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Pain referral
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Cranial nerve
Spinal nerve
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The Diaphragm is a muscle of the chest.
Anatomical Attachments: Action: Respiration, it increases and decreases the volume in the thoracic and abdominal cavities.
Nerve Supply: Phrenic nerve (C3, C4, and C5).
Vascular supply: Inferior Phrenic artery.
Trigger Point Signs and Symptoms: There appears to be a stitch in the side, chest pain, dyspnea (when it is severe the individual may have feelings of impending doom),
due to the individual not being able to take a full breath.
Trigger Point Activating and Perpetuating Factors: Vigorous exercise, persistent jogging, persistent cough.
Differential Diagnosis: (Segmental, Subluxation, Somatic dysfunction) C3 C4 or C5 radiculopathy, Peptic ulcer, Gastroesophageal reflux, Gallbladder disease, Appendicitis, Slipping rib syndrome (Tietze Syndrome), Rib fracture of lower ribs, Costochondritis, Dyspnea, Shortness of breath, Pleurisy, Polymyalgia rheumatica, Fibromyalgia, Herpes Zoster (Shingles), Pulmonary neoplasm (Lung cancer), Chronic
Obstructive Pulmonary disease (COPD, Emphysema), Pulmonary embolism, Cheyne-Stokes respiration (if CNS, coronary or pharmaceutical, insult is possible), Pneumonia or Bronchitis, Asthma, Anaphylactic shock, Hyperventilation secondary to anxiety reaction, Coughing, Hiccups, Angina pectoris, Myocardial infarction, Hepatic disease (Hepatomegaly), Splenic disease (Splenomegaly or Rupture), Pancreatitis, Pancreatic carcinoma, Sprain/Strain or Tear (of the Rectus abdominis, Internal or External Obliques, or Intercostals), Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.
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Pain referral
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Spinal nerve
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Diaphragm
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Travell and Simons Trigger Point Pain Referral: