Stress and Adaptation

Question 1

A complex of signs and symptoms that occur together to present a clinical picture of a disease or inherited abnormality.

Answer 1

syndrome

Question 2

Being, having, pertaining to, or occurring in a period or cycle of approximately 24 hours.

Answer 2

circadian

Question 3

Current stressors include: (5)

Answer 3

terrorism, paying bills, maintaining one’s health, keeping a job, and the economy.

Question 4

The concept of a stable internal environment was supported by Walter B. Cannon, who proposed that this kind of stability, which he called _____________, was achieved through a system of carefully coordinated physiologic processes that oppose change.

Answer 4

homeostasis

Question 5

The ability of the body to function and maintain homeostasis under conditions of change in the internal and external environment depends on the thousands of physiologic ________ ________ that regulate body function.

Answer 5

control systems

Question 6

The control systems that mediate the physical, emotional, and behavioral reactions to stressors that, taken together, are called the ________ ________

Answer 6

stress response

Question 7

Just like any control system, each stress response involves a ________ to detect the change, an _______ to sum all incoming data and compare it with “normal,” and _________ to try to reverse the change.

Answer 7

sensor
integrator
effector

For instance, a hiker’s eyes (sensor) see a snake (stressor). Her cerebral cortex (integrator) determines that the snake is a threat, and activates the heart, respiratory muscles, and many other organs (effectors) to assist her escape.

Question 8

The physiologic control systems that oppose change operate by _________ feedback mechanisms consisting of a sensor that detects a change, an integrator/comparator that sums and compares incoming data with a set point, and an effector system that returns the sensed function to within the range of the set point.

Answer 8

negative

Question 9

true or false

The reason most physiologic control systems function under negative rather than positive feedback mechanisms is that a positive feedback mechanism interjects instability rather than stability into a system.

Answer 9

true

Question 10

Physiologic and psychological adaptation involves the ability to maintain the constancy of the internal environment (homeostasis) and behavior in the face of a wide range of changes in the internal and external environments. It involves control and ________ feedback systems that regulate cellular function, control life’s processes, regulate behavior, and integrate the function of the different body systems.

Answer 10

negative

Question 11

_______ described stress as “a state manifested by a specific syndrome of the body developed in response to any stimuli that made an intense systemic demand on it.”

Answer 11

Seyle

Question 12

_______ noticed that patients with diverse disease conditions had many signs and symptoms in common. He observed, “whether a man suffers from a loss of blood, an infectious disease, or advanced cancer, he loses his appetite, his muscular strength, and his ambition to accomplish anything. Usually the patient also loses weight and even his facial expression betrays that he is ill.”

Answer 12

seyle

Question 13

In his early career as an experimental scientist, Selye noted that a triad of (3) appeared in rats he was using for his studies

Answer 13

adrenal enlargement, thymic atrophy, and gastric ulcers

Question 14

To Selye, the response to stressors was a process that enabled the rats to resist the experimental challenge by using the function of the system best able to respond to it. He labeled the response the..

Answer 14

general adaptation syndrome

Question 15

According to Selye, the GAS involves three stages: the alarm stage, the resistance stage, and the exhaustion stage. The _______ ________ is characterized by a generalized stimulation of the sympathetic nervous system and the HPA axis, resulting in the release of catecholamines and cortisol.

Answer 15

alarm stage

Question 16

During the ______ stage of GAS, the body selects the most effective and economic channels of defense. During this stage, the increased cortisol levels, which were present during the first stage, drop because they are no longer needed.

Answer 16

resistance

Question 17

If the stressor is prolonged or overwhelms the ability of the body to defend itself, the ________ stage of GAS ensues, during which resources are depleted and signs of “wear and tear” or systemic damage appear.

Answer 17

exhaustion

Question 18

The events or environmental agents responsible for initiating the stress response were called

Answer 18

stressors

Question 19

According to Selye, stressors could be ________, arising from within the body, or _______, arising from outside the body.

Answer 19

endogenous - in

exogenous - out

Question 20

mild, brief, and controllable periods of stress could be perceived as positive stimuli to emotional and intellectual growth and development

Answer 20

distress

Question 21

the severe, protracted, and uncontrolled situations of psychological and physical distress that are disruptive of health.

Answer 21

distress

Question 22

Stressors tend to produce different responses in different people or in the same person at different times, indicating the influence of the adaptive capacity of the person, or what Selye called…

Answer 22

conditioning factors

These conditioning factors may be internal (e.g., genetic predisposition, age, sex) or external (e.g., exposure to environmental agents, life experiences, dietary factors, level of social support).

Question 23

The manifestations of the stress response are strongly influenced by what three systems?

Answer 23

nervous
endocrine
immune

Question 24

The results of the coordinated release of ____________ include the mobilization of energy, a sharpened focus and awareness, increased cerebral blood flow and glucose utilization, enhanced cardiovascular and respiratory functioning, redistribution of blood flow to the brain and muscles, modulation of the immune response, inhibition of reproductive function, and a decrease in appetite.15

Answer 24

neurohormones

Question 25

Since the early 1980s, the term ___________ has been used by some investigators to describe the physiologic changes in the neuroendocrine, autonomic, and immune systems that occur in response to either real or perceived challenges to homeostasis.

Answer 25

allostasis

Question 26

The persistence or accumulation of these allostatic changes (e.g., immunosuppression, activation of the sympathetic nervous and renin–angiotensin–aldosterone systems) has been called an ____________ _______, and this concept has been used to measure the cumulative effects of stress on humans.16

Answer 26

allostatic load

Question 27

true or false

The stress response is an abnormal, coordinated physiologic system meant to increase the probability of survival, but also designed to be an acute response—turned on when necessary to bring the body back to a stable state and turned off when the challenge to homeostasis abates.

Answer 27

false - normal response

Question 28

The _________ ________ is involved with vigilance, cognition, and focused attention and the limbic system with the emotional components (e.g., fear, excitement, rage, anger) of the stress response.

Answer 28

cerebral cortex

Question 29

The ___________ functions as the relay center and is important in receiving, sorting out, and distributing sensory input.

Answer 29

thalamus

Question 30

The ____________ coordinates the responses of the endocrine and autonomic nervous systems (ANS).

Answer 30

hypothalamus

Question 31

The _____ modulates mental alertness, ANS activity, and skeletal muscle tone, using input from other neural structures.

Answer 31

RAS

Question 32

The locus caeruleus is densely populated with neurons that produce ____ and is thought to be the central integrating site for the ANS response to stressful stimuli

Answer 32

NE

Question 33

The LC–NE system confers an adaptive advantage during a stressful situation. The sympathetic nervous system manifestation of the stress reaction has been called the

Answer 33

fight or flight response

Question 34

This is the most rapid of the stress responses and represents the basic survival response of our primitive ancestors when confronted with the perils of the wilderness and its inhabitants. The increase in sympathetic activity in the brain increases attention and arousal and thus probably intensifies memory. The heart and respiratory rates increase, the hands and feet become moist, the pupils dilate, the mouth becomes dry, and the activity of the gastrointestinal tract decreases.

Answer 34

fight or flight

Question 35

_______ is a small peptide hormone found in both the hypothalamus and in extrahypothalamic structures, such as the limbic system and the brain stem. It is both an important endocrine regulator of pituitary and adrenal activity and a neurotransmitter involved in ANS activity, metabolism, and behavior.

Answer 35

corticotropin-releasing factor

Question 36

CRF from the hypothalamus induces secretion of _______ from the anterior pituitary gland.

Answer 36

ACTH

Question 37

ACTH stimulates the adrenal gland to synthesize and secrete the

Answer 37

glucocorticoid hormones (cortisol)

Question 38

________ acts not only as a mediator of the stress response but as an inhibitor, such that overactivation of the stress response does not occur.

Answer 38

cortisol

Question 39

________ maintains blood glucose levels by antagonizing the effects of insulin and enhances the effect of catecholamines on the cardiovascular system. It also suppresses osteoblast activity, hematopoiesis, protein and collagen synthesis, and immune responses. All of these functions are meant to protect the organism against the effects of a stressor and to focus energy on regaining balance in the face of an acute challenge to homeostasis.

Answer 39

cortisol

Question 40

Stimulation of the sympathetic nervous system also activates the peripheral ________ which mediates a peripheral increase in vascular tone and renal retention of sodium and water. These changes contribute to the physiologic changes that occur with the stress response and, if prolonged, may contribute to pathologic changes

Answer 40

RAAS

Question 41

Although growth hormone is initially elevated at the onset of stress, the prolonged presence of cortisol leads to suppression of growth hormone, insulin-like growth factor 1 (IGF-1), and other growth factors, exerting a chronically ________ effect on growth.

Answer 41

inhibitory

Question 42

Although the connection is speculative, the effects of stress on growth hormone may provide one of the vital links understanding what disorder in children?

Answer 42

failure to thrive

Question 43

Stress-induced cortisol secretion also is associated with _________\ levels of thyroid-stimulating hormone and inhibition of conversion of thyroxine (T4) to the more biologically active triiodothyronine (T3) in peripheral tissues. Both changes may serve as a means to conserve energy at times of stress.

Answer 43

decreased

Question 44

______ released from the posterior pituitary is also involved in the stress response, particularly in hypotensive stress or stress due to fluid volume loss.

Answer 44

ADH

Question 45

_____ also known as vasopressin, increases water retention by the kidneys and produces vasoconstriction of blood vessels. In addition, vasopressin synthesized in parvocellular neurons of the hypothalamus and transported to the anterior pituitary appears to synergize the capacity of CRF to stimulate the release of ACTH.

Answer 45

ADH

Question 46

_______ and ________ _______ can induce anovulation and amenorrhea in women and decreased spermatogenesis and decreased levels of testosterone in men.

Answer 46

sepsis and severe trauma

Question 47

The hormones and neurotransmitters (_______________ and _________) that are released during the stress response function to alert the individual to a threat or challenge to homeostasis, to enhance cardiovascular and metabolic activity in order to manage the stressor, and to focus the energy of the body by suppressing the activity of other systems that are not immediately needed.

Answer 47

catecholamines and cortisol

Question 48

true or false

The ability to adapt to stress is influenced by previous learning, physiologic reserve, time, genetic endowment, age, health status and nutrition, sleep–wake cycles, and psychosocial factors.

Answer 48

true

Question 49

__________ implies that an individual has successfully created a new balance between the stressor and the ability to deal with it.

Answer 49

adaptation

Question 50

__________ ____________ are the emotional and behavioral responses used to manage threats to our physiologic and psychological homeostasis.

Answer 50

coping mechanisms

Question 51

According to Lazarus, how we cope with stressful events depends on

Answer 51

how we perceive the event

Question 52

The ability of body systems to increase their function given the need to adapt is known as the

Answer 52

physiologic reserve

Question 53

Adaptation is most efficient when changes occur

Answer 53

gradually

Question 54

________ can ensure that the systems that are essential to adaptation function adequately. Even a gene that has deleterious effects may prove adaptive in some environments. In Africa, the gene for sickle cell anemia persists in some populations because it provides some resistance to infection with the parasite that causes malaria.

Answer 54

genetics

Question 55

The capacity to adapt is decreased at the extremes of

Answer 55

age

For example, the infant has difficulty concentrating urine because of immature renal structures and therefore is less able than an adult to cope with decreased water intake or exaggerated water losses.

Question 56

Within the last decade, primarily because females have been included in basic science and clinical investigations, differences between the sexes in cardiovascular, respiratory, endocrine, renal, and neurophysiologic function have been found, and it has been hypothesized that ____ _________ are the basis of these biologic differences.

Answer 56

sex hormones

Question 57

Premenopausal women tend to have a (higher/lower) activation of the sympathetic nervous system than men in response to stressors.

Answer 57

lower

Question 58

__________ and ___________ health status determines physiologic and psychological reserves and is a strong determinant of the ability to adapt.

Answer 58

physical and mental

Question 59

The importance of nutrition to enzyme function, immune response, and wound healing is well known. On a worldwide basis, _____________ may be one of the most common causes of immunodeficiency.

Answer 59

malnutrition

Question 60

_______ is considered to be a restorative function in which energy is restored and tissues are regenerated.

Answer 60

sleep

Question 61

The two most common manifestations of an alteration in the sleep–wake cycle are _________ and _______ __________ or increased somnolence. In some people, stress may produce sleep disorders, and in others, sleep disorders may lead to stress. Acute stress and environmental disturbances, loss of a loved one, recovery from surgery, and pain are common causes of transient and short-term insomnia.

Answer 61

insomnia and sleep deprivation

Question 62

Studies by social psychologists have focused on individuals’ emotional reactions to stressful situations and their coping mechanisms to determine those characteristics that help some people remain healthy despite being challenged by high levels of stressors. For example, the concept of ___________ describes a personality characteristic that includes a sense of having control over the environment, a sense of having a purpose in life, and an ability to conceptualize stressors as a challenge rather than a threat.

Answer 62

hardiness

Question 63

true or false?

people who can mobilize strong supportive resources from within their social relationships are less able to withstand the negative effects of stress on their health.

Answer 63

false - they are better able

Question 64

an _______ _________ ________ stressor is one that occurs over a short time and does not recur.

Answer 64

acute time limited

Question 65

a _______ ____________ stressor is one to which a person is chronically exposed.

Answer 65

chronic intermittent

Question 66

the __________ of circumstances to which the body is asked to respond often determines the availability and efficiency of the stress responses.

Answer 66

frequency

The response of the immune system, for example, is more rapid and efficient on second exposure to a pathogen than it is on first exposure. However, chronic exposure to a stressor can fatigue the system and impair its effectiveness.

Question 67

true or false

In situations of life-threatening trauma, these acute responses may be lifesaving

Answer 67

true

they divert blood from less essential to more essential body functions. Increased alertness and cognitive functioning enable rapid processing of information and arrival at the most appropriate solution to the threatening situation.

Question 68

for people with limited coping abilities, either because of physical or mental health, the acute stress response may be detrimental. for example….

Answer 68

person with heart disease, stress response of the SNS may cause arrhythmias

Question 69

• Mood disorders
• Anxiety
• Depression
• PTSD
• Eating disorders
• Sleep disorders
• Diabetes type 2
• Hypertension
• Infection
• Exacerbation of autoimmune disorders
• Gastrointestinal problems
• Pain
• Obesity
• Eczema
• Cancer
• Atherosclerosis
• Migraine

all of the above are…

Answer 69

possible stress induced health problems.

Question 70

The stress response is designed to be an acute self-limited response in which activation of the _____ and the ____ _____ is controlled in a negative feedback manner.

Answer 70

ANS and HPA axis

Question 71

Chronicity and excessive activation of the stress response can result from _______ ________ as well as contribute to the development of long-term health problems.

Answer 71

chronic illness

Question 72

________ is characterized by a severe stress response secondary to experiencing previous trauma.

Answer 72

PTSD

Question 73

PTSD that is manifested ____ ______ after the traumatic event is called PTSD with delayed onset.

Answer 73

six months

Question 74

PTSD was formerly called _______ _______ or shell shock because it was first characterized in soldiers returning from combat. Although war is still a significant cause of PTSD, other major catastrophic events, such as weather-related disasters (hurricanes, earthquakes, and floods), airplane crashes, terrorist bombings, and rape or child abuse, also may result in development of the disorder.

Answer 74

battle fatigue

Question 75

People who are exposed to traumatic events are also at risk for development of (4)

Answer 75

major depression
panic disorder
generalized anxiety disorder
substance abuse

Question 76

PTSD is characterized by a constellation of symptoms that are experienced as states of (3)

Answer 76

intrusion
avoidance
hyperarousal

Question 77

__________ refers to the occurrence of “flashbacks” during waking hours or nightmares in which the past traumatic event is relived, often in vivid and frightening detail.

Answer 77

intrusion

Question 78

___________ refers to the emotional numbing that accompanies this disorder and disrupts important personal relationships.

Answer 78

avoidance

Question 79

Because a person with PTSD has not been able to resolve the painful feelings associated with the trauma, _________ is commonly a part of the clinical picture. Survivor guilt also may be a product of traumatic situations in which the person survived the disaster but loved ones did not

Answer 79

depression

Question 80

___________ refers to the presence of increased irritability, difficulty concentrating, an exaggerated startle reflex, and increased vigilance and concern over safety.

Answer 80

hyperarousal

Question 81

what three things are commonly seen in people with PTSD?

Answer 81

memory problems, sleep disturbances, and excessive anxiety

Question 82

For a diagnosis of PTSD to be made, the person must have experienced, witnessed, or confronted a traumatic event, which caused a response in the person involving horror and fear. The triad of symptoms of intrusion, avoidance, and hyperarousal that characterize PTSD must be present together for at least ____ ______, and the disorder must have caused clinically significant distress.

Answer 82

one month

Question 83

It has been hypothesized that the intrusive symptoms of PTSD may arise from exaggerated _______ activation in response to the traumatic event. People with chronic PTSD have been shown to have increased levels of NE and increased activity of α2-adrenergic receptors.

Answer 83

SNS

Question 84

Recent neuroanatomic studies have identified alterations in these two brain structures suggest a neuroanatomic basis for the intense problems suffered by people diagnosed with PTSD.

Answer 84

amygdala and hippocampus

Question 85

the amygdala and hippocampus are involved in what?

Answer 85

fear responses

Question 86

in addition to fear response, the hippocampus also plays a role in…

Answer 86

memory

Question 87

People with PTSD demonstrate (increased or decreased) cortisol levels, increased sensitivity of cortisol receptors, and an enhanced negative feedback inhibition of cortisol release with the dexamethasone suppression test.

Answer 87

decreased

Question 88

Health care professionals need to be aware that people who present with symptoms of depression, anxiety, and alcohol or drug abuse may in fact be suffering from

Answer 88

PTSD

Question 89

_________ or talking about the traumatic event at the time it happens, often is an effective therapeutic tool. Crisis teams are often among the first people to attend to the emotional needs of those caught in catastrophic events.

Answer 89

debriefing

Question 90

Most importantly, the person with _____ should not be made to feel responsible for the disorder or that it is evidence of a so-called character flaw. It is not uncommon for people with this disorder to be told to “get over it” or “just get on with it, because others have.”

Answer 90

PTSD

Question 91

The change that occurs in the biochemical stress response system of people who have experienced some type of mistreatment as a child so that they are not able to respond effectively to stressors in the future is called the

Answer 91

traumatic stress response

Question 92

Evidence supports that ______ ______ can assist the person in adapting new and effective coping mechanisms to better manage stress in the future.

Answer 92

early intervention

Question 93

The treatment of stress should be directed toward helping people avoid coping behaviors that impose a risk to their health and providing them with

Answer 93

alternative stress reducing strategies

Other nonpharmacologic methods used for stress reduction are relaxation techniques, guided imagery, music therapy, massage, and biofeedback.

Question 94

scene visualization, in which the person is asked to sit back, close the eyes, and concentrate on a scene narrated by the therapist. Whenever possible, all five senses are involved.

Answer 94

guided imagery

Question 95

It involves listening to selected pieces of music as a means of ameliorating anxiety or stress, reducing pain, decreasing feelings of loneliness and isolation, buffering noise, and facilitating expression of emotion.

Answer 95

music therapy

Radio and television music is inappropriate for music therapy because of the inability to control the selection of pieces that are played, the interruptions that occur (e.g., commercials and announcements), and the quality of the reception.

Question 96

_______________ is a technique in which a person learns to control physiologic functioning. It involves electronic monitoring of one or more physiologic responses to stress with immediate feedback of the specific response to the person undergoing treatment.

Answer 96

biofeedback