Putting It All Together Lab Flashcards
Main physiological components of the stress sytem response
Activation of hypothalamic-pituitary-adrenal (HPA) axis
ANS arousal
Adrenalin secretion
Seyle first described interdependent process of responding to stress as the _____ _____ syndrome, a response following certain patterns and affecting specific organs
General adaptation
When patients are continually stressed, they move through 3 response stages - what are they?
- Startle response and orienting reflex as pt becomes aware of stress and is biologically alarmed. Adrenal, CV, resp, and MSK functions increase
- Attempt to cope and problem-solve biologically, psychologically, and socially. If pt fails, they become exhausted physically, mentally, emotionally
- Exhaustion — what osteopathic doc sees clinically as variety of dysfunctional signs/symptoms affecting any/all organ systems
A significant portion of the variance in an individual response to any disease outcome is accounted for by …..
the manner of behavior and emotional response to the stress of the illness
Medical research has shown that a life lived in a state of chronic stress can trigger and activate psychophysiologic disorders such as ….
HTN, peptic ulcer disease, and coronary artery disease
Although a number of stress scales are now available, the ________ remains one of the most highly validated and widely used
Holmes & Rahe Social Readjustment Scale
What life event is associated with the most Holmes Points (100) on the Social Readjustment Scale?
Death of a spouse
What are some life events included on the higher end of the Social Readjustment Scale?
Death of a spouse Divorce Marital separation Jail term Death of family member Personal injury of illness Marriage Fired from job Marital reconciliation Retirement Pregnancy Many others
The adaptive style of what personality type is considered a feature of coronary artery disease?
Type A personality — competitiveness, impatience, difficulty dealing with anger and hostility
Why is compliance with physician advice regarding stressors considered to be low in the current climate of health care delivery?
In the current climate, delivery of care is hectic and often impersonal. As patients shift between doctors and insurance plans, the personal relationships disappear. It is difficult to establish trusting relationships with providers in these circumstances
In patients presenting for assistance with stress-related symptoms, after a detailed history is taken and complete physical exam is done, the treatment strategy incorporates all elements of the osteopathic philosophy — including: ……..
Palpatory diagnosis Manipulative treatment Exercise, diet, smoking, alcohol, drug cessation Appropriate medication Coping strategy education
The primary care physician must always be aware that clinically evident stress reflects what 2 entities?
- A pt’s response to stress-induced events produces biopsychosocial consequences
- A pt’s long-term stress management style is an important factor determining health or disease and an area in which the doctor must intervene for long-term adaptive change
Physicians are able to intervene to help patients cope with stress-related conditions. Success increases with patient education, guided mentorship of their adaptation, and teaching coping and stress-mastery skills. In a primary care practice, diagnosis begins by accurately reviewing 4 of the most common behavioral consequences of stress — what are they?
- Depression
- Anxiety
- Substance abuse
- Insomnia
T/F: In pts with prolonged depression, anxiety, or fear, those parts of the body that are used to express these emotions tend to have increased tone, altered biomechanics, and lack efficient postural mechanics
True
Conversely, in the face of altered connective tissues of the parts of the body involved with the expression of a particular emotion, there is often inability of the pt to adequately express or communicate that emotion
There is ample evidence supporting the benefits of Cognitive Behavioral Therapy (CBT) for relief of both the stress of chronic pain and depression. How does this therapy work?
CBT assumes that a pt’s misconceptions and attitudes about the world and themselves precede and produce sx such as anxiety and depression. Therapy identifies habitual ways in which pts distort information and teaches pts to identify, evaluate, and respond to their dysfunctional thoughts and beliefs, using a variety of techniques to change thinking, mood, and behavior
Overall, a structured, goal-oriented, problem-focused, and time-limited intervention
