Telomere shortening or attrition is linked to biologic aging and can be accelerated by a number of conditions associated with: - answer-inflammation and oxidative stress
T/F Stress has a minor role on telomere shortening - answer-False; Stress has a major role on telomere shortening that can beg...
Understanding Pathophysiology: Chapter
10
Stress - answer-a perceived or anticipated threat that activates stress-related systems in the body and
the brain (the stress response).
fight-or-flight response - answer-was coined by Walter Cannon to describe how the brain's perception of
threat and rapid physiologic responses prepares the body to deal with threat.
General Adaptation Syndrome (GAS) - answer-Selye's concept of the body's adaptive response to stress
in three phases—alarm, resistance, exhaustion (now referred as allostatic overload); results in adrenal
gland enlargement, immune alterations (increased leukocytes), and gastrointestinal manifestations
(ulcers); diseases of adaption develop if the stage of resistance or adaptation does not restore
homeostasis
T/F Psychological stressors are as effective as physical stressors in activating adrenal gland hormone
secretion - answer-True; Psychological stressors can be anticipatory and triggers by expectations of an
upcoming stressor or can be reactive to a stressor. Both of these psychological stressors are capable of
eliciting a physiologic stress response
Allostasis - answer-stability through change; monitoring the environment for adaptive response; the
emerging link between stress and disease became the basis for this concept
How is allostasis different from homeostasis? - answer-Allostasis involves a dynamic adaptation of the
brain to constantly adjust its physiologic operating range to meet future anticipated demands; returning
stress-induced hormone levels to prestress levels may not be the most adaptive strategy to cope with
impending stressful encounters
Chronic dysregulation of the HPA axis, especially abnormal elevated levels of cortisol, is linked to: -
answer-A wide variety of disorders, including obesity, metabolic syndrome, sleep deprivation, lipid
abnormalities, coronary heart disease, diabetes, atherosclerosis, and loss of bone density
What may lead to cognitive impairments and emotional disorders? - answer-chronic glucocorticoid
secretion in the brain; e.g., chronic depression is accompanied by shrinkage of the hippocampus and the
prefrontal cortex
, Understanding Pathophysiology: Chapter
10
Activation of the autonomic nervous system consists of: - answer-sympathetic stimulation of the adrenal
medulla and nerve endings to rapidly secrete catecholamines (norepinephrine, epinephrine)
How does epinephrine exert its chief effects on the cardiovascular system? - answer-Increasing cardiac
output and blood flow to the brain, heart, and skeletal muscles by dilating vessels that supply these
organs; also dilates the airways, thereby increasing delivery of oxygen to the bloodstream
The parasympathetic nervous system balances or restrains the sympathetic system, resulting in: -
answer-slowed heart rates and anti-inflammatory effects; during prolonged stress (allostatic overload),
the parasympathetic system becomes less effective in opposing the sympathetic system
T/F Chronic activation of regulatory stress systems has the potential to tax the body and the brain and
lead to the emergence of disease and disorders - answer-True; in allostatic overload, chronic over
activation of adaptive regulatory physiologic systems may lead to pathophysiology and onset of disease
What three major physiologic stress systems get activated from the perception or anticipation of threat?
- answer-hypothalamic-pituitary-andrenal (HPA) axis; sympathetic nervous system (SNS); and the
immune system (IS)
Key physiologic changes involved in allostatic overload include: - answer-exaggerated or chronic
secretion of adrenal cortisol, catecholamines from the SNS, and proinflammatory cytokines that may
initiate gene expression changes with widespread effects on the body, and neurobiologic structures and
processes
Becoming "stressed out" by allostatic overload may lead to: - answer-sleep deprivation, heightened
insulin and blood glucose levels, increased blood pressure, and reduced parasympathetic activity; these
physiologic consequences are often linked to insomnia, chronic pain and fatigue syndromes, obesity,
metabolic syndrome, essential hypertension, type 2 diabetes, atherosclerosis and its cardiovascular
consequences, osteoporosis, and autoimmune inflammatory and allergic disorders
Adrenocorticotropic hormone (ACTH) - answer-Stimulates adrenal cortex to secrete glucocorticoids
T/F Cortisol secretion induced by stress binds to glucocorticoid receptors to activate diverse biologic
actions only in the brain - answer-False; throughout the body and in the brain
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