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Vomiting Centre -is in the medula -stimulated by: irritation in the tract, pain/stress, sensrory nberve endings in throat, vestibular apparatus in the inner ear (motion sickness), unplesant sights/smells, emotions CTZ (chemoreceptor zone) -triggered by chemical stimuli -drugs, toxins, chemicals -contains receptors for acetylcholine, dopamine, opiates, serotonin, histimine Physiological process of vomiting -deep breath then no resp -closure of glottis, raising soft palate - contraction of abdominal muscles and diaphram -relaxaton of cardiac sphincter -reverse peristalsis in proximal deuodenum and antrum of stomach -gastric contents forced up and out Malnutrition an excess or deficit or imbalance of essential components primary malnutrition nutritional needs not met -lack of food availability -willful eating behavior secondary malnutrition as a result of another condition affecting ingestion, digestion and absorption & or metabolism marasmus malnutrition deficiency of both calories and proteins= loss of fat and muscle kwashiokor malnutrition deficiency of protein intake=loss of muscle tissue but not necessarily wt starvation first 24 hrs uses carb stores in liver and muscle -body then converts protein to glucose -within 5-9 days body fat is used to supply energy needs -fat stores may last 4-6 weeks -body will then finally use protein (lean muscle) to use as engery