stress

Question 1

what are the three definitions of stress?

Answer 1

• To emphasise certain words in speech
• A force applied to a body causing deformation or strain
• Emotional or mental pressure

Question 2

what are the two categories within stressors?

Answer 2

• physical
• threats

Question 3

what are examples of physical stressors?

Answer 3

• injury/surgery
• infection/shock
• pain
• exposure to cold
• sustained exercise

Question 4

what are examples of threat stressors?

Answer 4

• imprisonment/torture
• exams

Question 5

which body systems are involved in stress?

Answer 5

• nervous
• endocrine
• immune

Question 6

what does the effect of stress depend on?

Answer 6

• duration and severity of the stressor
• effectiveness of any responses

Question 7

what are the stages in stress?

Answer 7

• alarm reaction
• resistance phase
• exhaustion phase

Question 8

what is involved in the alarm reaction stage of stress?

Answer 8

• acute stress response
• fight flight or fright response
• physiological effects

Question 9

what is involved in the resistance phase of stress?

Answer 9

• adapting to the stressor

Question 10

what is involved in the exhaustion phase of stress?

Answer 10

• severe persistent stress
• responses futile, systems fail
• pathological effects

Question 11

what are the sequence of the stages in stress called?

Answer 11

general adaptation syndrome

Question 12

is stress bad?

Answer 12

• a little stress can be good

Question 13

what are the components in the alarm reaction?

Answer 13

• sympathetic ns
• adrenal glands
  adrenaline (adrenal medulla)
  corticosteroids (adrenal cortex)

Question 14

describe the neural component (SNS) in the alarm reaction

Answer 14

• increased cardiac output
• redistribution of cardiac output (increased flow to muscle, decreased flow to gut/kidney)
• glycogen broken down to glucose
• mobilisation of fat stores
• stimulation of adrenaline release

Question 15

when would there be an exhaustion stage?

Answer 15

persistent stress

Question 16

what is the action of adrenaline in the alarm reaction?

Answer 16

• secreted by adrenal medulla
• releases augments and prolongs action of sympathetic nerves
• increases cardiac output
• redistribution of cardiac output
• metabolic effects

Question 17

what is the action of glucocorticoids in the alarm reaction?

Answer 17

• secreted by adrenal cortex
• (steroid eg cortisol)
• actions complement those of sympathetic ns and adrenaline

Question 18

what is the main stress hormone?

Answer 18

cortisol

Question 19

where is glucocorticoids released from?

Answer 19

adrenal cortex

Question 20

where is adrenaline released from?

Answer 20

adrenal medulla

Question 21

what are the actions of cortisol?

Answer 21

• metabolic
  increased energy production from glucose, aa and fats
  increased protein breakdown
• enhances adrenaline action
• anti-inflammatory
• immunosupression

Question 22

describe glucocorticoid action on immune response

Answer 22

• Glucocorticoids have anti-inflammatory and immunosuppressant actions
• They can inhibit release of prostaglandins and leukotrienes
• They inhibit macrophages and helper T lymphocytes
• Many patients receive corticosteroid drug therapy
• Increased incidence of illness at times of stress

Question 23

what is an example of a condition which can be treated with corticosteroids as anti-inflammatory drugs?

Answer 23

arthritis

Question 24

what is the effect of the long term use of corticosteroids?

Answer 24

• disrupt normal control mechanisms
• suppresses corticotrophin releasing hormone and adrenocorticotrophic hormone release, so natural stress response is supressed

Question 25

what controls the release of cortisol?

Answer 25

hypothalamic-pituitary- adrenal axis

Question 26

what is stress analgesia?

Answer 26

pain is diminished during physical stress due to the release of endogenous opioid peptides, endorphins, enkephalins in CNS which suppress nociception and pain

Question 27

stress for patients in dentistry

Answer 27

• Stress evident in anticipation of treatment
• Oral Surgery > scaling
• Effects greater in anxious patients and even greater in ‘dental phobics’
• Pain increases the amount of stress
• Local anaesthesia is stressful
• Noise of dental instruments (e.g. drills) can contribute to the stress
• Masks and gowns add to the stress
• Individuals vary in their responses to a stimulus or circumstances
• The anticipatory response differs in men and women
• Women have higher HR responses, but this varies with the type of treatment
• There are no significant differences in BP responses in men and women
• Stress responses tend to be greater in children than in adults

Question 28

stress in dentists

Answer 28

• Oral surgery: tooth extraction:
  Increased HR, BP
• Effects are greater:
  When standing
  With complex/difficult procedures
  With anxious patients
  When supervising a student’s first extraction

Question 29

what are the two possible outcomes of persistent stress?

Answer 29

• adaptation phase (cope)
• exhaustion phase (don’t cope)

Question 30

what happens in the adaptation phase?

Answer 30

• an individual’s stress response diminishes with persistent exposure to stressor
• The individual has ‘adapted’
• The stressor is no longer a ‘threat’
• The individual has become ‘resistant’ to the stressors
• This generally happens if the individual’s responses are effective in removing the stressor (or its perceived threat)

Question 31

what happens to individuals who fail to adapt to the stressors?

Answer 31

• exhaustion phase
• leads to
  adrenal failure
  immunosupression
  peptic ulcers
  CVS disease
• death can occur in extreme cases

Question 32

what is the difference between type A/B people?

Answer 32

type A - competetive, driven individuals prone to high bp
type B- relaxed individuals