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GI Disorders

Pathways

Pathway Location Receptor Stimuli Output
Chemoreceptor Trigger Zone (CTZ) Area postrema D2 Circulating emetogens/toxins Activates vomiting center
Chemoreceptor Trigger Zone (CTZ) Area postrema outside BBB Circulating emetogens/toxins Activates vomiting center
Chemoreceptor Trigger Zone (CTZ) Area postrema CB1 Circulating emetogens Activates vomiting center
GI tract & heart (Vagal afferents) GI tract → vagus → PNS 5HT3 Serotonin from enterochromaffin cells; GI irritation Signals to vomiting center
GI tract & heart (Vagal afferents) GI tract D2 GI irritation Signals to vomiting center
GI tract & heart (Vagal afferents) GI tract M1 GI irritation Signals to vomiting center
GI tract & heart (Vagal afferents) GI tract, smooth muscle, heart, endothelial H1 GI irritation Signals to vomiting center
GI tract & heart (Vagal afferents) GI tract CB1/CB2 GI irritation, cannabinoids Signals to vomiting center
Vestibular system (Cranial nerve VIII) Inner ear (CN VIII) H1 (Gq↑ PLC-IP3/DAG) Motion / balance disturbance Vestibular → VC → motion sickness
Vestibular system (Cranial nerve VIII) Inner ear motional sickness Motion / balance disturbance Vestibular → VC → motion sickness
Higher CNS (Cortex, limbic) Cortex / limbic GABA Fear, anxiety, pain, smell, sight Anticipatory/psychogenic nausea
Vomiting center Medulla H1 Inputs from CTZ, vestibular, GI Final integration of emesis
Vomiting center Medulla Inputs from CTZ, vestibular, GI Final integration
Vomiting center Medulla (NTS) NK1 Substance P Final integration
Vomiting center Medulla 5HT3 GI / CTZ signals Final integration
Vomiting center Medulla CB1 Endocannabinoids / cannabinoids Modulates emesis
Vomiting center Medulla (NTS & related nuclei) Multi (D2, 5-HT3, H1, M1, NK1) Integrated input from CTZ, vestibular system, GI afferents Final integration of emesis
Chemoreceptor Trigger Zone (CTZ) Area postrema (outside BBB) D2/D3 Circulating emetogens/toxins Activates vomiting center
Higher CNS (anticipatory) Cortex/limbic GABA Anxiety/fear/anticipation Modulates anticipatory nausea
Created by: CaristW
 

 



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