Vomiting and its cause

by. Dewi Lestari Handayani, S.Kep

Vomiting or emesis is being coordinated by the centre of emesis in Medulla. It can be started by the afferent neuron into its centre. Vomiting occurs by the respiration muscles contraction and abdomen muscle, it started when the deep inspiration occurs along with the closing of glottis. The contraction of diaphragm is pressing the gastric while abdomen muscle‘s contraction is pressing the abdomen, then intraabdomen pressure increased along with the mucous in gastric. The glottis closed.

Vomiting occurs by some causes:
1. Tactil stimulation (with the finger or spatel)
2. Iritation
3. Intracranial pressure. It occurs when there’s intracerebral bleeding. It also occurs after the brain injury that result in edema or bleeding in intracranial.
4. Rotation or head acceleration that leads dizziness.
5. Severe pain from any organs.
6. Chemical substance, including medicine or toxic agent, that stimulates chemoreceptor in CTZ (chemoreceptor trigger Zone) in the brain that leads to the vomit reflects.
7. Physical vomiting, that trigerred by the emotional factors like stressed or seeing or smelling something.

Reference:
Sherwood, Lauralee. (2001). Fisiologi manusia: Dari sel ke sistem. Jakarta: EGC

Extrapiramidal motoric control - Decortication & Decerebration-

by. Dewi L. Handayani, S.Kep

The muscle's soft and strong movement is affected by the cerebellum and ganglia basal. As we know that cerebellum is a part of the brain that lied under posterior lobe of the cerebrum, that has a responsibility in coordination, balance, timing, and all the muscle movement starting from motoric center in cortical cerebri.
Ganglia basal is the mass in grisea substation in the middle brain under the hemisphere. it has a function to control the involuntary activity and to keep the basic shape of the voluntary movement. it's keeping the the contractility of the muscle and constant condition of from the extremity. Someone can react right and fast for some olfaction, vision and hearing because of ganglia basal.

Dyskinesia

it happens when someone got the intracranial injury or there's a mass (hemorrhage, abscess, tumor) so he lost his cerebellum's function. Because of this, the muscle tone lose, and feels fatigue, but the symptoms are varied, it depends the wide of the distortion. it can be decortication, or decerebration.
Decortication occurs because of there are lessions in internal capsule or cerebral hemisphere.
Decerebration occurs when there are lessions in the middle brain. flaccid position in decerebration occurs when there's a dysfunction of the bottom brain stem. there are no motoric function, patient looks paralyze. Decerebration is of the indication of brain injury with severe neurology distortion.

image: http://www.zeadmph.com/resources/Decorticate_decerebate_post.jpg

the distortion of ganglia basal doesn't show any paralysis but spasm, where it's consequence is the distortion of the body posture and movement. Patient will show any involuntary movement, forming a hard tremor.

source:
Smeltzer, Suzanne C.; Bare, Brenda G. (2002). Buku ajar keperawatan medikal bedah brunner & suddarth. Jakarta. EGC.