An 18-year-old woman presented to the emergency department due to lower side abdominal pain, nausea, and vomiting. The pain started around the umbilical region this morning. The pain developed to become more severe and localized in the right lower quadrant. Temperature is 38.3 C (100.9 F), blood pressure is 120/84 mm Hg, the pulse is 122/min, and respirations are 13/min. On examination, there is tenderness in the right lower quadrant, two-thirds of the distance from the umbilicus to the anterior superior iliac spine. Decreased bowel sound. Laboratory studies show a white blood cell count of 19,000/mm3. The change in this patient's pain characteristics is most likely explained by which of the following?

Question

Quizplus · Accepted Answer

Eductional Objective: Appendicitis has two types of pain: visceral and parietal. Visceral abdominal pain is caused by the afferent visceral fibers at the level of T10, which will cause paraumbilical pain. While irritation the parietal peritoneum will cause localized pain and tenderness at McBurney Point.

An 18-Year-Old Woman Presented to the Emergency Department Due to Lower