Top 5 Missed NPTE Visceral Pain Patterns & Causes

Vocabulary flashcards detailing visceral pain referral patterns, anatomical locations, functions, and causes for organs frequently tested on the NPTE.

Spleen

An organ located in the upper left quadrant underneath the dome of the diaphragm that serves an immunologic function by filtering blood and storing platelets and white blood cells.

Spleen Referral Pattern

Pain located in the left upper quadrant that refers to the left shoulder, commonly caused by left-sided impact from a motor vehicle accident.

Diaphragm

A respiratory structure spanning the upper quadrants that is primarily responsible for inspiration.

Peripheral Diaphragm Referral Pattern

Sharp pain localized to the costal margins and sometimes into the lumbar region resulting from stimulation of the peripheral portions of the diaphragm.

Central Diaphragm Referral Pattern

Sharp pain referred to the upper trapezius and shoulder on the ipsilateral side of the stimulation.

Lower Urinary Tract

A system involved in waste removal composed of the bladder, urethra, urinary sphincter, and, in men, the prostate.

Bladder and Urethra Pain Pattern

Pain localized to the suprapubic region or presenting as diffuse lower back pain.

Prostate Referral Pattern

Pain referring into the low back, pelvis, sacrum, perineum, inner thighs, and testes.

Large Intestine

The last section of the digestive tract (also known as the large bowel) responsible for the absorption of water.

Diverticulitis

A condition characterized by the ballooning of the intestinal wall with subsequent inflammation, capable of causing damage to the large intestine.

Large Intestine Pain Pattern

Pain located in the lower midabdomen (across either or both quadrants) that refers to the sacrum when the rectum is stimulated by passing gas or defecation.

Myocardial Infarction

Permanent damage to the heart wall secondary to ischemia, which can be activity-induced.

Heart Pain Pattern (Classic)

Pain in the substernal or retrosternal region that refers to the mid-thoracic region, bilateral jaw, left upper trapezius, left shoulder, and down the medial aspect of the left arm to the 5th digit.

Female Cardiac Referral Presentation

Uncharacteristic-like cardiac symptoms including epigastric pain, right shoulder pain, feelings of indigestion, or a combination of standard symptoms.