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Pathophysiology > Stress And Adaptation > Flashcards

Stress And Adaptation Flashcards

1
Q

When does a person experience stress?

A

When a demand exceeds a persons coping abilities

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2
Q

What are 3 types of stressors?

A

Eustressors, distressesors or neutral

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3
Q

Where can stressors come from?

A

External environment or personal perception

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4
Q

What are quantity external stimuli?

A

Negative consequences due to accumulation

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5
Q

What are qualify external stimuli?

A

Major changes (large #of people), major change (few people), daily hassles

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6
Q

What are duration external stimuli?

A

Acute, sequential, chronic, intermittent

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7
Q

What are the 3 types of external stimuli?

A

Quantity, quality and duration

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8
Q

What is individual judgement?

A

Conscious appraisal, demand-resource imbalance

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9
Q

What hormones are involved in stress?

A

Glucocorticoid, mineralcorticoid and catecholamines

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10
Q

What glucocorticoid is involved in stress?

A

Cortisol

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11
Q

What mineralcorticoid is involved in stress?

A

Aldosterone

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12
Q

What catecholamines are involved in stress?

A

Epinephrine, norepinephrine and a little dopamine

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13
Q

Physiological response to stress

A

Perception, hormones and consequences

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14
Q

What are the parts of the adrenal glands?

A

Capsule, adrenal cortex and adrenal medulla

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15
Q

What is the capsule for?

A

A touch fibrous capsule enclosed in fat for protection

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16
Q

What is the adrenal medulla?

A

A knot of nervous tissue and is part of the sympathetic nervous system

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17
Q

What are the parts of the adrenal cortex?

A

Zona glomerulosa, Zona fasciculata, Zona reticularis

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18
Q

What does the zone glonerulosa produce?

A

Aldosterone

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19
Q

What does aldosterone do?

A

Regulates potassium and sodium secretion and retention
Plays a role in pH w/ ht excretion
Key in RAA pathway for BP and blood volume

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20
Q

What is aldosteronism?

A

Too much aldosterone leads to hypertension and edema due to increased sodium

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21
Q

What does decreased potassium do?

A

Cause weakness and sometimes paralysis

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22
Q

What does the zone fasiculata produce?

A

Cortisol

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23
Q

When is cortisol released?

A

With ACTH stimulation, there’s neg feedback with increased cortisol

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24
Q

What does cortisol do?

A

Increase blood glucose by decreasing peripheral uptake and promoting gluconeogenesis
Check if correct *

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25
Q

Why is diabetes hard to control in stressful situations?

A

Cortisol decreases insulin sensitivity

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26
Q

What does cortisol do in acute stage?

A

Promotes the breakdown of fatty acid Asa source of energy

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27
Q

What happens with sustained cortisol?

A

Body starts to redistribute fat (cushingoid signs)

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28
Q

How does cortisol effect immune system?

A

Supress t helper 1 cells (cellular immunity)
Promotes t helper 2 cells to increase humoral immunity and inc. Anti-inflammatory response

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29
Q

What is addisons disease?

A

Too little cortisol

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30
Q

What is cushings disease?

A

Too much cortisol, hyperglycemia, hypertension i edema, poor wound healing

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31
Q

What does the zone reticularis produce?

A

Gonadocorticoids, weak androgens, DHEA

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32
Q

What does DHEA do?

A

Can be conversed to testosterone or estrogen
Too much can lead to facial hair

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33
Q

What is the adrenal medulla made of?

A

Chromaffins or pheochromocytes

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34
Q

What are features of the adrenal medulla?

A

Rich nerve and blood supply
Epinephrine is secreted 10x more than norepinephrine
Responsive for SNS fight or flight

35
Q

What is pheochromocytoma?

A

Tomor that secretes excess catecholamines

36
Q

What does the zone glomerulosa produce?

A

Aldosterone

37
Q

How does aldosterone play a role in ph?

A

H+ excretion

38
Q

What is aldosteronism?

A

Too much aldosterone

39
Q

What does aldosteronism do?

A

Causes hypertension and edema due to increased Na

40
Q

What does the Zona fasciculata produce?

A

Cortisol

41
Q

What does ACTH stimulation do?

A

Releases cortisol

42
Q

What does cortisol do?

A

Increases blood glucose by decreasing peripheral uptake and promoting gluconeogenesis

43
Q

What does the hypothalamus do when activated by stress?

A

Stimulates the locus ceruleus

44
Q

What is synthesized in the locus ceruleus?

A

Norepinephrine

45
Q

What is the pathway for norepinephrine?

A

From the locus ceruleus by afferent pathways back to the hypothalamus lambic system, hippocampal area and cerebral cortex

46
Q

What happens when the SNS is activated?

A

Release of epinephrine and norepinephrine namely the chromatin cells

47
Q

What does epinephrine do?

A

Increase glucose
Limit insulin
Causes bronchodilation
Promotes lipolysis
Increase heart rate

48
Q

What does the anterior pituitary release?

A

ACTH, beta endorphins, prolactin and growth hormone

49
Q

How does cortisol move through circulation?

A

Mostly bound to cortisol binding globulin and a small amount bound to albumin (prevents all of it from being cleared by the liver)

50
Q

What do beta endorphins do?

A

Reduce pain

51
Q

What does growth hormone do?

A

Affects protein, lipid and carb metabolism and counters the effects of insulin

52
Q

What does the hypothalamus release?

A

Corticotropin releasing hormone

53
Q

What does the posterior pituitary release?

A

ADH

54
Q

What does ADH do?

A

Facilitates retention of Na and water and works in tandem with the ANS catecholamines and cortisol

55
Q

How is acute stress beneficial?

A

It prepares the body for fight or flight

56
Q

Where does acute stress occur?

A

Occurs at the level of the hypothalamus in the anterior pituitary

57
Q

What does increased cortisol do to the hypothalamus?

A

Inhibits it from releasing more CRF and the anterior pituitary from releasing more ACTH

58
Q

What happens to the negative feedback with chronic stress?

A

It becomes blunted or desensitized and no longer responsive to increased cortisol thus enabling the secretion of more CRF and ACTH

59
Q

What is predominant in short term stress?

A

Catecholamine effects

60
Q

What is predominant in prolonged stress?

A

Corticoids but calecholamines are still present

61
Q

What is a positive consequence of stress?

A

Hypermedabolic state

62
Q

What happens in a hypermetabolic state?

A

Lypolysis, gluconeogenesis and glycogenolysis which provides body with increased nutrient for healing and energy

63
Q

What are negative consequences of stress?

A

Loss of muscle mass, nitrogen depletion, immune suppression’ hyperglycemia and cardiovascular wear and tear

64
Q

Why would there be a loss of muscle mass?

A

Gluconeogenesis and protein catabolism

65
Q

Why would there be nitrogen depletion?

A

Muscle catabolism and increased nitrogen excreted in urine

66
Q

Why would there be immune suppression?

A

Decrease in t-cells and the thymi atrophy

67
Q

Why would there be cardiovascular wear and tear?

A

Due to constant catecholamine release

68
Q

What are two possible measurements of stress?

A

Biological and psychological/psychosocial

69
Q

What are psychological measurement examples

A

Assess anxiety, fear, mood, coping and support

70
Q

What are biological measurements of stress?

A

Testing for hyperglycemia, test adrenal function, cortisol levels etc

71
Q

How are cortisol levels measured?

A

Looking at metabolites in 24h wine collections or serum/salivary levels

72
Q

How do you access the adrenal cortex response?

A

Give ACTH

73
Q

How do you measure negative seedbake of ACTH?

A

Give dexamethasome (synthetic glucocorticoid)

74
Q

What is the hypoglycemic stress test?

A

Patient receives insulin to lower glucose to 2.2 then serum cortisol and growth hormone are measured

75
Q

How does stress affect healing?

A

Decreased immune response, increased susceptibility to infections and slow wound healing

76
Q

What all does increased cortisol affect?

A

Natural killer cells are depressed, these cells are first delense in detecting cancer cells

77
Q

Which immune system is affected the most?

A

Adaptive immune system is depressed and less likely to irradiate pathogens, causing longer healing time

78
Q

What part of the brain is very sensitive to glucocorticoids?

A

Hippocampus (important for verbal and contextual memory)

79
Q

What happens when hippocampus is damaged with stress?

A

Neuronal atrophy, decreased short term memory, decreased accuracy of contextual memory i impaired ability to recognize threat

80
Q

Symptoms of stress

A

Rising blood pressure, rapid heart rate, sweating hands, clenched teeth dropping sexual interest

81
Q

Emotional symptoms of stress

A

Anxiety, depression, butterflies, irritability, overreactions, memory problems

82
Q

What are clinical interventions for stress?

A

Eliminate stressor. Management of stress response and blocking the stress response

83
Q

Non-pharmalogical treatments for stress

A

Relaxation, imagery, exercise, music and massage therapy

84
Q

What does exercise do to cortisol?

A

Decreases cortisol secretion

Pathophysiology (3 decks)

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