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Physiologic Responses to Stressors

NRS 232 - Pathophysiology I
by

Katrina Dielman

on 16 March 2018

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Transcript of Physiologic Responses to Stressors

Physiologic Responses to Stressors
NRS 232 - Pathophysiology I
H-P-A Axis:
Hypothalamic Pituitary Adrenocortical Axis
The "Hallmark" of Acute & Chronic Stress
S-A-M System:
Sympathetic Adrenomedullary System
"Fight or Flight"
Pathophysiological Consequences
of
Untreated
or
Prolonged Stress
Coronary heart disease
Hypertension
Stroke
Dysrhythmias
Obesity
Tension headaches
Backache
Autoimmune disease
It All Starts with

Stress

External

or

Internal
Limbic System
Infection
Ulcers
Bowel problems
Urinary problems
Eczema
Acne
Diabetes
Menstrual cycle disorders
Fatigue
Depression
Insomnia
External

Stressors
Environment
Social
Accidents
Internal

Stressors
Physical illness
Psychological
Emotional
Copstead, L. & Banasik, J. (2014).
Pathophysiology
(5th ed.). St. Louis, MO: Elsevier.

Felver, L. (2013). Online Materials:
PROP- Pathophysiology online.
Retrieved from https://evolve.elsevier.com/

Giddens, J. (2017).
Concepts for nursing practice
(2nd ed.). St. Louis, MO: Elsevier Mosby.
References
Norepinephrine
Target Tissues/Organs
S-A-M
System
H-P-A
Axis
Epinephrine > Norepinephrine
Cortisol + Aldosterone
"Threat Appraisal"
Perception and response depends upon developmental stage, previous experiences, concurrent stressors, resources, etc.
CRH
Release of
CRH
Release of
ACTH
Cortisol

May synergize or antagonize the effects of catecholemines
Antiinflammatory role
Aldosterone
Mediator of relationship between psychological stress & heart disease
Norepinephrine
Constricts blood vessels
Reduces GI motility
Dilates pupils
Inhibits insulin secretion
Epinephrine
Cardiac performance
Glycogenolysis
Bronchodilation
CRH
Aldosterone
ADH
Effects of Stress on Body Systems
Neuroendocrine Response
Consider this quotation from William Shakespeare (
Hamlet, Act II, scene ii
; bold added for emphasis):

HAMLET:
Denmark's a prison.
ROSENCRANTZ:
Then is the world one.
HAMLET:
A goodly one, in which there are many confines, wards, and dungeons, Denmark being one o' the worst.
ROSENCRANTZ:
We think not so, my lord.
HAMLET:
Why then, 'tis none to you,
for there is nothing either good or bad but thinking makes it so
. To me it is a prison."

Explain to a classmate how this quotation applies to physiological responses to stressors.
What part of the brain does the thinking that "makes it so"?

"When I had that MRI, those banging noises drove me crazy!" said
Patient-1
. "It sounded like the machine was coming in to get me and tear me apart." "Oh," said
Patient-2
also sitting in the waiting room, "I pretended I was listening to a Lou Harrison percussion piece. It helped take my mind off my back pain."
Why did these two patients respond so differently to the same stimuli?
What are the physiological mechanisms that link our interpretation of environmental stimuli and our physiological responses to them?
Patient-3
has Type II diabetes that is managed with oral medications and diet. "I do not understand it,"
Patient-3
says. "I have been very good with my diet and my pills, but ever since my spouse died 2 months ago, my blood sugar has been out of control. I am having enough trouble trying to manage four kids, the house, and my job without having to worry about getting the complications of long-term high blood sugar too! I sure would like to know why my sugar is running so high."
Reply as if you are talking directly to
Patient-3
.
Use some physiology, in terms appropriate for a layperson, in your answer.
Full transcript