During acute appendicitis, the contribution of the somatosensory nociceptive afferents is which of the following?
A. Regulation of visceral function
B. Production of skeletal muscle guarding to protect the appendix
C. Modulation of respiratory function
D. Signaling visceral distress to the brain
E. Signaling conscious awareness of pain in the umbilical region
ANS: E
Rationale: Stimulation of nociceptive second-order neurons results in pain sensation referred to the umbilical region (see Figure 9-4).
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