What referred pain is the black arrow pointing to?

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Multiple Choice

What referred pain is the black arrow pointing to?

Referred shoulder pain from diaphragmatic irritation is produced when the spleen is involved. The spleen lies in the left upper quadrant under the ribs, and irritation of its capsule or nearby diaphragmatic pleura sends signals through the phrenic nerve (C3–C5). Those same spinal levels also contribute to sensation in the shoulder region, so the brain perceives pain in the left shoulder rather than deep in the LUQ. This is why a pain pattern can show up at the shoulder even though the spleen is the issue. If the problem were the pancreas, liver, or stomach, the pain would typically be felt in different areas—often more central or right-sided (liver) or epigastric/back regions (stomach, pancreas)—rather than the left shoulder.

Referred shoulder pain from diaphragmatic irritation is produced when the spleen is involved. The spleen lies in the left upper quadrant under the ribs, and irritation of its capsule or nearby diaphragmatic pleura sends signals through the phrenic nerve (C3–C5). Those same spinal levels also contribute to sensation in the shoulder region, so the brain perceives pain in the left shoulder rather than deep in the LUQ. This is why a pain pattern can show up at the shoulder even though the spleen is the issue.

If the problem were the pancreas, liver, or stomach, the pain would typically be felt in different areas—often more central or right-sided (liver) or epigastric/back regions (stomach, pancreas)—rather than the left shoulder.

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