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BIO 325 - Pathophysiology > Stress & Disease - CH. 21 > Flashcards

Stress & Disease - CH. 21 Flashcards

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1
Q

Stress is a relationship between…

A

An individual’s physiologic and psychologic processes and environment

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2
Q

Stress results from situations that…

A

Require a degree of adaptation

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3
Q

Hans Selye

A

Came up with the idea of General Adaptation Syndrome

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4
Q

General Adaptation Syndrome (overview)

A

Internal or external stressors can result in:
-Adrenal gland enlargement
-Immune alterations (reduced lymphocytes from damaged lymphatic structures)
-GI manifestations (bleeding ulcers)

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5
Q

What is needed to respond to stress?

A

A state of balance

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6
Q

Increased cortisol production

A

Suppresses the immune response

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7
Q

Stress response is meant to protect against

A

Acute threats and is normally time limited.

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8
Q

Acute stress

A

Considered to enhance immunity

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9
Q

Chronic stress

A

Suppresses immunity

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10
Q

Allostasis

A

Process by which the body responds to stressors in order to regain homeostasis - stability through change

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11
Q

Allostatic overload

A

When there is a chronic overactivation of adaptive responses that may in turn increase susceptibility to disease.

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12
Q

General (GAS)

A

Effect is a general systemic reaction

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13
Q

Adaptation (GAS)

A

Response was in reaction to a stressor

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14
Q

Syndrome (GAS)

A

Physical manifestations are coordinated and dependent on each other.

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15
Q

Example of stress and allostatic overload

A

Sleep alteration and associated damaging effects of elevated evening cortisol, insulin, and glucose.

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16
Q

Three stages of GAS

A
  1. Alarm stage (fight or flight)
  2. Stage of resistance/adaptation
  3. Allostatic overload or exhaustion
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17
Q

Alarm stage - physiologic activation

A

SNS -> HPA Axis -> release of catecholamines & cortisol

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18
Q

Alarm Stage - Suppression of certain hormones like GH, thyroid hormone, and reproductive

A

Necessary to conserve energy that is needed to fend off the stressor

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19
Q

Alarm Stage - ADH secretion

A

ADH is increased to retain fluid, thereby maintaining the BP needed to perfuse vital tissues.

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20
Q

Alarm Stage - Immune response

A

Humoral response boosted initially to thwart infection and disease, but with rising cortisol levels the immune response becomes inhibited.

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21
Q

Stage of resistance/adaptation - GAS

A

Individual attempts to compensate for changes induced by the alarm stage in response to sustained challenge

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22
Q

Persistent stress is followed by

A

The resistance stage where cortisol decreases through negative feedback

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23
Q

Why is excess cortisol helpful in early stages of stress

A

Increase metabolism by breaking down proteins, releasing lipids, and increasing circulating glucose

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24
Q

Hypercortisolism - Stage 2 GAS

A

Leads to exhaustion of inflammatory and immune responses, excessive loss of body proteins and breakdown of tissues, and glucose intolerance

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25
Q

Hormone levels suppressed during the resistance stage

A

Loss of circulating thyroid, growth, and reproductive hormones

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26
Q

GAS Stage 2 - Persistent increase in ADH

A

Manifested by excessive fluid retention and subsequent hypertension

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27
Q

Allostatic Overload or Stage of Exhaustion - GAS Stage 3

A

Can follow if an individual cannot successfully adapt to physiological changes that occur during resistance stage

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28
Q

Stage 3 GAS - Continuous Stress

A

Causes progressive breakdown of compensatory mechanisms and homeostasis

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29
Q

What specific term occurs during stage 3 of GAS?

A

Allostatic overload

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30
Q

Stage 3 GAS - Characterization

A

Characterized by energy depletion and degeneration of cells, tissues, organs, and organ systems

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31
Q

Stage 3 GAS - severe prolonged exposure to stress causes

A

Contributes to poor health and marks a significant loss to homeostasis

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32
Q

What does the individual lose during stage 3 of GAS?

A

Loses the capacity to sustain a defense against stress

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33
Q

What can stage 3 of GAS cause (long-term effects)

A

Organ damage and onset of certain diseases

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34
Q

Stage 3 GAS - Psychological Stressors

A

Can be anticipatory or reactive
Can cause or worsen several diseases/disorders

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35
Q

Reactive Response

A

Increased HR and cotton mouth in reaction to taking an exam

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36
Q

Anticipatory Response

A

Hypothalamus stimulates response from limbic system. Fear/memory generates stress in anticipation of experiencing events.

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37
Q

Brainstem makeup

A

Locus ceruleus and RAS

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38
Q

What does the brainstem make?

A

Norepinephrine

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39
Q

What does the brainstem do?

A

Coordinates performance of the ANS, cortex, limbic system, and HT

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40
Q

Three mechanisms for the physiologic response to stress

A

HPA axis, SNS, and immune system

41
Q

What are the HPA and SNS inhibited by

A

Opioids and GABA

42
Q

What does the HPA and SNS activate?

A

Activate the sympathetic response to stress

43
Q

Four major hormones/groups of hormones involved in the endocrine response to stress

A

CRH, ACTH, cortisol, and catecholamines

44
Q

HPA Axis

A

Hypothalamus releases CRF -> CRF causes anterior pit to release ACTH -> ACTH stimulates release of cortisol from adrenal cortex -> cortisol increases metabolism by breaking down proteins, releasing lipids, and increasing circulating glucose for use in making ATP

45
Q

Cortisol and CRF

A

Cortisol acts as a negative feedback loop to restrict release of CRF

46
Q

Key aspect to HPA axis

A

Negative feedback loops inhibit further secretion of cortisol, but can be altered by stress

47
Q

What responses does the hypothalamus trigger

A

Neural and hormonal responses

48
Q

ANS

A

Sympathetic stimulation of the adrenal medulla to secrete catecholamines

49
Q

Catecholamines

A

Epinephrine, norepi, and neuropeptide Y

50
Q

Effect of SNS stimulating release of catecholamines

A

HR, BP, respiration rate, pupil dilation, and sweating.
Blood flow increases to muscle, heart, lungs.
Gastric function decreased - less oxygen and blood alteration can cause stress ulcers

51
Q

What do neurons regulate?

A

Release of norepinephrine to control alertness, arousal, and vigilance

52
Q

Catecholamines

A

Prepare the body to act, mimic direct sympathetic stimulation
Person will look pale or ashen and digestion is decreased due to blood being shunted away to important spots

53
Q

Growth hormone

A

Released by anterior pit
Affects protein, lipid, and carbohydrate metabolism and counters the effects of insulin
Chronic stress decreases growth hormone secretion in children

54
Q

Posterior pit releases

A

Oxytocin and ADH

55
Q

Oxytocin

A

Promotes reduced anxiety

56
Q

ADH

A

Increased to retain fluid, thereby maintaining the BP needed to perfuse vital tissues
Can cause excessive fluid retention and subsequent hypertension

57
Q

What does adrenal gland secrete

A

Cortisol and catecholamines

58
Q

Cortisol (glucocorticoid)

A

Reach all tissues, easily penetrate cell membranes, and react with intracellular glucocorticoid receptors

59
Q

Catecholamines mimic

A

Direct sympathetic stimulation

60
Q

Affect of chronic stress on on the parasympathetic/sympathetic systems

A

During allostatic overload the parasympathetic system is less effective in opposing the sympathetic system

61
Q

Cortisol’s chief effects involve

A

Metabolic processes

62
Q

What is the purpose of cortisol promoting the formation of glucose, AA’s, lipids, and fatty acids

A

Delivers them to the bloodstream so cells can use them to make ATP.

63
Q

What does cortisol help with within the CNS?

A

Regulate memory, cognition, mood, and sleep

64
Q

Negative aspects of cortisol

A

Metabolic syndrome, pathogenesis of obesity, can directly cause insulin resistance

65
Q

Beneficial aspects of cortisol secretion during stress

A

Inhibiting initial inflammatory effects
-vasodilation, increased capillary permeability, promote resolution and repair by affecting transcription in leukocytes

66
Q

What can elevated levels of catecholamines and glucocorticoids do?

A

Decrease innate immunity and increase autoimmune responses

67
Q

How does cortisol and catecholamines help protect the body from disease

A

Bind to receptors on immune cells to increase synthesis and release of cytokines, including interleukin-18, interleukin-6, and tumor necrosis factor-a

68
Q

Adrenal medulla is involved with

A

Catecholamines, epinephrine, and norepinephrine

69
Q

Epinephrine

A

Chief effects on cardiovascular system
Increases CO and blood flow to heart, brain and skeletal muscles
Dilating vessels that supply those organs
Dilates airways to increase oxygen to the bloodstream
Binds with and activates both a and B receptors

70
Q

Norepinephrine

A

Constrict blood vessels of viscera and skin, increases mental alertness, directs blood flow to vessels dilated by epi, binds primarily with receptors

71
Q

Limbic system

A

Regulates emotional activities, stimulates RAS
Anticipatory response begins in limbic system

72
Q

Thalamus

A

Intensifies sensory input related to stressor like vision, hearing, smell

73
Q

RAS

A

Increases alertness and muscle tension and contributes to stimulation of the ANS

74
Q

Prefrontal cortex

A

Regulates cognitive activities such as intense focus, planning attention, and persistence

75
Q

B-endorphins

A

Proteins in brain w/pain-relieving capabilities
Released in response to stressor
Inflamed tissue activates endorphin receptors
Hemorrhage increases levels, which inhibits BP increases and delays compensatory changes

76
Q

Elevated b-endorphins

A

Activate endorphin (opiate) receptors on peripheral sensory nerves leading to pain relief or analgesia.

77
Q

Prolactin

A

Released from anterior pit
Necessary for lactation/breast development
Levels in plasma increase as a result of stressful stimuli

78
Q

Oxytocin

A

Produced by hypothalamus during childbirth and lactation
Produced during orgasm for both sexes
Can promote reduced anxiety

79
Q

Testosterone

A

Secreted by leydig cells in testes
Regulates male secondary sex characteristics and libido
Testosterone levels decrease because of stressful stimuli
Exhibits immunosuppressive activity

80
Q

Estrogen

A

Calming effect during stressful situations
Release during stressful situations causes depression of T cells and enhancement of B cells

81
Q

Melatonin

A

Decreases during stress response

82
Q

Negative affective states

A

Depression, anxiety

83
Q

Reciprocal relationship b/t stress and depression

A

Individual tries to cope and fails, feelings of helplessness and worthless may occur

84
Q

Acute stress disorder

A

Symptoms occur within a month of the event and not expected to last longer than 4 weeks

85
Q

Three criteria for traumatic event

A
  1. Persistent re-experiencing of traumatic event
  2. Persistent attempts to avoid stimuli associated w/event
  3. Persistent symptoms of increased arousal
86
Q

Memory process

A
  1. Registration of information from environment
  2. Information organized by comparison to perceptual maps then forwarded for meaning/interpretation
  3. Consolidation sets the permanence of the memory trace
87
Q

Hippocampus and thalamus with explicit memory

A

Bring together elements of memory trace from neo-cortical areas during retrieval
Unable to distinguish between cues that pose a genuine threat and those that are similar but nonthreatening. Allows for unconscious misinterpretation

88
Q

Re-experiencing original trauma

A

Triggers acute response w/activation of SNS -> increased norepi affects coding and retrieval of memory

89
Q

HPA axis w/ PTSD

A

Intrusive thoughts increase cortisol levels
Cortisol levels produce reversible alterations of declarative memory
Increased release of dopamine from prefrontal cortex contributes to PTSD

90
Q

Stress & Respiratory disease

A

Increased respiratory and heart rates which increases oxygen consumption

91
Q

Stress & neurologic disease

A

Alterations in immune function could be related to alterations in cytokine levels
Immune cells can infiltrate brain and secrete inflammatory mediators
Alters brain structure and function

92
Q

Multiple sclerosis

A

Have abnormal cytokine profile
Contribute to myelin destruction and death of oligodendrocytes
Decreased anti-inflammatory cytokines

93
Q

GI disease

A

Associated with IBD, peptic ulcer disease, and GERD
Slows gastric emptying and increases motility of colon
SNS response might contribute to hypersecretion of gastric acid
Can contribute to localized ischemia and further damage.

94
Q

Cardiovascular disease

A

Psych stress can contribute to acute myocardial infarction
Excess hostility and anxiety contribute to coronary artery disease
Chronic inflammation contributes to atherosclerosis

95
Q

Stress and negative emotions are directly associated with

A

Production of pro-inflammatory cytokines
Stress response directly influences immune system through HT and PiT peptides, epi and norepi

96
Q

Immunosenescence

A

Aging of the immune system

97
Q

Stress and Natural Killer cells

A

NKs are first defense against viruses
Reduced killer T cell cytotoxicity associated with higher perceptions of stress

98
Q

Major mediatory associated with illness & stress

A

IL-6

BIO 325 - Pathophysiology (8 decks)

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