Lecture 1.5- E1 Flashcards
Stress and Physical Adaptation
What is Stress?
It is the body’s reaction to harmful forces (Stressors) that are capable of disturbing our homeostasis.
- body’s way of responding to a challenge
characteristics of stress
Real or perceived
Short or long-term
Isolated or recurrent
what is routine stress
everyday issues like work, school, etc.
what is episodic acute stress
Transient, out-of-the-ordinary events such as loss of job, death in the family, major illnesses, etc.
what is traumatic stress
Life threatening events such as war, famine, assault, major accidents, etc.
Anxiety
The vague, uneasy feeling of discomfort or dread, which is often accompanied by an autonomic response (fight or flight)
Stressors
Any physical, physiological, or psychological force that is capable of disturbing our homeostasis equilibrium.
physical could be increase HR, nausea
Homeostasis
A state of dynamic equilibrium of the internal body. It is maintained by the ever-changing processes of feedback and regulation in response to external or internal stimuli.
if we are cold our body will increase HR to warm up
Adaptation
Response of an organism to stress to restore homeostasis and equilibrium.
- putting a jacket on when cold
What about an individual can affect their response to stress?
Age, General Health, Social Support, Genetic Influences (history mental illness in family) , and Nurture Influences (family doesnt handle stress well)
important to remember
your patient may be doing well and appear healthy on paper but are they really doing great? do they have support they need, are they eating healthy and enough, etc
fear vs anxiety
fear is the stress response from immediate danger
anxiety is the stress response just from your thoughts
Stressor characteristics
The Type of Stressor: routine, episodic, traumatic
Persistence of Stressor: chronic or short (PA school- 15 months of hard then done)
Perception of Stressor: How we perceive the stressor ( if you have good insurance you may not be scared if your house burns down, contrary is no insurance and you lost everything, etc)
Origin of Stressor: Endogenous (internal) or Exogenous (external)
example of endogenous and exogenous stressor
endogenous- dehydration from disease, anxiety about falling in a cheer competition
exogenous- mental stress from work (work is the stressor), recent death of spouse
what reactions can a stressor produce in a person?
similar responses in different people, different responses in similar people, similar or different responses in the same person at different times
factors that can vary stress
- properties of the stressor (severity or duration)
- time of life, prof Jensen lost her job a month ago would’ve been stressed bc husband in school vs now husband has income and insurance too
- conditioning of patient being stressed
How does stress affect the two ANS pathways?
Activates sympathetic, deactivates parasympathetic
what is eustress
mild, brief, controllable periods of stress that can be perceived as positive stimuli to emotional and intellectual growth and development
- may not feel good going through but will help in the end
what is distress
severe, protracted, and or uncontrollable situations of psychological and physical distress that are !!disruptive to health!!
fight or flight response
-meant to protect the person against acute threats
- normally time limited
- useful especially in immediate physical threat
- not so useful to stressors like work, exams
- activates sympathetic nervous system
Neurological Brainstem Response to Stress
Brainstem: Coordinates our body’s response
Autonomic nervous system response to sress
Coordinated by locus caeruleus (LC)
Increased sympathetic: BP, HR, RR, pupil dilation, sweating, skeletal muscle, heart, and lung blood flow
Decreased parasympatethic : gastric function, peripheral blood flow and other viscera.
cerebral cortex response in stress
Regulates cognitive activities like focus, planning, attention, and persistence.
limbic system response to stress
-Regulates emotional activities and the reticular activating system (RAS).
-Limbic includes fear, anxiety, anger, and excitement.
- RAS includes alertness, muscle tension, and ANS stimulation.
thalamus response to stress
Regulates and intensifies sensory input, such as our vision, hearing, or smell.
hypothalamus response to stress
Regulates stress hormones and acts on the ANS.
Endocrine Response to Stress
Release of 4 hormones: Cortisol, Dopamine, Epinephrine, and Norepinephrine.
What is the pathway and effect of cortisol?
Corticotropin releasing hormone (CRH in the hypothalamus) -> adrenocorticotropic releasing hormone (ACTH in the pituitary) -> cortisol (adrenal glands)
-Alters metabolism and increases blood glucose levels.
-Decreases inflammatory response.
What are the 3 catecholamines and what do they do?
-Dopamine, Norepinephrine, and Epinephrine.
-Increased blood flow to heart, lungs, brain, and skeletal muscles.
-Decreased blood flow to nonvital organs such as skin and stomach.
What happens to our other hormones during stress? growth, thyroid, repro, oxytocin
Growth Hormone: suppressed in chronic stress.
Thyroid hormones: Decreased TSH and inhibited conversion of T4 to T3.
Reproductive Hormones: Anovulation and amenorrhea in females. Decreased spermatogenesis and testosterone in males.
Oxytocin: Released in stressful periods -> encourages social contact.
What happens to our immune system due to stress?
Cortisol - steroidal effects, anti inflammatory- hindering bpdy’s natural response to immune and inflammatory insults
It inhibits the replication of T-cells and causes negative feedback to IL-1.
Prolonged stress can cause an increase in cytokines and cause illness-like symptoms.( fatigue, poor appetite)
prolonged stress leads to increased inflammatory mediators , increased susceptibility to infections
3 Stages of General Adaptation Syndrome
Alarm Stage
Resistance Stage
Exhaustion Stage
Alarm Stage
This is the fight or flight stage,
- catecholamines( dop, epi, norepi) and cortisol released
- supression GH, thyroid hormone, repro hormones
- ADH (anti diuretic) released ( fluid retention to increase BP)
Resistance Stage
This is the stage where the stressor is persisting.
Our parasympathetic system returns most of our function to normal (catecholamines and cortisol partially/totally decrease), but our hormones remain suppressed and blood glucose high. The immune system is also still suppressed.
Exhaustion Stage
This is the stage where the stressor is chronic and overwhelming.
Our tissues begin degenerating as they run out of energy and our hippocampus becomes impaired (thinking, focus, memory).
We are more susceptible to death and other diseases.
Acute Stress Physiological Effects
- less tendency to do extensive damage
*more commonly experienced
Emotional Distress
Muscular: tension headaches, back pain, jaw pain, strains and sprains
GI: heartburn, dyspepsia, flatulence, diarrhea, constipation, acid reflux/GERD, IBS
CV: HTN, tachycardia, palps, cold extremities, edema, CP
Pulm: SOB
Neuro: Migraines, dizziness, insomnia.
Chronic Stress Physiological Effects
*long term, more sever sequelae
Everything with acute PLUS
Immunologic: suppression
GI: stress ulcers
Endocrine: increased risk for DM and weight gain
Reproductive: decreased libido, infertility, irregular menses
Psych: mood disorders, substance abuse
Neuro: loss of focus and memory
when a patient is here try to get them back to homeostasis ASAP- meds, therapy, support, etc
Harmful Adaptation Patterns
Substance use
Diet: overeating
Sleep: Hyper or Hyposomnia
Behaviors: Risk-taking, self harm, over-exercising, procrastination
Relationships: redirection of negativity
what is adaptation
response of an organism to restore homeostasis and equilibrium
normal adaptations to physiologic and psychosocial environmental threats
Physiologic:
moment by moment basis by feedback mechanisms
specific to individual threat
specific response
Psychosocial:
not regulated with same specificity and intrinsic feedback mechanisms
response more likely to be inappropriate and sustained
examples of harmful adaptations
substances- smoking, drinking
diet- over/under eating
sleep - hyper hypo somnia
behavior- risk taking behaior, self har, ED
relationships- redirecting negativity onto co workers, loved one, etc
What 10 factors affect our ability to adapt?
Physiologic Reserve
Previous Experience/Learning
Time
Genetics
Age
Heath Status
Nutrition
Sleep
Hardiness
Psychosocial Factors
How can we manage stress?
Exercising regularly
Eating a good diet
Sleeping well
Taking breaks
What is CBT?
Cognitive Behavioral Therapy
Identify, question( should this be a stressor to me?), and restructure priorities (make room for stress relief).
Discuss feelings and keep perspective.
Non-pharmacological stress interventions
Relaxation Techniques, Spiritual Support, Acupuncture, and Hypnosis
What relaxation techniques are there?
Deep breathing exercises
Muscle relaxation
Meditation/Mindfulness
Biofeedback
Massage Therapy
