Surgical Stress Response

Question 1

What is the surgical stress response?

Answer 1

Hormonal and metabolic changes that occur following injury/trauma

Characterised by increased secretion of pituitary hormones and activation of the sympathetic nervous system

Question 2

What causes the activation of the sympathetic nervous system?

Answer 2

Increased secretion of catecholamines from adrenal medulla

Release of noradrenaline from presynaptic nerves

Question 3

What anterior pituitary hormones increase as a result of the surgical stress response?

Answer 3

ACTH

• stimulates adrenal cortex
• increases concentration of cortisol

Growth Hormone

• stimulates protein synthesis
• has an anti-insulin effect
• inhibits glucose uptake by cells

Question 4

What posterior pituitary hormone increases as a result of the surgical stress response?

Answer 4

ADH

Question 5

What is the effect of inuslin during surgery?

Answer 5

Concentrations decrease after anaesthesia

Question 6

What is the effect of cortisol during surgery?

Answer 6

Concentration increases

Promotes protein breakdown
Promotes gluconeogenesis in liver
Promotes lipolysis

Has some glucocorticoid effects

• inhibit accumulation of macrophages and neutrophils in areas of inflammation
• can interfere with synthesis of inflammatory mediators