恶心呕吐精品PPT课件
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Vomiting： the forceful oral expulsion of gastric contents via retro-peristalsis.
Nausea-Vomiting: simultaneity or separateness
恶心：紧迫欲吐， 通常伴有上腹不适 和迷走兴奋的临床 征候群。
Mechanisms of emesis
CTZ & Emetic Center (Vomiting center) Emetic Center（延髓外侧网状结构背测）接受大脑皮
质、消化器官、心血管以及化学感受器触发带（CTZ）的冲动
CTZ化学感受器触发带（第四脑室底面）：外源性或内源性化学
物质（阿片吗啡、洋地黄、代谢产物）
Pharyngeal Mechanisms Gastrointestinal Mechanisms Disease of biliary tract Peritoneal and mesentery
the five sense organs Cardiovascular diseases kidney Pelvic
呕吐：胃和/或小肠 内容物经食管和口 腔排除体外
恶心和呕吐常伴随 存在，也可单独出 现！
Nausea and Vomiting
Definition of emesis. (Three phases) 呕吐反射过程（三个阶段）
1. Nausea - the inclination or feeling of imminent desire to vomit, usually felt in the throat or epigastrum. Associated with decreased activity of the stomach.
Stomach
Esophagus
脊神经
膈神经
迷走神经
nausea and vomiting
1. Reflective vomiting 反射性呕吐
2.Central vomiting
中枢性呕吐
3. Neurological vomiting 神经性呕吐
Reflective vomiting （反射性呕吐）
Spinal nerve
Abdominal muscles
Emetic Center
1.Salivary center 2. Vasomotor center 3. Respiratory center 4. Cranial nerves
phrenic nerve
vagus nerve百度文库
Diaphragm
2. Retching - the labored rhythmic contraction of respiratory and abdominal musculature that frequently precedes or accompanies vomiting.
3. Vomiting - the forceful oral expulsion of gastric contents via retroperistalsis. (Abdominal effects).
1、恶心：咽部及 上腹部不适，胃张 力和蠕动减弱，幽 门和贲门开放。
2、干呕：胃窦部 和腹壁肌肉收缩， 腹压增加，食管及 咽部开放。
3、呕吐：胃和/或 小肠内容物经食管 和口腔排除体外。
发生机制
迷走兴奋表现
恶心
干呕
呕吐
呕吐区别于反食
呕吐：多数情 况有恶心的感 觉和呕吐反射 的协调动作。
反食：无恶心 的感觉和呕吐 反射的协调动 作。（儿童、 饱餐）
健康快乐每一天！
临床诊断学
上海第二医科大学仁济临床医学院
Nausea and Vomiting As the symptoms
症状学：恶心与呕吐
Goals
Briefly define Outline the prominent disease states
associated with nausea and vomiting. Characterize Nausea and Vomiting caused by
CTZ & Emetic Center (Vomiting center)
孤束核
Emetic Center
中脑ICP受体 化学感受器触发带 边缘系统
Midbrain Chemoreceptor Limbic
ICP Receptor Trigger Zone
System
Vestibular system
the prominent disorders Discriminate the accompanying symptoms. Suggest diagnostic strategies of the symptoms.
Definition of Nausea and Vomiting
Nausea ：the inclination or feeling of imminent desire to vomit, usually felt in the throat or epi-gastrum. Associated with decreased activity of the stomach.
Visceral afferents
内脏传入
Emetic Center 呕吐中枢（Vomiting center)
前庭系统
ICP=Inductively Coupled Plasma 感应耦合等离子体
Neurotransmitters in CTZ & Emetic Center
Neurotransmitters involved in stimulating the emetic center, chemo-receptor trigger zone and GI tract include;
5-HT, acetylcholine, histamine, dopamine (opiates and receptors for benzodiazepines are also found here)
Emetic Center
1、分泌唾液中枢 2、血管收缩中枢 3、呼吸中枢 4、中枢神经
Nausea-Vomiting: simultaneity or separateness
恶心：紧迫欲吐， 通常伴有上腹不适 和迷走兴奋的临床 征候群。
Mechanisms of emesis
CTZ & Emetic Center (Vomiting center) Emetic Center（延髓外侧网状结构背测）接受大脑皮
质、消化器官、心血管以及化学感受器触发带（CTZ）的冲动
CTZ化学感受器触发带（第四脑室底面）：外源性或内源性化学
物质（阿片吗啡、洋地黄、代谢产物）
Pharyngeal Mechanisms Gastrointestinal Mechanisms Disease of biliary tract Peritoneal and mesentery
the five sense organs Cardiovascular diseases kidney Pelvic
呕吐：胃和/或小肠 内容物经食管和口 腔排除体外
恶心和呕吐常伴随 存在，也可单独出 现！
Nausea and Vomiting
Definition of emesis. (Three phases) 呕吐反射过程（三个阶段）
1. Nausea - the inclination or feeling of imminent desire to vomit, usually felt in the throat or epigastrum. Associated with decreased activity of the stomach.
Stomach
Esophagus
脊神经
膈神经
迷走神经
nausea and vomiting
1. Reflective vomiting 反射性呕吐
2.Central vomiting
中枢性呕吐
3. Neurological vomiting 神经性呕吐
Reflective vomiting （反射性呕吐）
Spinal nerve
Abdominal muscles
Emetic Center
1.Salivary center 2. Vasomotor center 3. Respiratory center 4. Cranial nerves
phrenic nerve
vagus nerve百度文库
Diaphragm
2. Retching - the labored rhythmic contraction of respiratory and abdominal musculature that frequently precedes or accompanies vomiting.
3. Vomiting - the forceful oral expulsion of gastric contents via retroperistalsis. (Abdominal effects).
1、恶心：咽部及 上腹部不适，胃张 力和蠕动减弱，幽 门和贲门开放。
2、干呕：胃窦部 和腹壁肌肉收缩， 腹压增加，食管及 咽部开放。
3、呕吐：胃和/或 小肠内容物经食管 和口腔排除体外。
发生机制
迷走兴奋表现
恶心
干呕
呕吐
呕吐区别于反食
呕吐：多数情 况有恶心的感 觉和呕吐反射 的协调动作。
反食：无恶心 的感觉和呕吐 反射的协调动 作。（儿童、 饱餐）
健康快乐每一天！
临床诊断学
上海第二医科大学仁济临床医学院
Nausea and Vomiting As the symptoms
症状学：恶心与呕吐
Goals
Briefly define Outline the prominent disease states
associated with nausea and vomiting. Characterize Nausea and Vomiting caused by
CTZ & Emetic Center (Vomiting center)
孤束核
Emetic Center
中脑ICP受体 化学感受器触发带 边缘系统
Midbrain Chemoreceptor Limbic
ICP Receptor Trigger Zone
System
Vestibular system
the prominent disorders Discriminate the accompanying symptoms. Suggest diagnostic strategies of the symptoms.
Definition of Nausea and Vomiting
Nausea ：the inclination or feeling of imminent desire to vomit, usually felt in the throat or epi-gastrum. Associated with decreased activity of the stomach.
Visceral afferents
内脏传入
Emetic Center 呕吐中枢（Vomiting center)
前庭系统
ICP=Inductively Coupled Plasma 感应耦合等离子体
Neurotransmitters in CTZ & Emetic Center
Neurotransmitters involved in stimulating the emetic center, chemo-receptor trigger zone and GI tract include;
5-HT, acetylcholine, histamine, dopamine (opiates and receptors for benzodiazepines are also found here)
Emetic Center
1、分泌唾液中枢 2、血管收缩中枢 3、呼吸中枢 4、中枢神经