Thorax: sensory supply of the pericardium: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anatomy · Thorax: sensory supply of the pericardium

Sample item

A 30-year-old man has sharp chest pain that eases on leaning forward and is felt at the tip of the left shoulder. A friction rub is heard. Which nerve carries the pain from the inflamed parietal pericardium?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Phrenic nerve

The fibrous and parietal serous pericardium is supplied by the phrenic nerve (C3 to C5), which gives pain referred to the shoulder tip. Pain in the pericardium is sharp and pleuritic. The visceral pericardium is insensitive to pain.

Option by option

  • A. Phrenic nerve (correct)

    Correct. The phrenic nerve carries pain from the parietal pericardium and refers it to the shoulder tip.

  • B. Cardiac branch of the sympathetic trunk

    Sympathetic cardiac branches carry cardiac ischaemic pain to T1 to T4, not parietal pericardial pain.

  • C. Fourth intercostal nerve

    Intercostal nerves supply the parietal pleura of the chest wall, not the pericardium.

  • D. Vagus nerve

    The vagus carries autonomic and some visceral fibres but does not carry pericardial pain referred to the shoulder.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is A, Phrenic nerve. The fibrous and parietal serous pericardium is supplied by the phrenic nerve (C3 to C5), which gives pain referred to the shoulder tip.

Why is "Cardiac branch of the sympathetic trunk" not the answer?

Sympathetic cardiac branches carry cardiac ischaemic pain to T1 to T4, not parietal pericardial pain.

Why is "Fourth intercostal nerve" not the answer?

Intercostal nerves supply the parietal pleura of the chest wall, not the pericardium.

Why is "Vagus nerve" not the answer?

The vagus carries autonomic and some visceral fibres but does not carry pericardial pain referred to the shoulder.

What concept does this question test?

It tests Thorax: sensory supply of the pericardium in Anatomy. Pain in the pericardium is sharp and pleuritic. The visceral pericardium is insensitive to pain.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Thorax: sensory supply of the pericardium?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.