A previously healthy 35-year-old lady arrives at the hospital after several days of productive coughing accompanied by chills and fever. Her sputum is purulent, with slight pink blood streaks. Deep inspiration has also caused acute discomfort throughout the right shoulder and neck area. The patient's medical history is ordinary. Her temperature is 38.3 degrees Celsius (101 degrees Fahrenheit), her blood pressure is 130/70 mm Hg, her pulse is 98 bpm, and her respirations are 22 /minute. The right lower pulmonary lobe exhibits crackles and dullness on examination. The examiner has the patient speak the letter "E" while listening with the stethoscope over the right midback, and the sound is heard by the examiner as a loud letter "A." A chest x-ray is obtained and is shown in the image below. The pain experienced by this patient is most likely carried by which of the following nerves?

Question

A previously healthy 35-year-old lady arrives at the hospital after several days of productive coughing accompanied by chills and fever. Her sputum is purulent, with slight pink blood streaks. Deep inspiration has also caused acute discomfort throughout the right shoulder and neck area. The patient's medical history is ordinary. Her temperature is 38.3 degrees Celsius (101 degrees Fahrenheit), her blood pressure is 130/70 mm Hg, her pulse is 98 bpm, and her respirations are 22 /minute. The right lower pulmonary lobe exhibits crackles and dullness on examination. The examiner has the patient speak the letter "E" while listening with the stethoscope over the right midback, and the sound is heard by the examiner as a loud letter "A." A chest x-ray is obtained and is shown in the image below.  The pain experienced by this patient is most likely carried by which of the following nerves?

Quizplus · Accepted Answer

Eductional Objective: Irritation of the parietal pleura causes acute discomfort that worsens with inspiration. The phrenic nerve will carry pain from the mediastinal or diaphragmatic pleura to the C3-C5 distribution.

A Previously Healthy 35-Year-Old Lady Arrives at the Hospital After