Can be considered as two separate stages:

Pre-Ejection Phase
  • Symptoms of nausea occur
  • Sympathetic stimulation:
    • Tachycardia, tachypnoea, sweating
  • Parasympathetic stimulation:
    • Salivation
    • Upper and lower oesophageal sphincters relax
    • Retrograde peristalsis to the stomach
Ejection Phase
  • Protection of the airway occurs:
    • Respiration temporarily ceases mid-inspiration
    • Hyoid and larynx rise to open crico-oesophageal sphincter
    • Glottis closes and soft palate elevates to close posterior nasal space
    • Soft palate elevates to close off the nasopharynx
  • Ejection of gastric contents follows:
    • Contraction of the abdominal muscles results in raised intra-abdominal pressure
    • Gastro-oesophageal sphincter opens