pathophysiology of stress

Question 1

what are themajor physical manifestation of stress?

Answer 1

• tachycardia/hypertenstion
• acuter hypoinsulinemaia= hyperglycaemia
• splenic contraction- r;eease of RBC
• decrease GI axctivity
• sweating
• pupillary dilation

Question 2

describe the physiological Method of action of acute stress- SNS?

Answer 2

• perceptions via the sense or psycholopgical trhreat
• Amygdala interpets the infromation
• communicates to hypothalamus- stimulating the SNS
  
  • Release of Nadr (repceotrs in adrneegric tissue)
  • receptors in sweat gland Ach- muscarinic
• eye, lung, heart GI, glucose rgulation
  
  • dilation, increase ccardiac contractility, vasconstrictionb
• srimualtion of the adrenal medulla- secret cortisol

Question 3

describe how acute stress causes activation of the adrenal medulla and the effects

Answer 3

preganglionic neuorne synapse directly onto meduall

will release - adrrenal (80% and Nadr (20%

cardiovcascular effects

• B1 recepotrs- heart contracitllity
• A1 receptors- vasoncontrticion
• hypertension

increas glucos levles (hyperglycaemia

liver- glycogenesis and gluconeogenesis-

pancrease B cells- inhbiiton of insulin ecretion

adipose tisuse- inhbit gluocs uptak-0 GLUT4 recepeotrs

Question 4

what would we see in blood results after stress?

Answer 4

blood sugar up

cortisol upo

Hba1c unchanged

Question 5

explain how Cortisol is released

Answer 5

• hypothalamus recievres sensory or psychlogicla stress
• hypothalamus secreesh CRH—> anterior pituriaty screats ACTH
• scitvaes cortex of the adrenal gland (zona fasciulata)
• secrete cortiols (glucocortiocid)
  
  • acts on nuclear hormone receptors

Question 6

what are cortiols effect son metabolism?

Answer 6

mobilisation of energy stores in times of stress

gluconeogensis in the liver stops glycogenesis

skelelal uslce- increase protein degration- AA for Gluconeeoengeis

adipose tisuse= lipolysis- gluconeoegenesi

Pancreas-e inhbit insulin release- hyperglycaemia

Question 7

how do gluccorticoids (cortiosl) have immunosuprression effects? (inside cells)

Answer 7

gneomioc- GR receptors promites IkBa sysntheiss which prvents p/50/.p65 (trnascirption factors-

prevent production of cytopkine-s block inflamamtory genees ( needed by immune cells to activate)

non gneomic- GR complexes directly bind to p65 subunit prevents p50/p65 nuclear trnactipion

suppres immune cell actviation (T cells and b cells)- blockjing trancritipn factors and trnacrpito of cytokines

Question 8

how do glucocorticoids like Cortisol limit the recuitment of WBC to inflammed or infected tissues?

Answer 8

suppress cytokine production

prveebitn leukocyte extrvasaion into tissues (mehcnaism unclear)

vasocontriction of smooth muscle cells ( increase in andgreneric receptos on smooht muscle and Angiotensin 2)