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Canada (162,364)
HSM 330 (12)
Chapter 10

Chapter 10

7 Pages

Health Services Management
Course Code
HSM 330
Daolun Chen

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Chapter 10- Stress, Coping and Health - Affects on CVS AND immune systems - Older adults may be particularly vulnerable to effects of physical stress - Mistake to believe that the effects of stress are exclusively negative - Growing body of evidence that stress can have toughening or strengthening effects on everything from heat shock to protein to sicla ties - Whether stress has positive or negative effects may depend on its temporal patterning and also on how we cope with it - All of the antiaging genese appear to regulate cell-based stress resistance, a variety of genetically based mechanism protect against stress at the cellular level including DNA repair mechanism, antioxidants, and heat shock pritens - Neuroendorcine stress reactions can be very toxic Stress Classic Theories o Phsyiological state of organism or strain, define stress to environment or stressor, third to view stress as a transaction between the person and the environment o Barking of dogs would respond with a rush of epinephrine or adrenaline into systems o perception of a threat activated the SNS which readies the organism for fight or flight o Sympathetic nerves originate in the spinal column (preganglonic nerves) and radiate to target organs (postganglionic nerves) o Pregang. Nerves are cholinergic that is they secrete the NT acetylcholine, and PGN use norephinephrine o Symp. Nerves directly enervate the heart, the bronchi in the lungs, the gut and the kidney, they influence the blood vessels, sweat glands, and piloerector muscles in the skin o Sympathetic/adrenal medulla (SAM) sympathetic nerves radiate to the adrenal medulla, which is a small structure lying atop of the kidneys o Adrenal medulla or center, secretes both epinephrine (or adrenaline) and norepinephrine (noradrenaline) into blood o Epinephrine is a more powerful cardiac stimulant and also increases the metabolic rate, norepinphrine more strongly stimulates the peripheral vascular system and raises blood pressure o The two systems (direct innervations and SAM) are redundant- an indicator of importance of stress-related SNS activation) o Butterflies in the stomach reflect the diverted blood flow from the gut to the muscles o Pilo erection response is when the hair on the arms or the back of the neck may stand up and peripheral blood vessel constrictuion results in facial pallor o PNS activation returns body to homeostasis o Overactivation of the SNS can result in a state of shock. Increased BP forces liquids out of the vascular system into the surrounding tissues o If prolonged, process decreases circulating blood volume and the blood volume is insufficient to sustain adequate blood pressure levels o Porcine stress syndrome: percentage of pigs being shipped to market die simply from the stress of being transported o Okay (cousin of zebra) lived in berlin zoo, okapy died of fright o Prolonged increases in BP and blood clotting would eventually result in hypertension and CVD o Hypothalamus secrete corticotrophin-releasing hormone (CHA) which activates the posterior lobe of the pituitary o Pituitary releases adrenocorticotropin hormone (ACTH) into the blood stream o Glucocorticoids are fat soluble molecules, cortisol suppresses the inflammatory responses of gluces into the blood system and raise metabolic rates o Three stages in reactions to stress alarm, adaption, exhaustion Modern Theories o Stress on sympathetic arousal including HR, respiratory rate and galvanic skin response o Others HR decreased although perspired more o Activation of the HPA axis is an attempt to buffer the rather damaging influence of prolonged SNS activation o HPA activation suppresses the immune/inflammatory response o Stressed organism do not die because their hormone become depleted, but because of the toxic effects of stress response itself o Post traumatic stress disorder (PTSD) is associated with lower levels of cortisol o Chronic stress can deplete if it does not totally exhaust, glucocorticoids o Individuals with low levels of cortisol may be unable to mount any sort of response to a chllange o Stress activates those hormones that increase metabolic functioning and sippresses those involved in long term growth and maintenance o Growth hormone is humans initially increases in response to stress o Growth hormone helps to stimulate metabolism, and it actions on cell division are mediated by somatomedins o Interestingly stroking the skin appears to stimulate growth hormone and can reverse these effects o Oxytocin is a hormone that is very important in reproductive activities such as breast feeding o Women’s response to stress is mediated more by oxytocin and can be characterized by a tend and befriend response as opposed to the male flight or fight reaction mediated by the SNS o Characterized as flight-fight-affiliate a 3-d reaction to stress, allows for the influence of such factors as gender, age, personality, and environmental factors in the patterning of stress response Stress and the development of Chronic Illness  Stress can result in Heart disease and cancer  Temporary increases in CVD risk factors such as BP and cholesterol, promotes atherosclerotic and arteriosclerotic process and impairs immune functioning  Stress can promote tumor proliferation through pathways such as angiogenesis (development of blood vessels that feed the tumor) and by shunting glucose preferentially to tumors  Stress has been shown to suppress NK cells in humans  Stress does appear to play a role in the development of certain types off tumors such as breast cancer  Between genetic and environmental factors that result in individual differences in vulnerability to stress and risk of disease  Allostasis refers to the fluctuation in physiological systems to meet external demands  Allostatic load as the physiological costs of chronic exposure to fluctuating or heightened neural or neuroendocrine responses that result from repeated chronic environmental challenges Positive Physiological Changes  Stress possible positive outcomes overlooked  Infant mice and rats subjected to mild electric shock or handling matured more quickly than their nonstressed peers  As adults, they showed better neurendocrine responses to stress, showing quicker and larger increases in epinephrine and norepinphrine but returning to baseline more quickly as well  Adults tend to be taller in culture in which infants are subjected to stressors in the first 2 years of life  Stress can induce physiological toughness if it is followed by an adequate recovery period  Increase ones future capacity for more positive forms of arousal and the suppression of more costly forms of arousal  SAM activation is associated with better performance on cognitive and physical tasks as well as emotional stability whereas HPA axis arousal is less beneficial an may interfere with performance  Hormesis, low levels of exposure to a stressor can result in resistance to more lethal levels  Moderate exposure to toxins can result in increased resiliency to stress on a number of different levels and perhaps greater longevity Physiological stress and aging  Optimal stress response is a sharp increase in cortisol and other stress related hormones and peptides followed by a quick return to baseline  Stress response stay in the system longer and can create a numb
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