Case 1 Flashcards

Question

where are peripheral chemoreceptors located? and what are they important for?

Answer 1

* Located outside the brain. * Important for detecting changes in oxygen levels in the blood. * Transmit nervous signals to the respiratory centres in the brain. * Carotid bodies: found in the carotid arteries. Their nerve fibres pass through the glossopharyngeal nerves and then to the dorsal respiratory area. * Aortic bodies: found in the arch of the aorta. Their nerve fibres pass through the vagi, also to the dorsal respiratory area.

Answer 2

Carotid bodies = glossopharyngeal nerves | Aortic bodies = vagi nerves (A and V look similar)

Answer 3

Located in the muscular portions of the walls of the bronchi and bronchioles throughout the lungs

Answer 4

through the vagus nerve into the dorsal respiratory group of neurons when the lungs become over stretched - when the lungs become over inflated, the stretch receptors activate an appropriate feedback response that 'switches off' the inspiratory ramp and thus stops further inspiration - Hering-Breuer inflation reflex - this reflex also increases the rate of respiration

Answer 5

- The rising Pco2 relaxes smooth muscle in walls of arteries and capillaries, causing vasodilation and so increasing blood flow - In alveolar capillaries, blood is directed where Po2 is relatively high, this occurs because alveolar capillaries constrict when local Po2 is low - In bronchioles, oxygen is directed towards lobules where Pco2 is high, because these lobules are actively engaged in gas exchange - this occurs because smooth muscle in the bronchioles bronchodilate when Pco2 is high

Answer 6

1. Inadequate oxygenation of the blood in the lungs because of extrinsic reasons  - Deficiency of oxygen in the atmosphere  - Hypoventilation (neuromuscular disorders) 2. Pulmonary disease  - Hypoventilation caused by increased airway resistance or decreased pulmonary compliance  - Abnormal alveolar ventilation – perfusion ratio  - Diminished respiratory membrane diffusion 3. Venous-to-arterial shunts (“right-to-left cardiac shunts”) – allows blood to flow from the right heart to the left heart 4. Inadequate oxygen transport to the tissues by the blood  - Anaemia or abnormal haemoglobin  - General circulatory deficiency  - Localized circulatory deficiency (peripheral, cerebral, coronary vessels etc)  - Tissue oedema 5. Inadequate tissue capability of using oxygen  - Poisoning of cellular oxidation enzymes (cyanide poisoning)  - Diminished cellular metabolic capacity for using oxygen, because of toxicity, vitamin deficiency, or other factors

Answer 7

- caused as a result of excessive amounts of deoxygenated haemoglobin in the skin blood vessels - this deoxygenated blood has an intense dark blue-purple colour that is transmitted through the skin

Answer 8

- the pressure of the 'fluid' in the pleural cavity | - normally it is slightly negative and becomes more negative during inspiration

Answer 9

- when the glottis is open and no air is flowing into or out of the lungs - considered to be zero reference pressure in the airways - that is, 0 cmH2O

Answer 10

enough to pull 0.5 litres of air into the lungs in the 2 seconds required for normal quiet inspiration

Answer 11

- Tidal volume: increased tidal volume = more work done by the lungs - Respiratory frequency: increased frequency = more work done by the lungs - Lung compliance: increased compliance = less work done by the lungs - Airways resistance: increased resistance = more work done by the lungs

Answer 12

change in pressure/airways resistance change in pressure = Palv - Patm airways resistance is proportional to length/radius^4

Answer 13

the longer the airway, the greater the airways resistance

Answer 14

* This is a surface active agent in water, which means that it greatly reduces the surface tension of water. * It is secreted by special surfactant-secreting epithelial cells called type II alveolar epithelial cells, which constitute about 10% of the surface area of the alveoli. * Surfactant is a complex mixture of several phospholipids, proteins, and ions.

Answer 15

- sudden onset of unilateral pleuritic pain - progressively increasing breathlessness - if the pneumothorax enlarges, the patient becomes more breathless and may develop pallor and tachycardia

Answer 16

1. primary spontaneous pneumothorax 2. secondary spontaneous pneumothorax 3. traumatic pneumothorax 4. tension pneumothorax

Answer 17

primary spontaneous pneumothorax

Answer 18

- caused by rupture of a small subpleural emphysematous bulla or pulmonary bleb (usually apical) - thought to be due to congenital defects in the connective tissue - this is a weakness and out-pouching of the lung tissue, which can rupture - this introduces air into the pleural space, causing the lung to start collapsing - as the lung collapses, the hole formed by the ruptured bleb seals, preventing more air from entering the intrapleural cavity - tall, thin, young men (20-40 years) with no underlying disease usually affected - in patient over 40 years, the usual cause is underlying COPD - male: female ratio = 5:1 - rarely causes significant physiological disturbance - at higher risk if already had one spontaneous pneumothorax - risk factor: smoking - treatment: pleurodesis (needle aspiration and chest drain) to fuse visceral and parietal pleura by medical (bleomycin/talc) or surgical (abrasion of pleural lining)

Answer 19

- much more deadly - caused by respiratory diseases that damage lung structure: most commonly COPD and asthma, infective diseases (pneumonia), rarely inherited diseases - incidence increases with age and severity of underlying disease - usually occurs in males >55 years - ICU patients with lung disease are at a particular risk due to high presses (barotrauma) and alveolar distention (volutrauma) associated with mechanical ventilation

Answer 20

- blunt or penetrating chest trauma - gas may enter the intrapleural space either from the atmosphere through a hole in the chest wall or from alveoli through a hole in the lung - flow of air is two way - therapeutic procedures such as line insertion or thoracic surgery are common causes - traumatic pneumothorax can usually be associated with haemothorax

Answer 21

- most common during mechanical ventilation/following traumatic pneumothorax - flow of air is one way (from the lung into the pleural cavity) upon inspiration - the air from the atmosphere enters the pleural cavity (from the stab wound) down the pressure gradient - upon expiration, the air can't escape from the pleural cavity and remains trapped there because the pleural pressure doesn't increase above the atmospheric pressure - every inspiration results in a build-up of air and pressure - specific symptoms: cyanosis, severe breathlessness - treatment: needle aspiration and chest drain

Answer 22

a reduction in breath sounds on the affected side

Answer 23

note will be resonant

Answer 24

* Examination of the chest with a stethoscope reveals decreased or absent breath sounds over the affected lung. * The diagnosis is confirmed by chest x-ray. * An x-ray can illustrate the collapse of the lung as extra black space, indicating the presence of air, will be seen in the x-ray around the lung. * In tension pneumothorax, the lung shrivels up away from the affected side and the mediastinum (trachea and other components) will shift towards the unaffected side – trachea displacement. * The combination of absent breath sounds and resonant percussion is diagnostic of pneumothorax.

Answer 25

1. Inspection: - Patient looks distressed and is sweating. - Dyspnoea (SOB) may be apparent. - Cyanosis, depending on degree of respiratory inadequacy. 2. Palpation: - Palpation may show affected side moves less than normal side. (air in intrapleural space allows ribcage to expand outwards) 3. Percussion: - Affected side sounds hyperresonant (sound similar to percussion of puffed cheeks). 4. Auscultation: - Breath sounds on the affected side are diminished. - This is because less gas enters the collapsed lung during inspiration, air in intrapleural space acts as a barrier to the transmission of sounds from lungs to the chest wall. 5. Trachea displaced away from side of collapsed lung in tension pneumonia. 6. Pulse Examination • Tachycardia common, pulse rate >135 beats per minute suggests tension pneumothorax. • Pulsus paradoxicus (slow pulse on inspiration) suggests severe pneumothorax 7. Monitoring reveals hypotension and desaturation (less oxygen being carried in the blood)

Answer 26

``` A = airways B = breathing and bones C = cardiac D = diaphragm E = everything else ```

Answer 27

``` small = observe moderate = aspirate complete = aspirate / chest drain ```

Answer 28

chest drain

Answer 29

- a tension pneumothorax must be drained immediately | - a small PSP can be managed by observation using clinical assessment and chest X-ray

Answer 30

plastic tubing inserted into the intrapleural space through a small incision

Answer 31

- as pressure in intrapleural space becomes positive (during coughing/forced expiration), air passes along chest drain and out to the atmosphere through the underwater seal, pneumothorax is drained - bubbles appear in the underwater seal until the hole in the pleura has sealed - after the hole has healed, the water level will rise and fall slowly and the chest drain can be removed

Answer 32

Airway maintenance with cervical spine protection: - ensure airway is clear and patient can breathe - neck and cervical spine must be maintained in the neutral position to prevent secondary injuries to the spinal cord Breathing and ventilation: - chest examination by inspection, palpation, percussion and auscultation - life-threatening injury like tension pneumothorax must be identified ``` Circulation with Haemorrhage Control: - external bleeding must be controlled - internal bleeding must be diagnosed  Disability and Neurologic status: - neurological assessment is made  Exposure and Environment: - patient should be completely undressed, usually by cutting off the garments - privacy maintained - cover the patient with warm blankets to prevent hypothermia - intravenous fluids should be warmed and a warm environment maintained ```

Answer 33

* This begins when the primary survey is completed, resuscitation efforts are well established, and the vital signs are normalizing. * It is a head-to-toe evaluation of the trauma patient, including a complete history and physical examination, including the reassessment of all vital signs - each region of the body must be fully examined. * If at any time during the secondary survey the patient deteriorates, another primary survey is carried out as a potential life threat may be present. * The person should be removed from the hard spine board and placed on a firm mattress as soon as feasible, as the spine board can rapidly cause skin breakdown and pain while a firm mattress provides equivalent stability for potential spinal fractures.

Answer 34

cholinergic = acetylcholine

Answer 35

most of the sympathetic are adrenergic = norepinephrine | almost all parasympathetic are cholinergic = acetylcholine

Answer 36

1. Nicotinic receptors - found in the autonomic ganglia at the synapses between the preganglionic and postganglionic neurons of both the sympathetic and parasympathetic systems 2. Muscarinic receptors - found on all effector cells that are stimulated by the postganglionic cholinergic neurons of the parasympathetic nervous system.

Answer 37

1. Alpha receptors Alpha 1: - Found in the walls of blood vessels. - Upon activation, cause smooth muscle contraction. - Vasoconstriction and vasodilation are controlled by the SNS. Stimulation of SNS causes vasoconstriction - less stimulation of SNS causes vasodilation.  Alpha 2: - Inhibits adenylate cyclase – decreasing cAMP formation. - Negative feedback for the release of norepinephrine from the presynaptic neuron. - Inhibition of insulin release and induction of glucagon release in the pancreas. 2. Beta receptors - All beta receptors stimulate adenylate cyclase Beta 1: - Located mainly in the heart - Increase cardiac output Beta 2: - Found mainly in the lungs – Bronchodilation. Beta 3: - Located in fat cells - Lipolysis in adipose tissue.

Answer 38

they are both G-protein coupled receptors (intracellular messengers)

Answer 39

- norepinephrine excites mainly alpha receptors and beta receptors to a lesser extent - epinephrine excites both types of receptors equally

Answer 40

any condition, physical or emotional, that threatens homeostasis is a form of stress

Answer 41

1. the alarm phase 2. the resistance phase 3. the exhaustion phase

Answer 42

* During the alarm phase, an immediate response to the stress occurs. * This response is directed by the sympathetic nervous system. * Activation of the SNS causes increased secretion of adrenaline. * Adrenaline is the dominant hormone of the alarm phase, and its secretion accompanies a generalized sympathetic activation. In the alarm phase: 1. Energy reserves are mobilized, mainly in the form of glucose 2. The body prepares to deal with the stress-causing factor by “fight or flight” responses

Answer 43

1. Increased mental alertness. 2. Increased energy use by all cells, especially skeletal muscles. 3. Mobilization of glycogen (Hepatocytes perform glycogenolysis) and lipid reserves (adipose tissue cells perform lipolysis). 4. Changes in circulation, including increased blood flow to skeletal muscles and decreased blood flow to the skin, kidneys, and digestive organs. 5. A drastic reduction in digestion and urine production. 6. Increased sweat gland secretion. 7. Increases in blood pressure, heart rate, respiratory rate and metabolic rate. * Although the effects of adrenaline are most apparent during the alarm phase, other hormones play supporting roles. * In this phase, there is increased production of adrenaline and noradrenaline so that both the alpha and beta adrenergic receptors are activated with better efficiency. * For example, the reduction of water losses resulting from ADH production and aldosterone secretion can be very important if the stress involves a loss of blood.

Answer 44

* If a stress lasts longer than a few hours, the individual enters the resistance phase of the stress response. * Glucocorticoids (cortisol) are the dominant hormones of the resistance phase. * Growth Hormone, ADH and glucagon are also involved. * Energy demands in the resistance phase remain higher than normal. * Neural tissue has a high demand for energy, and neurons must have a reliable supply of glucose. If blood glucose concentrations fall too far, neural function deteriorates. * Glycogen reserves are adequate to maintain normal glucose concentrations during the alarm phase, but are nearly exhausted after several hours. Therefore, alternate energy sources are sought for in the resistance phase. 1. Mobilization of remaining lipid and protein reserves: - The hypothalamus produces GHRH, stimulating the release of GH and glucocorticoids. o Adipose tissue responds to GH and glucocorticoids by releasing stored fatty acids. o Skeletal muscles respond to glucocorticoids by breaking down proteins and releasing amino acids into the bloodstream. 2. Conservation of glucose for neural tissues: - Glucocorticoids (cortisol) and GH stimulate lipid metabolism in peripheral tissues. o Peripheral tissue (except neural) breaks down lipids to obtain energy. - Neural tissues do not alter their metabolic activities, however, and they continue to use glucose as an energy source. 3. Elevation and stabilization of blood glucose concentrations: - As blood glucose levels decline, glucagon and glucocorticoids (cortisol) stimulate the liver to manufacture glucose from other carbohydrates (glycerol) and from amino acids provided by skeletal muscles. 4. Conservation of salts and water, and the loss of K+and H+: - Blood volume is conserved through the actions of ADH and aldosterone. - As Na+ is conserved, K+ and H+ are lost.

Answer 45

- If starvation is the primary stress, the resistance phase ends when lipid reserves are exhausted and structural proteins become the primary energy source. - If another factor is the cause, the resistance phase ends due to complications brought about by hormonal side effects.

Answer 46

• When the resistance phase ends, homeostatic regulation breaks down and the exhaustion phase begins. • Unless corrective actions are taken almost immediately, the failure of one or more organ systems will prove fatal. • Mineral imbalances contribute to the existing problems with major systems.  - The production of aldosterone throughout the resistance phase results in a conservation of Na+ at the expense of K+.  - As the body’s K+ content declines, a variety of cells—notably neurons and muscle fibers—begin to malfunction.  - Although a single cause (such as heart failure) may be listed as the cause of death, the underlying problem is the inability to sustain the endocrine and metabolic adjustments of the resistance phase.

Answer 47

when the perceived demands of a situation are appraised as exceeding a person's perceived resources and ability to cope

Answer 48

* Males tend to respond to stress with increased levels of cortisol relating to ah higher chance of the fight-or-flight behavior in males. In females, they discovered that instead of increased cortisol levels, an increase in the activity of the limbic system was initiated. * Females’ increased limbic activity gave proof to the tend-and-befriend theory for female coping strategies and says that females are more likely to alleviate stressful situations by nurturing and running to acceptable social groups

Answer 49

Allostatic load is "the wear and tear on the body" that accumulates as an individual is exposed to repeated or chronic stress. It represents the physiological consequences of chronic exposure to fluctuating or heightened neural or neuroendocrine response that results from repeated or chronic stress.

Answer 50

The body’s physiological systems constantly fluctuate as the individual responds and recovers from stress – a state of allostasis – and that, as time progresses, recovery is less and less complete and the body is left increasingly depleted.

Answer 51

• Lazarus argued that stress involved a transaction between the individual and their external world, and that a stress response was elicited if the individual appraised a potentially stressful event as actually being stressful. • Lazarus’s “model of stress”:  Described individuals as psychological beings who appraised the outside world, not simply passively responding to it.  Lazarus defined two forms of appraisal: primary and secondary. 1. Primary appraisal:  The individual initially appraises the event itself.  There are four possible ways that the event can be appraised: 1) Irrelevant 2) Benign (gentle) and Positive 3) Harmful and a Threat 4) Harmful and a Challenge 2. Secondary appraisal:  The individual evaluating the pros and cons of their different coping strategies. • Therefore primary appraisal involves an appraisal of the outside world and secondary appraisal involves an appraisal of the individual themselves. • The form of the primary and secondary appraisals determines whether the individual shows a stress response or not. • This stress response can take different forms:  Direct action  Seeking information  Doing nothing  Developing a means of coping with the stress in terms of relaxation or defense mechanisms * Lazarus’s model of appraisal and the transaction between the individual and the environment indicated a novel way of looking at the stress response – the individual no longer passively responded to their external world, but interacted with it. * It is not an event itself that elicits stress, but the individual’s interpretation or appraisal of those events. * This appraisal can be modified by providing information or withholding information from the individual. * An event needs to be appraised as stressful before it can elicit a stress response. * It could be concluded from this that the nature of the event itself is irrelevant – it is all down to the individual’s own perception. * Multitasking seems to result in more stress than the chance to focus on fewer tasks at any one time. Therefore a single stressor which adds to a background of other stressors will be apprised as more stressful than when the same stressor occurs in isolation. * If a stressor can be predicted and controlled then it is usually appraised as less stressful than a more random uncontrollable event. * A feeling of being in control reduces the stress of an event and contributes to the process of primary appraisal.

Answer 52

``` • Acute:  Increased sympathetic activation  Increased cognitive performance  Increased muscular priming  Increased immune functioning • Chronic:  Decreased immune functioning  Decreased cognitive performance  This eventually leads to exhaustion. ```

Answer 53

- an anaesthetic (blocks sensation) with minor analgesic (pain killer) properties - class Ib drug - It has a fast onset. - It counters kinetics – it has little or no effect at slower heart rates, and more effects at faster heart rates - Shorten the action potential duration. - Decrease refractoriness.

Answer 54

- block voltage-sensitive (voltage-gated) sodium channels; this blockage causes a loss of sensation and eliminates the responsiveness of these cells to pain. - bind to the sodium channels most strongly when they are in either the open or the refractory/inactive state, less strongly to channels in the resting state. - their action therefore shows the property of 'use dependence' (i.e. the more frequently the channels are activated, the greater the degree of block produced).

Answer 55

- Ia: lengthen the action potential (bind to sodium channel in the open or inactive/refractory states (open state binding > refractory/inactive state binding)) - Ib: shorten the action potential (bind to sodium channel in the open or inactive/refractory states (refractory/inactive state binding >> open state binding)) - Ic: no significant effect on the action potential (bind to sodium channel in the open state)

Answer 56

* Given by intravenous infusion to treat and prevent ventricular dysrhythmias in the immediate aftermath of a myocardial infarction. * Also used as a local anaesthetic (analgesic) for minor surgery. * Widely used for local anaesthesia (analgesic) (for needle aspirations/ chest drains).

Answer 57

Side-effects – drowsiness, disorientation, convulsions, bradycardia, decreased cardiac output, vasodilation.

Answer 58

- Feeling numb to the world with a lack of interest in former activities and a sense of estrangement from others - Reliving the trauma repeatedly - Sleep disturbances - Difficulty concentrating - Over alertness

Answer 59

- Duration of symptoms = ≥1 month. - Clinically significant distress or impairment in functioning. - Acute = symptoms of 1 to 3 months. - Chronic = symptoms duration of 3 months or more. - Delayed onset = onset of symptoms at least 6 months after stressor

Answer 60

to undergo some sustained emotional processing of the traumatic experiences

Answer 61

exposure (relearning response): - acclimatisation of anxiety through exposure to trauma related stimuli anxiety management: - learning how to cope cognitive therapy: - modification of thinking styles * CBT is a structured therapy that focuses on clearly identified and achievable treatment goals. * CBT for PTSD is designed to desensitise the person to the traumatic event. * CBT techniques are used to reprocess the feared event and improve their strategies to decrease the sense of threat. * The aim of CBT is to modify unhelpful and maladaptive beliefs and to generate more flexible, rational and adaptive beliefs. * CBT emphasizes that the way we think about situations (ourselves, others, our world, future) influences our mood and behaviours.

Answer 62

changing maladaptive behavioural responses (behaviours that inhibit a person's ability to adjust to particular situations) and substituting them with new responses

Answer 63

- Cochrane Review are systematic reviews of primary research in human health care and health policy, and are internationally recognised as the highest standard in evidence-based health care - They investigate the effects of interventions for prevention, treatment and rehabilitation – they also asses the accuracy of a diagnostic test for a given condition in a specific patient group and setting Method: - Each systematic review addresses a clearly formulated question - All the existing primary research on a topic that meets certain criteria is searched for and collated - Its then assessed using stringent guidelines, to establish whether or not there is conclusive evidence about a specific treatment - The reviews are updated regularly, ensuring that treatment decisions can be based on the most up-to-date and reliable evidence

Answer 64

compliance = pressure x change in volume

Answer 65

- reduced surfactant | - pulmonary fibrosis

Answer 66

out of the 0.5L that you take in of air, only 0.35ml is getting into the alveolar space for gas exchange (0.15L is dead space)

Answer 67

pulmonary ventilation = tidal volume x respiratory rate

Answer 68

Trachea – ciliated epithelium Primary bronchus – basal cells (stem cells) Secondary bronchus – basal cells Tertiary bronchus – basal cells Smaller bronchi Bronchioles Terminal bronchioles ``` Respiratory bronchioles Alveolar sacs (150 million) – alveolar type I & II ```

Answer 69

- ciliated epithelium - basal cell - goblet cell - club cell - serous cell - brush cell - alveolar type I - alveolar type II

Answer 70

Ciliated epithelium – protective barrier, mucociliary clearance Basal cell – renew damaged cells Goblet cell – mucus secretion Club cell – production of surfactant (lubricant) Serous cell – antibacterial secretions Brush cell – unknown – at bifurcations Alveolar type I – gas exchange Alveolar type II (much thinner than club cells) – production of surfactant

Answer 71

Higher in airways – lubricant so airways don’t stick together Lower in airways – reduces surface tension at the air-liquid interface – holds airspace open, because no cartilage there to do this

Answer 72

- Airway lumen - Ciliated epithelial cell - Basement membrane - Blood vessels - Mucous glands which channel into lumen - Bronchial smooth muscle – innervated - Cartilage

Answer 73

- Protection by secretion and movement of mucus by cilia towards the pharynx – mucociliary clearance (these epithelial cells don’t have receptors for pathogens to bind to, or the cilia gets in the way) - Physical barrier to pathogens – junctional components between cells (tight, adherens, desmosomes – keep epithelial cells together) - Production of regulatory and inflammatory mediators: - chemokines (e.g. IL-8 and IL-6) – attract inflammatory cells - cytokines (e.g. GM-CSF and TGF-B) – cell signalling - proteases (e.g. plasminogen activators, MMPs) – migration, degradation of ECM (extracellular matrix), growth factor activation

Answer 74

- Reduced cartilage, more smooth muscle (to control opening of airways) - Fewer goblet cells and submucosal glands - Increase in club cells producing surfactant

Answer 75

- Single layer of ciliated epithelium - No cartilage - Reduced smooth muscle - No goblet cells or submucosal glands - More club cells producing surfactant

Answer 76

- Alveoli – passive gas exchange with capillary network – 150 million - Collagen, elastic fibres and fibroblasts and macrophages present (not many in health) in septal junctions – matrix surrounding them – keeps alveoli in place (and tiny bit of small muscle to regulate airway tone) - Several alveoli grouped into lobules surrounded by connective tissue - In each alveolus you have one macrophage

Answer 77

Alpha -> constricts blood vessels – affect gas exchange Beta2 agonists -> relaxes smooth muscle (increase airflow – more oxygen – heart can pump more (don’t get confused with relaxing blood vessels)

Answer 78

- Mast cell histamine – constriction - Arachidonic acid metabolites – constrict and dilate (e.g. prostaglandins, leukotrienes) - Cytokines – constrict and dilate, increase mucus - Hormones (e.g. adrenaline)

Answer 79

- Mucus hypersecretion - Denuded (stripped) epithelium - Goblet cell hyperplasia - Reticular thickening - Appearance of myofibroblasts - Smooth muscle cell hypertrophy - Angiogenesis - Plasma extravasation (escaping of blood into tissues)

Answer 80

chronic stress is maladaptive (stress does not respond to the environment – stress will stay with you even if you change environment)

Answer 81

Chronic work stress – changes in physiology (increase blood pressure, increase heart rate) and behaviour which over time lead to damage to the cardiovascular system Chronic stress -> atherosclerosis -> heart attack Acute stress can go straight to atherosclerosis or heart attack

Answer 82

What if flight or fight response is prolonged? - Alarm - recognising a stressor - Resistance - cope with or adapt to the stressor - Exhaustion - depletion of resources if stressor cannot be overcome - symptoms reappear - Physiological responses to stress – adaptive in the short term - However, prolonged activation of stress response systems damaging - depletion of resources and ill health

Answer 83

``` Emotional response to health threat - Fear - Anxiety - Depression Representation of health threat (illness beliefs) - Identity - Cause - Consequences - Timeline – e.g. short-term = alleviates stress - Cure/control ```

Answer 84

1. Sympathetic activation - Triggers responses in the sympathetic nervous system - Results in production of adrenaline and noradrenaline which cause changes in blood pressure, heart rate, sweating and pupil dilation - Similar to fight or flight - Have an effect on a range of body tissues and can lead to changes in immune function 2. Hypothalamic-pituitary-adrenal axis (HPA) - Results in increased levels of corticosteroids (cortisol) - Physiological changes such as the management of carbohydrate stores and inflammation - Background effect of stress, and cannot be detected by the individual - Similar to alarm, resistance, exhaustion approach as part of General Adaptation Syndrome - Raised levels of brain opioids beta endorphin and enkephalin following stress – lead to immune related problems

Case 1 Flashcards

(108 cards)