15. Referred pain from ureteric colic is felt in the groin .

Discussion in 'Question Zone' started by Guest, Jan 23, 2003.

  1. Guest

    Guest Guest

    15. Referred pain from ureteric colic is felt in the groin due to involvement of the following nerve:

    1.Subcostal.
    2.Iliohypogastric.
    3.Ilioinguinal.
    4.Genitofemoral

    Ans. 2 [ Das textbook surgery page 1136 1st ed says that upper ureteric colic referred to loin and groin is carried by Iliohypogastric and Ilioinguinal nerve. Since skin is supplied by Iliohypogastric then is should be the answer. When ureteric colic pain is referred to testicles / thigh then Genitofemoral nerve is involved]

    Grays Anatomy 38th Edition - Abdominal Urinary Organs - Ureters Page 1833
    Clinical Anatomy
    As in the case of the gut, excessive ureteric distension or spasm of its muscle provokes severe pain (renal colic), for example by a stone (calculus) causing incomplete and intermittent obstruction, particularly if it is gradually forced down by the muscle spasm. The pain, spasmodic and agonizing, is referred to cutaneous areas innervated from spinal segments which supply the ureter, mainly T11–L2. It shoots down and forwards from the loin to the groin and scrotum or labium majus and may extend into the proximal anterior aspect of the thigh by projection to the genitofemoral nerve (L1, 2); the cremaster (which has the same innervation) may reflexly retract the testis. A ureteric stone is liable to impact at one of the ureteric constrictions, namely (1) its superior end, (2) where it crosses the brim of lesser pelvis or (3) as it passes through the vesical wall; radiologically it would appear near the tip of the second lumbar transverse process, overlying the sacro-iliac joint, or slightly medial to the ischial spine. Sometimes the ureter is duplicated on one or both sides even as far as the bladder; separate vesical openings are rare in such cases.

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