Emetic reflex

EMETIC REFLEX

Emesis is the regurgitation of materials from stomach and upper intestine through oesophagus to oral cavity.

Vomiting centre

  • This reflex is initiated by irritating stimuli from vicera.(pharynx, stomach, duodenum, heart, uterus) or from external auditory canal.
  • Protective mechanism to remove the irritating stimuli.
  • Motion sickness results due to irritation of the vestibular receptor organs. This particular event involves the  participation of flocculonodular lobe of cerebellum.
  • This reflex is preceded by salivation & swallowing.
  • The nerves of afferent limbs are glossopharyngeal, vagus or vestibular and visceral afferent of the spinal cord (for abdominal/pelvic visceral).
  • Emetic center is located in the caudal medulla.
  • Cells present in chemo receptor triggerzone of medulla can also initiate emesis on stimulation by specific chemical (apomorphine, ergot alkolids morphine, glycosides or metobolites of systemic acidosis, alkolosis, uremia)
  • The central neural mechanism of efferent limb includes nerves supplying to
    • Smooth muscles of G.I tract.
    • Skeletal muscle of larynx, pharynx, thorax, abdominal wall.
  • Effernt nerve of emeticreflex causes closure of glottis with inhibition of inspiration; These together produce negative pressure in the intrathoracic and oesophagus.
  • Relaxation of cardia, fundus, body of the stomach and oesophagogastric cardiac sphincter prior to act of vomiting.
  • Followed by forceful contraction of the abdominal muscle.
  • This result in movement of  content of stomach to oesophagus.
  • Closure of nasopharynx prevents the entry of contents to respiratory organs.
  • Powerful antiperistalsis with negative I/oesophageal pressure expels the content to oral cavity.
  • Creation of negative pressure by forceful inspiration against closed glottis and strong abdominal muscle contraction is important than antiperistalsis.
  • Relaxation of pyloris allow contents from duodenum to oesophagus and then to oral cavity.
  • Efferent fibers also reaches salivatory nucleus to initiate salivation before emesis to prevent oral mucosa from acid contents.
  • Fibers project to respiratory and cardiac centre  to modify appropriately the B.P and the rate of respiration.

Last modified: Tuesday, 27 December 2011, 6:38 AM