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Pathophysiology of vomiting and regurgitation - Coggle Diagram
Pathophysiology of vomiting and regurgitation
Vomiting (emesis)
4 Main triggers
Chemoreceptor trigger zone
Blood-borne emetic substances / toxins
Chemo drugs
Apomorphine
Induce emesis
Toxins ingestion
Dopamine D2 receptor agonist
Uraemic toxins
Renal failure
Excessive stomach acid production
Medulla
Outside blood-brain barrier
Vestibular system
Motion activated
Eg. car rides
Vestibular nuclei
Via vestibulocochlear nerve(CN 8)
Vestibular system disorder
Head tilt, ataxia, eye fast-phase
Geriatric vestibular syndrome
Otitis media and interna
Cerebral cortex input (rare)
Food aversion -cats
Associate given food with nausea
Nausea / anorexia
Visceral organs + pharynx - afferent receptors
Chemoreceptors
Irritation (inflammation)
Mechanoreceptors
Distension
Foreign body
Overeating
Neoplasia
Via vagus and sympathetic nerves
Clinical signs
Predictable onset
Hypersalivation
Marked abdominal effort
Forceful explusion
Vomit contents
Digested
Bile present
pH <5 or >8
Regurgitation
Clinical signs
Unpredictable onset
Passive explusion
Minimal abdominal effort
Vomitus contents
No bile
Undigested food
pH >7
Oesophageal weakness
Inability to drink / eat
Risk for aspiration pneumonia
Respiratory effort
Causes - oesophageal disease
Structural / obstructive disorder
Intraluminal
Foreign body
Oesophageal stricture
Scar tissue
Extraluminal
Congenital vascular ring anomaly
Residual ligament constriction
Neoplasia
Thymoma
Functional / motility disorder
Megaoesophagus - lumen dilation
Primary
Congenital
Idiopathic
Secondary
Neuromuscular disorders
Hormonal disorders
Toxins
Tick paralysis
Progressive flaccidity
Oesophagitis
Lining inflammation
Diagnostics
Endoscopy
Radiography
Neurological examination
History taking - location, diet