Chapter 12: The Influence of Stress



Chapter 12: The Influence of Stress

I. Review of the Stress Response

A. Generalized/Systemic complex response to a change (stressor)

1. Body maintains homeostasis

2. quick response

3. physiologic response same to different stressors

4. intensity/effect may vary

B. Stressor

1. factor creating change in body or environment

2. physical or psychological or combination

3. real or anticipated

4. short or long term

5. examples: pain, exposure to cold, trauma, anxiety, fear, new job, infection,

happy occasion

6. individuals perceive stressors differently

7. if person can cope, body returns to normal

8. distress - if person can't cope, harmful effects may result

a. body systems become more disrupted

b. homeostasis not possible

c. factors: aging, pathologic disorders (illness, etc.)

C. Stress: status altered by reaction to stressor

D. Three stages in the stress response (GAS)

1. alarm

a. body's defenses mobilized

b. involves hypothalamus, sympathetic nervous system, adrenal glands

2. resistance

a. hormonal levels elevated

b. body systems operate at peak performance

3. exhaustion

a. body unable to respond further

b. body damaged by increased demands and can't respond further

E. Effects of stress response

1. elevated bp and increased heart rate

2. bronchodilation/increased ventilation

3. increased blood glucose levels

a. due to glycogenolysis (converts glycogen to glucose)

b. gluconeogenesis (makes glucose from noncarbohydrate substances)

4. arousal of cns

5. decreased inflammatory/immune responses

-cortisol reduces early and later stages

6. function in critical areas of body increases (heart, brain, muscles, etc.)

a. due to increase in oxygen levels, circulation, rate of cell metabolism

b. short term stressors enhance cognitive function /short term memory

c. release of endorphins increases - blocks pain

7. serum cholesterol elevated

F. Body responds positively - body activity returns to normal

G. Distress results if stress prolonged/severe/can't cope

1. intellectual function disrupted

2. memory disrupted - due to lg. amt. of glucocorticoids released

II. Stress and Disease

A. Prolonged stress

1. headache

2. prolonged vasoconstriction (bv smaller in diameter)

a. inflammation and necrosis

-stomatitis (ulcers in mouth)

-necrotizing periodontal disease

-nausea

-tissue damage in gastrointestinal tract or kidneys

b. elevated bp

c. if have preexisting pathologic condition

-exacerbates original problem making it more severe

-creates acute complication

-example: person has damaged heart; stress response elevates bp or creates dysrhythmia (irregular heartbeat)

B. Stress precipitating factor in some disorders/diseases

1. chronic infections/diseases affected

a. herpes simplex I and II (oral and genital)

b. asthma

c. seizure

d. multiple sclerosis

e. rheumatoid arthritis

f. systemic lupus erythematosus

g. acne

h. ulcerative colitis

i. eczema

2. some tend to follow serious life crisis: cancer/infection

4. stress etiologic factor (cause)

a. hypertension

b. diabetes mellitus

c. coronary heart disease

C. Potential Effects of Prolonged or Severe Stress

1. serious complications

a. renal failure

-prolonged severe vasoconstriction

-reduced blood flow to kidneys

-tubular necrosis

-obstruction of filtrate flow

-cessation of glomerular filtration or shutdown

-permanent kidney damage

b. stress ulcers

-multiple gastric ulcers

-often asymptomatic

-gastric hemorrhage

-cause:

-intense vasoconstriction in gastric mucosa

-reduced mucosal regeneration

-reduced mucus production

-stasis of chyme due to reduced motility

-excess glucocorticoids delay tissue regeneration

c. infection

-depressed inflammatory response/immune system due to cortisol secretion

-b/c of above, opportunistic infections may develop

-lymphoid tissue atrophies

-circulating leukocytes reduced in #/function

d. growth of malignant tumors

-linked to depressed immune system

e. may impede healing of tissue/increased scar tissue

-increased amt. of cortisol

-reduces protein synthesis

-reduces tissue regeneration

-increased catecholamine levels

-causes vasoconstriction

-reduced blood supply

-reduced delivery of nutrients

f. PTSD (post-traumatic stress disorder)

-flashbacks

-nightmares

-depression

-anxiety

-increased irritability

-altered interpersonal relationships

2. Coping with Stress

a. recognize stress-inducing factors

b. discover best way to deal with them

c. factors affecting coping

-fatigue

-age

-inadequate nutrition

-insufficient knowledge

-lack of emotional support

d. strategies to cope

-adequate rest

-healthy diet

-change in lifestyle

-regular/moderate exercise

-releases muscle tension

-improves circulation

-provides distraction from problem

-maintains stable blood sugar level

-constant blood supply to brain prevents mood swings/irritability

-engage in distracting activities

-counseling and support services

-relaxation techniques

-biofeedback

-music/art therapy

-imagery

-antianxiety medications

-antidepressant medications

E. Each person perceives stressors differently

1. recognize general maladaptive behaviors

2. general maladaptive behaviors

a. avoiding sleep

b. eating junk food

c. drinking too much coffee

d. smoking constantly

e. self-medicating

-drinking

-drugs

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