We use optical spectroscopy to investigate the disk, wind, and accretion during the 2008 Z CMa NW outburst. The emission lines are used to constrain the locations, densities, and temperatures of the structures around the star. Over 1000 optical emission lines reveal accretion, a variable, multi-component wind, and double-peaked lines of disk origin. The variable, non-axisymmetric, accretion-powered wind has slow (~0km/s ), intermediate (~-100km/s) and fast (>=-400km/s) components. The fast components are of stellar origin and disappear in quiescence, while the slow component is less variable and could be related to a disk wind. The changes in the optical depth of the lines between outburst and quiescence are consistent with increased accretion being responsible for the observed outburst. We derive an accretion rate of 10^-4^M_{sun}_/yr in outburst. The FeI and weak FeII lines arise from an irradiated, flared disk at ~0.5-3(M*/16M_{sun}_) au with asymmetric upper layers, revealing that the energy from the accretion burst is deposited at scales below 0.5au. Some line profiles have redshifted asymmetries, but the system is unlikely sustained by magnetospheric accretion, especially in outburst. The accretion-related structures extend over several stellar radii and, like the wind, are likely non-axisymmetric. The stellar mass may be ~6-8M_{sun}_, lower than previously thought (~16M_{sun}_). Emission line analysis is found to be a powerful tool to study the innermost regions and accretion in stars within a very large range of effective temperatures. The density ranges in the disk and accretion structures are higher than in late-type stars, but the overall behavior, including the innermost disk emission and variable wind, is very similar independently of the spectral type. Our work suggests a common outburst behavior for stars with spectral types ranging from M-type to intermediate-mass stars.