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Patho exam #1 pt 2
stress
Question | Answer |
---|---|
Why Study Stress? | Linked to leading causes of death Heart disease Cancer Accidents Suicide Chronic stress doubles risk of MI Related to 75% of office visits |
Stress | -Perception that one cannot adequately cope with demands being made on person or well-being -Perception and personal meaning of a potential stressor influences response |
Stress Response | Homeostasis -Body’s compensation to minor changes in needs or environment Stressor -Factor that creates significant change in body function |
Stress Response | Severe or prolonged stress can cause dysfunction: -Increased wear and tear on tissues -Exhaustion of resources -Exacerbation of chronic conditions |
GAS – General Adaptation Syndrome | Alarm stage Mobilization of defenses Hypothalamus, sympathetic nervous system, adrenal glands Resistance stage Elevation of hormone levels Body systems operate at peak performance Final stage Resolution or death |
Significant Effects ofStress Response | Elevated blood pressure and increased heart rate Bronchiodilation and increased ventilation Increased blood glucose levels Arousal of the central nervous system Decreased inflammatory and immune responses |
Factors Affecting Response to Stressors | Internal and external influences Key personal characteristics -Hardiness -Sense of coherence -Resilience -Attitude |
Hardiness | Mediating factor in the relationship between stress and illness -Clear sense of personal values and goals -Strong tendency toward interaction with the environment -Sense of meaningfulness -Internal rather than external locus of control |
Sense of Coherence | -Powerful mediator of stress and illness and a key determinant of health -Refers to how an individual sees the world and one’s life in it |
Resilience and Attitude | Resilience: -Resourceful, flexible, and having available source of problem-solving strategies Attitude: -Positive emotional attitudes can prevent disease and prolong life |
GAS "Alarm Reaction" | Perception of a stressor physically or mentally Fight-or-flight response is initiated Temporarily decreased resistance -May result in disease or death if the stress is prolonged and severe |
GAS "Resistance" | -Ideal transition from alarm to resistance is quick -Few overt physical signs and symptoms occur compared with the alarm stage -Adaptation occurs or person advances to exhaustion |
GAS "Exhaustion" | -Final stage of GAS -Occurs when all energy for adaptation has been exhausted |
GAS "Exhaustion (Cont'd)" | -Physical symptoms of alarm reaction may briefly reappear in final effort by body to survive -This stage can be reversed by external sources such as medication |
Physiologic Response | Stress affects three interrelated systems (nervous, endocrine, and immune) -Activation of these systems affects other systems (cardiovascular, respiratory, gastrointestinal, renal, and reproductive) |
Nervous System: Cerebral cortex | Plans a course of action after evaluating stressor in light of past experiences and future consequences |
Nervous System (Cont'd): System | Mediator of emotions, feelings, and behavior that ensure survival and self-preservation |
Nervous System (Cont'd): Reticular Formation | -Contains the reticular activating system to send alertness impulses to limbic system and cerebral cortex -Stress increases frequency of alertness impulses *Leads to wakefulness and sleep disturbances |
Nervous System (Cont'd):Hypothalamus | -Central to connection between nervous and endocrine systems -Regulates the function of sympathetic and parasympathetic branches of the autonomic nervous system |
Endocrine System | Sympathetic nervous system (SNS) stimulates adrenal medulla to release epinephrine and norepinephrine (catecholamines) Sympathoadrenal response Fight-or-flight response |
Endocrine System: Physiologic effects of cortisol | -Increases blood glucose levels -Potentiates catecholamine action on blood vessels -Inhibits the inflammatory response |
Endocrine System:Corticosteroids | -Increase cardiac output, blood glucose levels, oxygen consumption, and metabolic rate -Blunt aspects of stress response that could be self-destructive if uncontrolled |
Immune System: Psychoneuroimmunology (PNI) | -Interdisciplinary science involving the interactions among psychologic, neurologic, and immune responses |
Immune System (Cont'd) | -Brain is connected to the immune system by neuroanatomic and neuroendocrine pathways -Stressors have the potential to lead to alterations in immune function |
Immune System (Cont'd): Acute and chronic stress can affect immune function | -Decreased number and function of natural killer cells -Altered lymphocyte proliferation -Decreased production of cytokines |
Effects of Stress on Health | -Acute stress leads to physiologic changes that are important to one’s adaptive survival -If stress is excessive or prolonged, physiologic responses can be maladaptive and lead to harm and disease |
Effects of Stress on Health " Stress effects": Cognitive Function | Poor concentration, impaired decision making, or memory problems |
Effects of Stress on Health " Stress effects": Behavior | Withdrawing from others, irritability, or substance abuse |
Effects of Stress on Health " Stress effects": Excessive activation of the sympathetic nervous system | -Induces hippocampal damage Memory impairment -Increases risk of cardiovascular disease |
Potential Effects of Prolonged or Severe Stress: Renal Failure | Prolonged severe vasoconstriction; ischemia causes cell damage |
Potential Effects of Prolonged or Severe Stress: Stress Ulcers | -Vasoconstriction and glucocorticoids -Decrease in mucosal regeneration and mucus production |
Potential Effects of Prolonged or Severe Stress: Infection | Depression of the inflammatory and immune responses |
Potential Effects of Prolonged or Severe Stress: Slowed healing-Following trauma or surgery | -Increased secretion of glucocorticoid – reduction in protein synthesis and tissue regeneration -Increased catecholamine levels – vasoconstriction – reduced nutrients and oxygen to the tissue |
Potential Effects of Prolonged or Severe Stress: Post-traumatic stress disorder | -Serious consequence of major disaster or personal threat -Usually occurs within 3 months of event *May cause symptoms years later -High risk of developing dependence on drugs and/or alcohol |
Coping | -A person’s cognitive and behavioral efforts to manage specific external or internal stressors that seem to exceed available resources |
Types of coping | Positive (+)-activities such as exercise and use of social support Negative (-) may include substance abuse and denial |
Coping (Cont'd) :Coping resources: | characteristics or actions drawn on to manage stress and include factors within the person or the environment Resources: -Health status -Belief systems -Problem-solving skills -Social skills and support -Financial |
Coping Stress (cont'd) : Emotion-focused coping | -managing emotions that one feels when a stressful event occurs ***Purpose—to help decrease negative emotions and help create a feeling of well-being |
Coping Stress (cont'd) :Problem-focused coping | -find solutions to resolve problems causing stress ***Purpose—allow one to look at a challenge objectively, take action to address the problem, and reduce the stress |
Coping with Stress (additional information) | -Ensure adequate rest and a healthy diet. -Use creative solutions to minimize stressors and adapt quickly to stressor. -Regular moderate exercise -Engage in distracting activities. -Counseling and support services -Relaxation techniques |