NBCE Exam 2026 – 400 Free Practice Questions to Pass the National Board of Chiropractic Examiners

The correct answer highlights that pain from a viscerosomatic reflex related to the gallbladder is often referred to the inferior border of the right scapula. This phenomenon occurs because of the specific nerve pathways linking the gallbladder's visceral afferents to the somatic nerves that supply the shoulder and upper back regions.

The gallbladder is innervated by the celiac plexus, and the associated pain can manifest in the right upper quadrant but may also project to the area around the right scapula due to the convergence of sensory pathways. This is a classic example of referred pain, where discomfort in an internal organ is perceived in a different location in the body.

Understanding this process is crucial in clinical practice, as it aids in accurately diagnosing conditions that may not present with typical pain patterns and highlights the importance of considering visceral sources for musculoskeletal pain, especially in the right upper quadrant.