恶心呕吐.PPT课件
合集下载
相关主题
- 1、下载文档前请自行甄别文档内容的完整性，平台不提供额外的编辑、内容补充、找答案等附加服务。
- 2、"仅部分预览"的文档,不可在线预览部分如存在完整性等问题,可反馈申请退款(可完整预览的文档不适用该条件!)。
- 3、如文档侵犯您的权益，请联系客服反馈,我们会尽快为您处理(人工客服工作时间：9:00-18:30)。
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！
5
Nausea and Vomiting
6
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.
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).
14
15
wenku.baidu.com
16
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
Spinal nerve
Emetic Center
1.Salivary center 2. Vasomotor center 3. Respiratory center 4. Cranial nerves
健康快乐每一天！
1
临床诊断学
上海第二医科大学仁济临床医学院
2
Nausea and Vomiting As the symptoms
症状学：恶心与呕吐
3
Goals
Briefly define Outline the prominent disease states
associated with nausea and vomiting. Characterize Nausea and Vomiting caused
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。
7
发生机制
迷走兴奋表现
恶心
干呕 呕吐
8
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）
phrenic nerve
vagus nerve
Abdominal muscles
Diaphragm
Stomach
Esophagus
脊神经
膈神经
迷走神经
17
18
nausea and vomiting
1. Reflective vomiting 反射性呕吐
2.Central vomiting
中枢性呕吐
System
Vestibular system
Visceral afferents
内脏传入
Emetic Center
前庭系统
呕吐中枢（Vomiting center)
ICP=Inductively Coupled Plasma 感应耦合等离子体
13
Neurotransmitters in CTZ & Emetic Center
by the prominent disorders Discriminate the accompanying symptoms. Suggest diagnostic strategies of the
symptoms.
4
Definition of Nausea and Vomiting
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)
9
Mechanisms of emesis
10
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
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。
3. Neurological vomiting 神经性呕 吐
19
Reflective vomiting （反射性呕吐）
Pharyngeal Mechanisms Gastrointestinal Mechanisms Disease of biliary tract Peritoneal and mesentery
物质（阿片吗啡、洋地黄、代谢产物）
11
CTZ & Emetic Center (Vomiting center)
孤束核
12
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
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.
恶心和呕吐常伴随 存在，也可单独出 现！
5
Nausea and Vomiting
6
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.
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).
14
15
wenku.baidu.com
16
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
Spinal nerve
Emetic Center
1.Salivary center 2. Vasomotor center 3. Respiratory center 4. Cranial nerves
健康快乐每一天！
1
临床诊断学
上海第二医科大学仁济临床医学院
2
Nausea and Vomiting As the symptoms
症状学：恶心与呕吐
3
Goals
Briefly define Outline the prominent disease states
associated with nausea and vomiting. Characterize Nausea and Vomiting caused
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。
7
发生机制
迷走兴奋表现
恶心
干呕 呕吐
8
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）
phrenic nerve
vagus nerve
Abdominal muscles
Diaphragm
Stomach
Esophagus
脊神经
膈神经
迷走神经
17
18
nausea and vomiting
1. Reflective vomiting 反射性呕吐
2.Central vomiting
中枢性呕吐
System
Vestibular system
Visceral afferents
内脏传入
Emetic Center
前庭系统
呕吐中枢（Vomiting center)
ICP=Inductively Coupled Plasma 感应耦合等离子体
13
Neurotransmitters in CTZ & Emetic Center
by the prominent disorders Discriminate the accompanying symptoms. Suggest diagnostic strategies of the
symptoms.
4
Definition of Nausea and Vomiting
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)
9
Mechanisms of emesis
10
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
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。
3. Neurological vomiting 神经性呕 吐
19
Reflective vomiting （反射性呕吐）
Pharyngeal Mechanisms Gastrointestinal Mechanisms Disease of biliary tract Peritoneal and mesentery
物质（阿片吗啡、洋地黄、代谢产物）
11
CTZ & Emetic Center (Vomiting center)
孤束核
12
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
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.