Initially appendicitis manifests as diffuse pain in the periumbilical region and later as circumscribed pain in the right lower quadrant. Why?

Question

A) Because the appendix swells with appendicitis so that it contacts both the anterior and posterior abdominal walls.
B) Because the pain is first conveyed via vagal parasympathetic fibers and then by somatic fibers in the parietal peritoneum of the abdominal wall.
C) Because the pain is first conveyed via sympathetic fibers that enter the spinal cord at the T10 level and then by somatic fibers in the parietal peritoneum of the abdominal wall.
D) Because the appendix first irritates the subcostal nerve and then the ilioinguinal nerve.
E) Because the most sensitive afferents of the appendix are those that are associated with the sympathetic fibers that enter the T10 level of the spinal cord, but later less sensitive afferents associated with the lower quadrant become activated.

Answer 1

Ans: C