~untuk memahami dengan lebih detail tentang bagaimana seseorang itu muntah/vomitting..
-dari wikipedia
Receptors on the floor of the fourth ventricle of the brain represent a chemoreceptor trigger zone, known as the area postrema, stimulation of which can lead to vomiting. The area postrema is a circumventricular organ and as such lies outside the blood-brain barrier; it can therefore be stimulated by blood-borne drugs that can stimulate vomiting or inhibit it.
There are various sources of input to the vomiting center:
- The chemoreceptor trigger zone at the base of the fourth ventricle has numerous dopamine D2 receptors, serotonin 5-HT3 receptors, opioid receptors, acetylcholine receptors, and receptors for substance P. Stimulation of different receptors are involved in different pathways leading to emesis, in the final common pathway substance P appears to be involved.[1]
- The vestibular system which sends information to the brain via cranial nerve VIII (vestibulocochlear nerve). It plays a major role in motion sickness and is rich in muscarinic receptors and histamine H1 receptors.
- Cranial nerve X (vagus nerve), which is activated when the pharynx is irritated, leading to a gag reflex.
- Vagal and enteric nervous system inputs that transmit information regarding the state of the gastrointestinal system. Irritation of the GI mucosa by chemotherapy, radiation, distention, or acute infectious gastroenteritis activates the 5-HT3 receptors of these inputs.
- The CNS mediates vomiting arising from psychiatric disorders and stress from higher brain centers.[2]
The vomiting act encompasses three types of outputs initiated by the chemoreceptor trigger zone: Motor, parasympathetic nervous system (PNS), and sympathetic nervous system (SNS). They are as follows:
The
neurotransmitters that regulate vomiting are poorly understood, but inhibitors of
dopamine,
histamine, and
serotonin are all used to suppress vomiting, suggesting that these play a role in the initiation or maintenance of a vomiting cycle.
Vasopressin and
neurokinin may also participate