class 2

Question 1

Stress is

Answer 1

a process involving perception, interpretation, response and adaptation to harmful, threatening, or challenging events

Question 2

Perception of stress:

Answer 2

arises from events that cause stress
 Stressors (e.g. excessive noise, pain)
 Life events (e.g. new job, moving house, exams)

Question 3

Interpretation of stress:

Answer 3

Cognitive and affective processes that
 evaluate the stress, and the available coping mechanisms
 this is a process of appraisal

Question 4

Response to stress:

Answer 4

Biological responses and adaptations needed to cope with the stressor
 Systems: GI, CNS, musculoskeletal, cardiovascular, endocrine, respiratory, other
 Acute and chronic responses

Question 5

Adaptation to stress:

Answer 5

Behavioral and cognitive response to the stressful event
 Coping
 e.g. changes in sleep patterns, eating habits, thought processes, changing priorities, etc.
So what

Question 6

definition of stress was coined by Hans Selye, a Canadian endocrinologist

Answer 6

“the body’s non-specific response to any demand made upon it. It is not a disease but can contribute to ill health.” This definition refers to the body’s need to maintain homeostasis at all times.

Question 7

positive aspects of stress.

Answer 7

Positive stress includes the normal physiological activity needed to maintain homeostasis, and the healthy emotional stress that makes life interesting & exciting. He calls this EUSTRESS.

Question 8

negative aspects of stress.

Answer 8

Negative stress indicates the harmful effects of physical & emotional stress. An overload of stress from a situation of under or over arousal going on for too long produces first unpleasant feelings, and then physical damage and fatigue and ultimately even death. He calls this DYSTRESS.

Question 9

Selye’s distinction is a valuable one. It recognizes the

Answer 9

inevitability and desirability of having some stress in your life while guarding against its ill effects. Manageable levels of stress, for reasonable duration, mobilize your resources and get you going on tackling the tasks and problems in your life.

Question 10

 STRESSOR:

Answer 10

potential triggers to the stress response (fight or flight); can be environmental agents/events, within or outside the body eg: physical effort, heat, cold, hunger, fatigue, pain, threats to self-esteem

Question 11

 STRESS REACTIVITY:

Answer 11

the body’s physiological response to the stressor; very individual; responses may be uncontrolled or excessive, not appropriate, or necessary to the trigger

Question 12

duration of a stressor

 a brief, acute event that does not recur:

Answer 12

the body’s response is rapid & efficient eg: jumping out of the way of an oncoming car

Question 13

duration of a stressor

 a series of stressful events that occurs as a result of an initiating event:

Answer 13

repeated stressful events which increase physiological responses; response may escalate over time; eg: job loss, can’t pay rent, car is repossessed, etc

Question 14

duration of a stressor

 chronic intermittent stress:

Answer 14

requires frequent responses to a regularly occurring stressor; eg: school exams, work deadlines

Question 15

duration of a stressor

 chronic & sustained stress:

Answer 15

continued exposure to stress depletes the body’s resources, allowing illness to take hold; eg: single parent trying to balance work, children, finances, etc

Question 16

General Adaptation Syndrome (GAS)refers to

Answer 16

the 3 stages the body goes through, according to the DURATION of the stressor.

Question 17

GAS stage 1: ALARM:

Answer 17

the first exposure to a particular stressor; cortisol levels are high

Question 18

GAS stage 2: RESISTANCE/ADAPTATION:

Answer 18

if stress continues, the body tries to resist the stress & adapt to it; cortisol levels decrease as the initial alarm diminishes; the duration of this phase depends on the intensity of the stressor and the body’s ability to adapt; the ability to adapt will be decreased by lack of sleep, poor diet, working long hours

Question 19

GAS stage 3: EXHAUSTION:

Answer 19

after long exposure to the stressor, the body’s adaptive energy is exhausted; signs of acute stress (the alarm phase) reappear

Question 20

autonomic nervous system regulates the internal functions of the body and maintains homeostasis. It has 2 parts -

Answer 20

the parasympathetic system (rest and digest or feed and breed) and the sympathetic system (fight or flight).

Question 21

Stimulation of the parasympathetic system results in:

Answer 21

 reduced heart rate
 constriction of pupils
 stimulation of salivary & gastric glands
 stimulation of peristalsis in the gut
 stimulates urination by contracting bladder & relaxing urethral sphincter

Question 22

Stimulation of the sympathetic system results in:

Answer 22

 mental alertness to deal with danger
 increased cellular metabolism
 release of glucose from fat & liver for a burst of energy
 increased heart rate, increased force of heart contractions
 vasoconstriction in skin and abdomen to limit bleeding in case of injury
 increased blood pressure due to vasoconstriction (above)
 dilation of bronchioles to increase oxygen intake
 dilation of pupils to increase visual acuity
 inhibition of salivary & gastric glands (not essential if life is in danger)

Question 23

Short term sympathetic stimulation is normal & is needed to deal with daily stressors. However, if the stressor is very intense, or if the stress lasts for long periods, sympathetic stimulation can lead to other health problems:

Answer 23

 too much glucose can lead to diabetes
 high heart rate & blood pressure can lead to heart attack
 inhibited GI system leads to irritable bowel, constipation

Question 24

The human body has a remarkable system to help us function when we are “under stress”. This is called the Stress Axis, or the

Answer 24

hypothalamic-pituitary-adrenal axis, and it was first described by Hans Selye.

Question 25

The "first stop" along the stress axis and site of CRH synthesis in response to stress. This region of vertebrate brain is involved in regulation of neural and hormonal functions.

Answer 25

Hypothalamus

Question 26

a peptide synthesized and secreted by the hypothalamus in the early stages of the stress response along the stress axis.

Answer 26

CRH, Abbreviation for corticotrophin releasing hormone,

Question 27

A gland located just below the brain, adjacent to the hypothalamus. When CRH reaches the pituitary, this gland synthesizes and secretes a hormone, ACTH.

Answer 27

Pituitary Gland

Question 28

a peptide from the pituitary that carries the "stress response" message to the adrenal glands.

Answer 28

ACTH | Abbreviation for adrenocorticotrophin hormone,

Question 29

In response to ACTH, the ---------- synthesize and secrete the stress hormone, cortisol, into the blood.

Answer 29

Adrenal Glands | A pair of glands found atop the kidneys.

Question 30

The stress hormone in humans. This steroid-type hormone can influence the operation of many physiological systems.

Answer 30

Cortisol

Question 31

Stress Axis Basics - a Feedback Loop

Answer 31

1. A physiological stress or psychological trauma hits. The hypothalamus receives input from elsewhere in the brain and other organ systems. It responds by secreting CRH. 2. CRH travels to the nearby pituitary gland. The pituitary gland then secretes a hormone, ACTH, into the bloodstream. 3. ACTH reaches the adrenal glands, located on top of each kidney. In response, the adrenal glands release the "stress hormone", cortisol. 4. Cortisol acts on many systems to adjust the body physiology, helping it to cope with the stress. And, since too much cortisol causes problems, this hormone completes the loop by signaling the hypothalamus and pituitary to "turn off" the stress response.

Question 32

Glucose metabolism;

Answer 32

Cortisol promotes gluconeogenesis, a process that causes amino acids (breakdown products of protein) to be converted into glucose. At the same time, it reduces the utilization of glucose by the cells. Both these effects increase the blood glucose levels

Question 33

Protein metabolism:

Answer 33

Cortisol decreases protein stores in the cells by reducing protein synthesis within the cells and promoting protein breakdown. This causes protein depletion in most tissues. However, the liver cells are stimulated to produce more protein and this also increases the blood proteins. At the same time, the protein that is “recalled” is ultimately used for gluconeogenesis as explained above under carbohydrate metabolism

Question 34

Immune function & inflammatory response:

Answer 34

Cortisol can block the various stages of inflammation thereby stopping the inflammatory process or even preventing it from starting up. Therefore, it is a natural anti-inflammatory in the body. Cortisol also reduces the concentration of certain white blood cells like eosinophils and lymphocytes which may also reduce inflammation but at the same time, the immunity is partly compromised. 1. A physiological stress or psychological trauma hits. The hypothalamus receives input from elsewhere in the brain and other organ systems. It responds by secreting CRH. 2. CRH travels to the nearby pituitary gland. The pituitary gland then secretes a hormone, ACTH, into the bloodstream. 3. ACTH reaches the adrenal glands, located on top of each kidney. In response, the adrenal glands release the "stress hormone", cortisol. 4. Cortisol acts on many systems to adjust the body physiology, helping it to cope with the stress. And, since too much cortisol causes problems, this hormone completes the loop by signaling the hypothalamus and pituitary to "turn off" the stress response.

Question 35

Other important Cortisol functions:

Answer 35

 BP regulation |  Insulin release for blood sugar maintenance

Question 36

a SMALL amount of cortisol is okay...

Answer 36

 quick burst of energy for survival reasons  heightened memory function  decrease in pain sensitivity  helps maintain homeostasis

Question 37

too much cortisol is bad...

Answer 37

```  impaired cognitive function  decreased thyroid function  blood sugar imbalance - hyperglycemia  decreased bone density  decreased muscle tissue  increased BP  lowered immunity & inflammatory responses; slow wound healing, increased risk of infection  increased abdominal fat heart attack, stroke, metabolic disorder ```

Question 38

Anxiety Disorder presents as

Answer 38

a chronic generalized sense of uneasiness & fear. Often, there is no clear cause for the emotions. People with anxiety disorder often have chronic fatigue & headaches. Phobic behavior may also be present, such as fear of heights, flying, or creatures

Question 39

Panic Attacks are much more

Answer 39

abrupt & intense. Along with severe anxiety, there is a feeling of impending disaster or death. Other symptoms may include heart palpitations, shortness of breath, hot flashes, GI disturbances, insomnia. Those who suffer from panic attacks seem to be more sensitive to lactic acid imbalances. When there is too much lactic acid, the body triggers hyperventilation, to remove the excess CO2 from the blood stream. This hyperventilation can trigger a panic attack

Question 40

Hyperventilation, or over-breathing, is a widespread disorder closely connected to panic attacks and phobic behavior. It is commonly found in those undergoing stress related to marriage, work, or finances. It results in

Answer 40

a rapid reduction of blood carbon dioxide, which causes:  Increased blood alkalinity (homeostasis)  Increased nociceptor activity (hypersensitivity)  Anxiety

Question 41

Most cases of hyperventilation exist due to a learned pattern of breathing in response to a real or assumed stressful situation. If this response occurs inappropriately (when even small, daily stressors trigger it) it can lead to

Answer 41

imbalanced blood gas levels, changes in blood alkalinity/acidity, and a host of other symptoms:  Erratic heartbeats and/or chest pain  Breathless “attacks” at rest for no reason  Frequent sighing and/or yawning (average is once every 5-10 minutes)  Irritable coughing and chest tightness  Dizziness and “spaced out” feelings  “pins and needles” or numbness in lips, fingertips and toes  Gut disturbances – indigestion, nausea, wind or irritable bowel  Muscles aches, pains, or tremors  Tiredness, weakness, disturbed sleep, and nightmares  Phobias  Clammy hands, flushed face, feelings of high anxiety  Sexual problems

Question 42

Normal, easy breathing:

Answer 42

 12 regular breaths/minute (10-14 acceptable)  70-80% of the work of respiration is done by the diaphragm  Accessory muscles of respiration are used during or shortly after extreme effort or stress  Inspiration: 2-3 seconds  Expiration: 3-4 seconds  Little or no upper chest movement  Nose breathing

Question 43

chronic hyperventilators:

Answer 43

```  18 or more breaths per minute  work is being done by accessory muscle of respiration  very little work done by the diaphragm  inspiration is longer than expiration  mouth breathing ```

Question 44

Physiological changes related to Hyperventilation | Short term changes:

Answer 44

```  Adrenalin pours into the bloodstream  Heart and breathing rates speed up  Muscles become tense  Eyesight and hearing sharpen  The pain threshold drops and pain is less intense ```

Question 45

Physiological changes related to Hyperventilation | Chronic changes:

Answer 45

 More carbon dioxide is breathed out; carbon dioxide levels in the blood start to drop  Normal pH becomes more alkaline = respiratory alkalosis  Smooth muscle cells are galvanized into action by lowered carbon dioxide levels, which leads to tightening or constriction of the blood vessels  The heart and pulses start pounding; the hyperventilator may feel panic stricken, with palpitations and chest pain  The brain may have its oxygen supply cut by as much as 50%  Habitual mouth breathers develop irritable upper airways, with the risk of repeated throat infections  A very common sign of hyperventilation is repeated throat clearing – the AAHHRRRRMMMMM bug  Triggers increased histamine levels in the blood – sweaty palms and armpits, clammy skin, flushed face are all signs of this  People with allergies such as hayfever, skin rashes, food intolerances, or asthma find their symptoms much worse  Response to pain is amplified – stiffness in muscles and joints feels rheumatoid-type pain  Heart disease-type symptoms, like tight chest pain or pounding pulses  Mental fuzziness, headaches, or loss of concentration can erode self-confidence, especially if work suffers  Making love can be a nightmare – for both partners – if the “heavy breathing” that precedes orgasm leads to a panic attack  Vivid dreams, nightmares, and disturbed sleep patterns commonly accompany hyperventilation – creates distress 24/7

Question 46

Treating Hyperventilation

Answer 46

 Becoming aware of faulty breathing problems  Learning to nose-diaphragm breathe  Suppressing upper-chest movement during normal breathing  Reducing breathing to a slow, even, rhythmic rate

Question 47

LUNG HO Salute

Answer 47

 Place your dominant hand on your abdomen, between the lower ribs and umbilicus  Other hand on the sternum; just below the clavicles  Take a deep breath  Notice which part of your chest moved first? Which part moved the most? Did you breathe through your nose or your mouth? If you breathed in through your nose, and your abdomen expanded first, and you felt almost no upper-chest movement, then you are a good breather. If you breathed in fast through your mouth, and your upper chest heaved first, and you felt little or no movement (or your abdomen drew INWARD), then you are a weak breather. You can change this through breath training.

Question 48

Pranayama

Answer 48

Pranayama is a traditional practice of yoga breathing. A very simple form of it has been found to be useful in retraining hyperventilators to use a more appropriate pattern of breathing, especially in stressful situations. It calls for an ideal ratio of inhalation to exhalation of 1:4 The focus is for the exhalation to take appreciably longer than the inhalation, and breath must be through the nose