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Pathophysiology 212 > Stress & Adaptation > Flashcards

Stress & Adaptation Flashcards

1
Q

Homeostasis

A

-State of constancy
-Requires feedback control systems
-Integrates a variety of body systems
Cannon’s 4 features:
-Mechanisms to maintain constancy
-Change from “steady-state” causes a response
-Response is multifactorial & cooperative
-Simultaneous or successive
“Organized self-government”

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2
Q

Eustress

A

Controllable (mild/brief) periods of stress contributing to emotional and intellectual growth

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3
Q

Allostasis

A

Interactive physiologic changes in neuroendocrine, autonomic, and immune systems in response to real or perceived challenges/threats to homeostasis

It increases chance of survival!

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4
Q

Stress Definition

A

“A state manifested by a specific syndrome of the body developed in response to any stimuli that made an intense systemic demand on it”

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5
Q

Endogneous & Exogenous Stress

A

Stressor

  1. Endogenous (within the body)
  2. Exogenous (outside the body)

Response to stress dependent upon:

  • Properties of stressor
  • Condition of person being stressed

Factors affecting condition are:

  • Internal (genetic, age, gender)
  • External (environmental exposure, life experiences, dietary, social support)
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6
Q

General Adaptation Syndrome Stages

A
  1. Alarm Stage
    - SNS & HPA axis stimulation
    - Release of catecholamines & cortisol
  2. Resistance Stage
    - Body responds and adapts
    - Cortisol levels drop
  3. Exhaustion Stage
    - Resources are depleted
    - Damage to systems if prolonged
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7
Q

Neuroendocrine System Response

A
  • Release of neurohormones result in
  • Energy
  • Sharpened focus & awareness
  • Increased cerebral blood flow and glucose utilization
  • Enhanced CV & respiratory function
  • Shunting of blood to brain/muscles
  • Modulation of immune response
  • Inhibition of reproductive function
  • Decreased appetite
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8
Q

Neurohormones involved in stress

A

Catecholamines
Cortisol:
- Potentiates epinephrine and glucacon
Decreases non-essential energy-using activities (metabolic rate, reproductive, osteoblasts, rbc/wbc production, immune system)

Angiotensin II
Aldosterone
ADH

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9
Q

Sympathetic System—“Fight-or-Flight”Response

A
  • Rapid response to trauma and emergency
  • Epinephrine & norepinephrine both released
  • Both attach to adrenergic receptors on cells
  • Blood pressure restored
  • Blood flow to skin, guts, and kidneys reduced
  • Skin becomes pale
  • Urine production decreases
  • GI activity decreases

look at slides 12 & 13

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10
Q

Cortisol—The “Stress Hormone”

A
  • Helps regulate the stress response
  • Diverts metabolism from building to supplying energy for dealing with the stress
  • Causes signs and symptoms of chronic stress
  • Alters glucose, fat, and protein metabolism
  • Suppresses inflammatory and immune response
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11
Q

Effect of Stress on Immune System

A
  • Decreased immune cell production
  • Decreased thymus activity (eventual atrophy)
  • Fewer t-lymphocytes
  • Monocytes/lymphocytes release inflammatory mediators and cytokines which interfere with brain activities
  • Exact mechanisms unclear
  • Variable from person-to-person
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12
Q

Adaptation

A

-The ability to adapt is influenced by coping mechanisms /strategies, both emotional & behavior , attempting to maintain physiologic and psychosocial homeostasis

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13
Q

Factors affecting ability to adapt

A
  • Time available to adapt
  • Genetic endowment/acquisition
  • Age
  • Gender
  • Health status
  • Nutrition
  • Sleep-wake cycles
  • Hardiness (ability to conceptualize stressors as a challenge rather than a threat)
  • Psychosocial factors (support/family/friends)
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14
Q

What Can The Acute Stress Response be Caused by?

A
  1. Threat to physiologic environment
    -Moment-to-moment feedback mechanisms specific to threat
    Eg: baroreceptors response to position change
  2. Threat to psychosocial environment
    -Response is not specific, and therefore may be inappropriate and sustained
    Eg: death of family/friend/pet
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15
Q

Affects of Acute Stress

A

ANS result in arousal, alertness, vigilance, cognition, focused attention, appropriate aggression
If pre-existing health issue, ANS is already “pushed”

HPA axis response is crucial
Resultant hyperglycemia is not understood well but results in poorer outcomes for serious illness
Low-dose insulin has positive effect

If healthy, redirection of health-promoting activities may (will?) result

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16
Q

Chronic Stress Response

A

Occurs when
Component of system fails
Original stimulus is prolonged/adaptation exhausted
Results in over-reaction or under-reaction

Examples of chronic stress manifestations:
Necrotizing gingivitis
Herpes Simplex Virus (HSV) 1
Rhinovirus infections
Exacerbation of any disease process
17
Q

Posttraumatic Stress Disorder (PTSD)

A

-Chronic activation of stress response d/t significant traumatic event
-Traumatic event = actual or threatened death/major injury
Combat
Major accident/bombing
Environmental
Rape
Child abuse

18
Q

PTSD patho

A
  • Increased levels of catecholamines & thyroid hormones
  • Decreased cortisol levels
  • Symptom Triad
  • Present together x 1 month /and/
  • Clinical symptoms or functional impairments
19
Q

PTSD Symptom Triad

A
  1. Intrusion
    - Flashbacks/nightmares of event
  2. Avoidance
    - Emotional numbing
    - Depression
    - Survivor guilt
  3. Hyperarousal
    - Irritability/anxiety
    - Exaggerated startle reflex
    - Difficulty concentrating/memory problems
    - Increased concern over one’s safety
    - Sleep disturbances
20
Q

PTSD increases risk for…

A 
Depression
Panic disorder
Generalized anxiety disorder
Substance abuse
Physical illnesses (e.g. HTN, asthma, chronic pain syndrome)
21
Q

Treatment options for PTSD

A 
Main Goals
- Avoid poor coping behaviours
- Provide stress-reducing strategies
Relaxation Techniques
Guided Imagery
Music Therapy
Massage Therapy
Biofeedback
22
Q

Factors affecting the ability to adapt

A 
> Physiologic Reserve
-Ability of the body systems to increase their function 
RBCs, HR, vasodilation/constriction
> Anatomic Reserve
-Paired organs

Pathophysiology 212 (18 decks)

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