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Stress Patho
the stress response
87
Nursing
Undergraduate 2
02/08/2011

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Term
Hans Selye
Definition
was the first to describe  a group of specific anatomic changes that occurred in rats that were exposed to different variety of experimental stimuli in the 1930s
Term
stress
Definition
a state manifested by a specific syndrome of the body developed in response to any stimuli that made an intense systemic demand on it.
Term
Seyle noticed what in patients?
Definition
that although they had diverse disease conditions, they had many signs and symptoms in common- they experience loss of appetite, muscular strength, and ambition to accomplish anything along with lose of weight and facial expression.
Term
Hypothalamic pituitary-adrenal (HPA) axis plays a role in
Definition
development of stress response
Term

General adaptation syndrome.

(GAS)

Definition

general=because the effect is a general systemic reaction

adaptive=because the response was in reaction to a stessor

Syndrome=because the physical manifestations were coordinated and dependent on eachother.

Term
there are three stages to GAS
Definition
alarm stage, resistance stage, and exhaustion stage.
Term
alarm stage
Definition
generalized stimulation of the sympathetic nervous system and the HPA axis, resulting in release of catecholamines and cortisol
Term
resistance stage
Definition
the body selects the most effective and economic channels of defense. Cortisol levels that were present during the first stage drop because they are no longer needed
Term
exhaustion stage
Definition
resources are depleted and signs of "wear and tear" systemic damage appear.many ailments are initiated by the "body itself because of its faulty adaptive reactions to potentially injurious agents.
Term
stressors
Definition
can be endogenous, arising from within the body or exogenous, arising from outside the body.
Term
2 factors determine the nature of the stress response
Definition

the properties of the stressor and the conditioning of the person being stressed.

NOT ALL STRESSORS ARE BAD

(eustress-not harmful vs. distress= harmful)

Term
when does stress become detrimental
Definition
when it is severe, protracted, and uncontrolled situations of psychological and physical distress that are disruptive of health.
Term
stressors are complicated because
Definition
they produce different responses in different persons or in the same person at different times, indicating the influence of the adaptive capacity of the person, or "conditioning factors"
Term
cognitive activation theory of stress
Definition
stress response depends on what a person expects to happen in a given situation given previous learning experiences. and that the HPA axis, adrenomedullary hormonal system, and sympathetic nervous system are differentially activated depending on type and intensity of stressor
Term
neuroendocrine system
Definition
integrates signals recieved along neurosensory pathways and from circulating mediators that are carried in the blood stream
Term
results of coordinated release of neurohormones
Definition
include mobilization of energy, a sharpened focus and awareness, increased cerebral blood flow, and glucose utilization, enhanced cardiovascular and respiratory functioning, redistribution of blood flow to the brain and muscles, modulation of the immune response, inhibition of reproductive function, and a decrease appetite
Term

stress response is meant to be a chronic response.

TRUE OR FALSE

Definition

FALSE!!!!

it is meant to be acute so that it only stays on as long as it takes to get body back to homeostasis

Term
allostasis
Definition
it is used to describe the physiologic changes in the neuroendocrine, autonomic, and immune systems that occur in response to either real or perceived challenges to homeostasis.
Term
allostatic load
Definition
used to measure the cumulative effects of stress on humans
Term
Catecholamines
Definition

source= locus ceruleus, adrenal medula

produces a decrease in insulin release and increase in glucagon release resulting in increased glycogenolysis, gluconeogenesis, lipolysis,proteolysis, and decreased glucose uptake by peripheral tissue

Term
catecholamines also...
Definition
increase heart rate, cardiac contractibility, and vascular smooth muscle contraction; and relaxation of bronchial smooth muscle.
Term
Corticotropin-releasing factor
Definition

source: hypothalamus

stimulates ACTH release from the anterior pituitary and increased activity of the locus ceruleus neurons

Term
Adrenocorticotropic hormone
Definition

source: anterior pituitary

stimulates the synthesis and release of cortisol

Term
Glucocorticoid hormones (ex. cortisol)
Definition

source: adrenal cortex

potentiates the actions of epinephrine and glucagon; inhibits the release and/or actions of the reproductive hormones and thyroid-stimulating hormone; and produces a decrease immune cells and inflammatory mediators

Term

Mineralocorticoid hormones

ex. aldosterone

Definition

source:adrenal cortex

increases sodium absorption by the kidney

Term

antidiuretic hormone

ex. vasopressin

Definition

source: hypothalamus, posterior pituitary

increases water absorption by the kidney; produces vasoconstriction of blood vessels; and stimulates the release of ACTH

Term
where do components of the stress response occur
Definition
at the level of the central nervous system
Term
what does the stress response rely on?
Definition
communication along neuronal pathways of cerebral cortex, limbic system, thalamus, hypothalamus,pituitary, and reticular activating system (RAS)
Term
The cerebral cortex is involved in...
Definition
vigilance, cognition, and focused attention, and the limbic system with the emotional components of the stress response.
Term
The thalamus functions as...
Definition
the relay center and is important in receiving, sorting out, and distributing sensory imput.
Term
the hypothalamus does?
Definition
coordinates the responses of the endocrine and autonomic systems.
Term
the RAS does...
Definition
modulates mental alertness, ANS activity, and skeletal muscle tone, using input from other neural structures. Also stimulates musculoskeletal tension that occurs during the stress response
Term
the RAS is very complex because
Definition
individual brain circuits that participate in the mediation of the stress response interact and regulate the activity of each other.
Term
Locus Ceruleus
Definition
central to the neural component of the neuroendocrine response to stress and is densely populated with neurons that produce norepinephrine and is thought to be central integrating site for the ANS response to stressful stimuli
Term
Locus Ceruleus norepinephrine
Definition
has afferent pathways to the hypothalamus, the limbic system, the hippocampus, and the cerebral cortex.
Term
Sympathetic nervous system manifestation of the stress reaction
Definition
is called fight or flight reaction
Term
what happens during fight or flight
Definition
the heart and respiratory rates increase, the hands and feet become moist, the pupils dialate, the mouth becomes dry, and the activity of the gastrointestinal system decreases
Term
CRF is located
Definition
central to the endocrine component of the neuroendocrine response to stress and is a small peptide hormone found in both the hypothalamus and the extrahypothalamic structures, such as the limbic system and brain stem
Term
CRF is important because
Definition
it is an endocrine regulator of pituitary and adrenal activity and a neurotransmitter involved in ANS activity, metabolism and behavior
Term
Receptors for the CRF
Definition
are distributed throughout the brain as well as many peripheral sites
Term
Glucocorticoid hormones can
Definition
have direct or indirect physiologic effects that mediate the stress response enhance the action of the other stress hormones, or suppress other components of the stress system
Term
Cortisol
Definition
acts not only as a mediator of the stress response but as an inhibitor, such that overactivation of the stress response does not occur. Also can do is supress osteoblast activity, hematopoiesis, protein and collagen synthesis, and immune response.
Term
Cortisol maintains blood glucose how?
Definition

by antagonizing the effects of insulin and enhances the effect of catecholamines on the cardiovascular system.

 

Term
Stimulation of the sympathetic nervous system and activate what system
Definition
the peripheral renin-angiotensin-aldosterone system which mediates a peripheral increase in vascular tone and renal retention of sodium and water.
Term
the changes of the RAAS contribute to...
Definition
physiologic changes that occur with stress response and, if prolonged, may contribute to pathologic changes.
Term
Angiotensin II, peripherally delivered or locally produced effect the CNS
Definition
receptors are widely distributed in the hypothalamus and locus ceruleus which contributes to the release of ACTH from the pituitary, enhances stress-induced release of vasopressin, and stimulates the release of norepinephrine from the locus ceruleus
Term
Systems responsible for reproduction, growth and immunity are
Definition
directly linked to the stress system
Term
prolonged presence of cortisol
Definition
leads to suppression of growth hormone, insulin-like growth factor, and others. Along with decreased levels of thyroid-stimulating hormone and inhibition of conversion of thyroxine to the more biologically active triiodothyronine in peripheral tissue.
Term
CRF inhibits
Definition
the firing of serotonergic neurons as well as most reproductive hormones at the hypophyseal level
Term
Reproductive hormones
Definition

are inhibited by cortisol at the pituitary,gonadal, and target tissue levels.

sepsis can induce anovulation and amenorrhea in women and decreased spermatogenesis and levels of testosterone in men

Term
Endocrine-immune interactions
Definition

are known to suppress the immune system

ex. increased corticosteriod production and atrophy of the thymus

Term
Endocrine-immune interaction effects
Definition
emotional and psychological manifestations of the stress response reflect alterations in the CNS resulting from the immune response
Term
Monocytes and lymphocytes
Definition
can penetrate the blood-brain barrier and take up residence in the brain, where they secrete chemical messengers called cytoines that influence the stress response
Term
What evidence supports that the immune and neuroendocrine systesm interact
Definition
they share common signal pathways that hormones and neuropeptides can alter the function of immune cells, and that the immune system and its mediators can modulate neuroendocrine function. receptors for CNS-controlled hormones have also been found on lymphocytes
Term

Cortisol is known to suppress immune system.

True or False

Definition
TRUE!!!!
Term
HPA axis is activated by
Definition
cytokines like interleukin-1, interleukin-6, and tumor necrosis factor that are released from immune cells
Term
Second possible route for neuroendocrine regulation of the immune function
Definition
is through the sympathetic nervous system and the release of catecholamines. Also lymph nodes, thymus and spleen are supplied with ANS nerve fibers. acting CRF activates ANS through multisynaptic descending pathways, and circulating epinephrine acts with CRF and cortisol to inhibit immune system
Term
Stress hormones
Definition
differentially stimulate the proliferation of subtypes of T-lymphocyte helper cells which secrete cytokines to stimulate immune response.
Term
activated B lymphocytes
Definition
are activated by a second type of stress hormone and they humoral-mediated immune response
Term
adaptability
Definition
is found throughout life and is perhaps the one attribute that distinguishes most clearly the world of life from the world of inanimate matter. WE DO NOT PASSIVELY SUBMIT TO IMPACT OF ENVIRONMENTAL FORCES
Term
our body's responses to physiologic disturbances
Definition
are controlled on a moment-by-moment basis by feedback mechanisms that limit their application and duration of action
Term

physiologic disturbances that threaten the integrity of the internal environment is specific to the threat.

TRUE OR FALSE?

Definition
TRUEEEEEE!! our body doesnt raise our body temperature when an increase in heart rate is needed.
Term

psychological disturbances are treated with the same specificity of feedback control as with physiological.

True or false?

 

Definition
FALSE. our body can not regulate what it is responding to when it is psychological so the effect may be inappropriate and sustained
Term
Coping mechanisms
Definition
the emotional and behavioral responses used to manage threats to our physiologic and psychological homeostasis.
Term
physiologic reserve
Definition
the ability of body systems to increase their function given the need to adapt
Term
anatomic reserve
Definition
many organs have on such as lungs, kidneys and adrenals. They are paired because both are not needed buy they ensure the continued existence and maintenance of the internal environment
Term
Efficient changes in adaptation
Definition
occur gradually
Term
We must have available adaptive responses
Definition
for the flexibility of our body's selection of the most appropriate and economical response to work.
Term
Genetic endowment
Definition
ensure or essential systems are able to adapt adequately
Term
Adaptability and age
Definition
it is affected by the extremes. as infants we are impaired by our bodys immaturity and as elders our physiologic reserve function decreases
Term
Adaptability and gender
Definition
our sex hormones are what set men and women apart in terms of diseases. we have differences in locale and regulation of individual genes that accout for the differences in the physiologic function and disease manifestation
Term
Gender effect the stress response
Definition

because there are different physiologica stress responses in the HPA axis and the ANS.

ex. male hypothalamus produces more CRF and ACTH than premenopausal women in response to psychological stess.

Premenopausal women have lower activation of sympathetic nervous system.

Term
Adaptability and Health status
Definition
Phsyical and mental health determine our physiologic and psychologic reserves and determine our adaptability. Severe emotional stress often producess disruption of physiologic function and limits the ability to make appropriate choices related to long-term adaptive needs.
Term
Adaptability and Nutrition
Definition
malnutrition may be one of the most common causes of immunodeficiency. Among dietary problems is excesses such as obesity and alcohol abuse.
Term
Nutrition affects
Definition
brain function and with long term use can seriously impair the function of the liver, brain and other vital structures.
Term
Adaptability and sleep
Definition

sleep is cyclic with periods of wakefulness and increased energy use. Sleep disorders lead to altered immune function decreased circadian hormone secretion, and change in physical and psychological functioning.

most common are insomnia and sleep deprivation (increased somnolence)

Term
adaptability and hardiness
Definition
personality characteristics that includes a sense of having control over the environment, a sense of having a purpose in life, and an ability to conceptualize stressors as a challenge rather than a threat
Term
adaptability and psychological factors
Definition
social support has direct and indirect possitive effects on health status and serves as a buffer or modifier of the physical and psychological effects of stress
Term
manifestations of acute stess
Definition
pounding headache, cold, moist skin, a stiff neck caused by neural pathways mediating arousal, alertness, vigilance, cognition,and focused attention as well as appropriate aggression
Term
acute stress response my be lifesaving because
Definition
they divert blood from less essential to more essential body functions. Increased alertness and cognitive functioning enable rapid processing of information and arrival at a good solution to a threatening situation.
Term
when and why can acute stress be detrimental
Definition

when: people with limited coping abilities.

It can interrupt compliance with medication regimens and exercise programs in sick adults and it can redirect attention away from proper health techniques in healthy adults.It can be life threatening if the person is physically immobilized in a time of disaster

Term
physiological function and be altered in many ways by chronic stress.
Definition
components may fail, neural and hormonal connections may become dysfunctional, and when the stimulus of stress response is too prolonged our body starts to send out inappropriate responses
Term
Chronic stress is linked to many diseases
Definition
cardiovascular, gastrointestinal, immune, and neurologic systems, along with depression, alcoholism, drug abuse, eating disorders, accidents and suicides.
Term
Psychological stress
Definition
is associated with increased risk of the common cold, and this is attributed to increased rates of infection.
Term
other effects of stess
Definition
decreased immune response and slower wound healing
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