C3-C5) carries sensory afferents from the central diaphragm and the parietal peritoneum/pleura immediately adjacent to it. These afferent fibres converge in the spinal cord at C3-C5 segments alongside somatic afferents from the shoulder skin (also C3-C5 dermatomes), producing referred pain in the ipsilateral shoulder tip — a classic sign of diaphragmatic irritation (e.g., sub-diaphragmatic abscess, haemoperitoneum, ruptured ectopic pregnancy). Intercostal nerves supply the peripheral diaphragm and refer pain to the lower chest/abdominal wall instead.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.