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A 55-Year-Old Woman with a History of Flatulent Dyspepsia Suddenly

Question 1

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A 55-year-old woman with a history of flatulent dyspepsia suddenly experienced an excruciating colicky pain across the upper part of the abdomen. On examination in the emergency department, she was found to have some rigidity and tenderness in the right upper quadrant. A diagnosis of biliary colic was made.
-The following statements would explain this patient's symptoms except which?


A) The pain of gallstone colic is caused by spasm of the smooth muscle in the wall of the gallbladder and distension of the bile ducts by the stones.
B) The pain fibers from the gallbladder and bile ducts ascend through the superior mesenteric plexus and the greater splanchnic nerves to enter the thoracic segments of the spinal cord.
C) Referred pain is felt in the right upper quadrant or the epigastrium.
D) T7 through T9 dermatomes are involved.
E) The violent contractions of the gallbladder wall are attempts to expel the gallstones.

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