Beruflich Dokumente
Kultur Dokumente
Mechanisms of
emesis
Classification of
vomiting
1. Reflective vomiting
2.Central vomiting
3. Neurological vomiting
Reflective vomiting
Pharyngeal Mechanisms
Gastrointestinal
Mechanisms
Disease of biliary tract
Peritoneal and mesentery
the five sense organs
Cardiovascular diseases
kidney
Pelvic
Pharyngal Reflexion
Gastrointestinal Mechanisms
Liver Gall
bladder pancre
as
Others
Central vomiting
Intra-cranial infection
Cerebrovascular disorders
Craniocerebral injury
Epilepsy
Metabolic disorders
Drugs
Intra-cranial infection
Cerebrovascular
disorders
Craniocerebral injury
Metabolic disorders
Ketosis acidos
is
Early
pregnancy
Uremia
Liver
coma
Drug
Antibiotics
Anticarcinoma
Digitalis
morphia
Excite Emetic Center or act on
Gastrointestinal smooth muscle movement
Gastrointestinal tract
neurosis
apositia
Early
pregnancy
Functional
indigestion
Mornin
g
vomitin
g
Nose&pharyn
x disease
Alcohol
GERD
achalasia of
cardia
pylorus
obstructio
n
Night&overnight
vomiting
Timing with
meals
Immediate after meal Neurologic &
Character of
vomiting
Neurologic & high intracranial pressure
No obvious nausea very
frequent propellant
vomiting
Characters
of vomitus
Accompanying
symptoms
Abdominal pain diarrhea food
poison intestinal contagious disease;
rhythmic pain peptic ulcers
Right upper quadrant pain with
fever jaundice cholecystitis bile duct
stones
infection
Headache
dizzy visual
abnormality ejective vomiting high
intracranial pressure glaucoma
Vertigo nystagmus vestibular
dysfunction
Women of childbearing age(menopause)
pregnancy?
Timing with drug from drugs
CAUSES OF
NAUSEA/VOMITING
Early pregnancy
Psychogenesis
vomiting
Bulimia( )
Pyloric channel ulcer
Acute gastritis
Gastric retention(
Viral gastroenteritis
Toxic gastroenteritis
Myocardial infarction
Peritonitis
Acute obstruction
Neurological
emergency
Drug toxicity
Cancer therapy
Drug withdrawal
Review
1. How vomiting is classified? And
identify which kind vomiting does one
diseases vomiting belongs to.
2. What is propellant vomiting?
3. What does different smell of vomitus
suggest?
4. What does accompanying symptoms
suggest?
Break
Goals
Definition
Outline the disease associated with nausea
and vomiting.
Characterize Nausea and Vomiting caused by
prominent disorders
Discriminate the accompanying symptoms.
Suggest diagnostic strategies of the
symptoms.
Mechanism
Vagal
excitation
Nause
a
Retching
Vomitin
g
Food
reflux No
such feeling
and
movement.
(infant hug
e meal
ICP
3
4
History taking
History/Background
a) Age
b) GI history required
c) Food intolerance
d) Timing with meals
e) Consistency
f) Content
g) Odor
h) Frequency
i) Fever
j) Weight loss
k) Precipitating
factors
l) Myalgias ,
visual disturbances,
headache, pain
outside abdomen
PHYSICAL EXAM
Vital signs
Skin
HEENT
head,eyes,ear,nose,thro
at)
Abdomen
Neurological
LABORATORY