Pain from the body of the uterus (fundus and corpus) is referred to the T10–L1 dermatomes. Which pathway carries this visceral afferent signal?

• A Sympathetic fibers traveling via the hypogastric plexus and lumbar splanchnic nerves ✓
• B Parasympathetic fibers via pelvic splanchnic nerves (S2–S4)
• C Somatic afferents via the ilioinguinal nerve
• D Pudendal nerve carrying visceral afferents from the uterine body

Explanation

Visceral pain afferents from the uterine fundus and body travel with sympathetic fibers through the hypogastric plexus, then via lumbar splanchnic nerves to enter the spinal cord at T10–L1. This explains referred pain to the lower abdomen and lumbar region during primary dysmenorrhea. Parasympathetic fibers (pelvic splanchnic S2–S4) carry pain from the cervix and lower uterine segment (referred to sacral dermatomes). The pudendal nerve carries somatic sensation from the perineum, not visceral uterine pain.

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

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Written and medically reviewed by the StethoPrep medical team.