Stress

Question 1

what are the physical stressors?

Answer 1

injury, surgery, infection, shock, pain, exposure to cold, sustained exercise

Question 2

what are the threat stressors?

Answer 2

imprisonment, torture, exams

Question 3

what does stress involve?

Answer 3

complex interactions of several body systems

Question 4

what systems are involved in stress?

Answer 4

nervous, endocrine, immune

Question 5

what do the effects of stress depend on

Answer 5

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

Question 6

what are the stages of stress?

Answer 6

alarm reaction, resistance phase, exhaustion phase

Question 7

what is the alarm reaction to stress?

Answer 7

fight, flight, fright response, physiological effects

Question 8

what is the resistance phase of stress?

Answer 8

adapting to stressor

Question 9

what is the exhaustion phase of stress?

Answer 9

sever, persistent stress, responses futile, systems fail, pathological effects

Question 10

what is the neural component of the alarm reaction?

Answer 10

sympathetic nervous system

Question 11

what is the hormonal component of the alarm reaction?

Answer 11

adrenal glands: adrenaline (adrenal medulla), corticosteroids (adrenal cortex)

Question 12

what is the neural component of the alarm reaction responsible for?

Answer 12

increased cardiac output, redistribution of cardiac output, metabolism, stimulation of adrenaline release

Question 13

how does the sympathetic nervous system increase cardiac output?

Answer 13

increase heart rate and increased ventricular contractility

Question 14

how does the sympathetic nervous system redistribute cardiac ouput?

Answer 14

increased flow to muscle, decreased flow to gut and kidney

Question 15

what is the metabolic role of the sympathetic nervous system in the alarm reaction

Answer 15

glycogen breakdown -> glucose release, mobilisation of fat stores (release of free fatty acids)

Question 16

where is adrenaline secreted from?

Answer 16

adrenal medulla

Question 17

what does adrenaline do?

Answer 17

release augments and prolong the action of the sympathetic nerves

Question 18

what are glucocorticoids secreted by?

Answer 18

adrenal cortex

Question 19

what is the main stress hormone

Answer 19

cortisol

Question 20

what do the actions of glucocorticoids do?

Answer 20

complement the actions of the sympathetic NS and adrenaline

Question 21

what are the main actions of cortisol?

Answer 21

metabolism, enhances the actions of adrenaline, anti-inflammatory actions, immunosuppression

Question 22

what are the metabolic actions of cortisol?

Answer 22

increased energy production from glucose, amino acids and fats, increased protein breakdown

Question 23

what is it called when cortisol enhances the actions of adrenaline?

Answer 23

a permissive effect

Question 24

what action do glucocorticoids have?

Answer 24

anti-inflammatory and immunosuppressant

Question 25

what do glucocorticoids inhibit?

Answer 25

release of prostaglandins and leukotrienes, macrophages and helper T cells

Question 26

what do the drugs taken in corticosteroid therapy do?

Answer 26

supress CRH and ACTH release making the natural stress response suppressed

Question 27

what is the control of cortisol release by hypothalamic-pituitary-adrenal axis

Answer 27

stressor - hypothalamus - CRH acts on anterior pituitary - ACTH acts on adrenal cortex - cortisol release - actions/inhibit hypothalamus and AP

Question 28

what is stress analgesia?

Answer 28

pain being diminished during physical stress

Question 29

what is stress analgesia due to?

Answer 29

release of endogenous opioid peptides, endorphins, enkephalins in the CNS

Question 30

what do endogenous opioid peptides, endorphins and enkephalins do?

Answer 30

suppress nociception and pain

Question 31

what can stress a dental patient?

Answer 31

severity of treatment, pain, phobia, local anaesthesia, noise, masks and gowns

Question 32

what is the range of change in systolic BP when stressed?

Answer 32

+5-20mmHg

Question 33

what is the range of change in diastolic BP when stressed?

Answer 33

+4-8mmHg

Question 34

what is the range of change in heart rate when stressed?

Answer 34

up to +20

Question 35

when are the effects of stress greater in dentists?

Answer 35

when standing, with complex/difficult procedures, with anxious patients, when supervising a students first extraction

Question 36

when does the adaption phase happen?

Answer 36

when the individual has adapted, the stressor is no longer a threat, the individual has become resistant to the stressor, when the individuals responses are effective in removing the stressor

Question 37

what is the effects if the individual fails to adapt to stress?

Answer 37

adrenal failure, immunosuppression, peptic ulcers, CVS disease

Question 38

what are type A individuals?

Answer 38

hard-driving, competitive individuals who are more prone to high blood pressure and CHD

Question 39

what are type B individuals?

Answer 39

more relaxed and less impatient