Emetic reflex
Emesis is the regurgitation of materials from stomach and upper intestine through oesophagus to oral cavity.
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This reflex is initiated by irritating stimuli from vicera.(pharynx, stomach, duodenum, heart, uterus) or from external auditory canal.
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Protective mechanism to remove the irritating stimuli.
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Motion sickness results due to irritation of the vestibular receptor organs. This particular event involves the participation of flocculonodular lobe of cerebellum.
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This reflex is preceded by salivation & swallowing.
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The nerves of afferent limbs are glossopharyngeal, vagus or vestibular and visceral afferent of the spinal cord (for abdominal/pelvic visceral).
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Emetic center is located in the caudal medulla.
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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)
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The central neural mechanism of efferent limb includes nerves supplying to
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Smooth muscles of G.I tract.
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Skeletal muscle of larynx, pharynx, thorax, abdominal wall.
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Effernt nerve of emeticreflex causes closure of glottis with inhibition of inspiration; These together produce negative pressure in the intrathoracic and oesophagus.
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Relaxation of cardia, fundus, body of the stomach and oesophagogastric cardiac sphincter prior to act of vomiting.
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Followed by forceful contraction of the abdominal muscle.
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This result in movement of content of stomach to oesophagus.
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Closure of nasopharynx prevents the entry of contents to respiratory organs.
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Powerful antiperistalsis with negative I/oesophageal pressure expels the content to oral cavity.
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Creation of negative pressure by forceful inspiration against closed glottis and strong abdominal muscle contraction is important than antiperistalsis.
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Relaxation of pyloris allow contents from duodenum to oesophagus and then to oral cavity.
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Efferent fibers also reaches salivatory nucleus to initiate salivation before emesis to prevent oral mucosa from acid contents.
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Fibers project to respiratory and cardiac centre to modify appropriately the B.P and the rate of respiration.
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Last modified: Tuesday, 27 December 2011, 6:38 AM