Chapter 4: Stress, Exercise & Mobility
The response to a stressor such as Jennifer experienced involves a number of tissues. The elevation in cortisol that Jennifer likely experienced is the results of which signal from anterior pituitary? Corticotropin-releasing factor Adrenocorticotropic hormone Antidiuretic hormone Norepinephrine
Adrenocorticotropic hormone In the stress response, adrenocorticotropic hormone (ACTH) from the anterior pituitary stimulates the adrenal cortex to secrete the hormone cortisol. Corticotropin-releasing factor is from the hypothalamus, whereas antidiuretic hormone is from the posterior pituitary. Norepinephrine is secreted by the adrenal medulla.
After a traumatic car accident, Jennifer, a 22-year-old college student, was rushed to the emergency department by ambulance transport. In addition to multiple shallow lacerations and broken bones, you are worried that Jennifer may be experiencing internal hemorrhaging and have her rushed into surgery.When the car accident initially occurred, which stage of the stress response did Jennifer experience? Alarm Resistance Exhaustion Eustress
Alarm The initial response to a stressor is referred to as the "alarm stage" of the stress response. In this stage, the body attempts to meet the demands of and compensate for the stressor. The resistance stage is marked by prolonged release of hormones and catecholamines to counteract the stressor. If adaptation to the stressor fails, the exhaustion phase develops when the body is unable to cope with the stressor. Eustress refers to a positive stressor and is not reflective of Jennifer's experience.
Jennifer has a catheter inserted. Urine output for Jennifer is significantly reduced. Which hormone works directly on the kidneys to reduce urine output during stress? Antidiuretic hormone Epinephrine Cortisol Norepinephrine
Antidiuretic hormone Antidiuretic hormone is released from the posterior pituitary in response to dehydration, low blood volume, and low blood pressure. Given Jennifer may have internal bleeding, her blood volume and pressure are low, causing antidiuretic hormone release. Antidiuretic hormone works directly on the kidney to stimulate water reabsorption to increase blood volume and pressure while reducing urine output.
Who created the theory of allostasis and the body's response to chronic stressors? Carl Langerhans Bruce McEwen Hans Seyle Albert Kuppfer
Bruce McEwen
Which hormone directly reduces the effectiveness of the immune system in the body in response to prolonged stress? Antidiuretic hormone (ADH) Thyroid stimulating hormone (TSH) Cortisol Adrenocorticotropic hormone (ACTH)
Cortisol
Which hormone(s) is/are responsible for the increase in glucose availability in the body in response to stress? Select all that apply. Antidiuretic hormone Cortisol Epinephrine Norepinephrine Aldosterone
Cortisol
A blood sample shows elevation of Jennifer's blood glucose. Which of the following most likely explains this elevation? Jennifer must have diabetes mellitus. Jennifer must be dehydrated. The pancreas has been injured in the accident and too much insulin has been released. Cortisol, a hormone in the stress response, caused the elevation in glucose levels.
Cortisol, a hormone in the stress response, caused the elevation in glucose levels. The most likely reason for an increase in blood glucose in a traumatic event is the release of cortisol from the adrenal cortex. Cortisol serves to raise blood glucose levels as a fuel source during the stressful event. Diabetes mellitus may result in elevated blood glucose levels, but an elevated blood glucose does not indicate that Jennifer must have diabetes mellitus. Insulin lowers blood glucose. Dehydration may result in elevated blood glucose levels, but this is not the most likely cause in this case.
In addition to sympathetic nervous system activation, the adrenal glands also produce hormones to assist in the stress response. If a blood sample were taken from Jennifer, which of the following would indicate increased activity by the adrenal medulla in response to the car accident? Select all that apply. Epinephrine Norepinephrine ACTH Aldosterone Cortisol
Epinephrine Norepinephrine Epinephrine and norepinephrine are hormones released from the adrenal medulla in response to stress. Aldosterone and cortisol are also released in response to stress; however, these are produced by the adrenal cortex, not the adrenal medulla. Adrenocorticotropic hormone (ACTH) is produced by the anterior pituitary.
Which of the following statements are true? Select all that apply. Cortisol inhibits increases in blood glucose. Epinephrine is released from the adrenal medulla. Antidiuretic hormone is inhibited during stress. Stress activates the SNS (sympathetic nervous system). Allostatic load is comparable to the alarm stage of stress.
Epinephrine is released from the adrenal medulla. Stress activates the SNS (sympathetic nervous system).
In response to her accident, Jennifer's cortisol levels increased significantly. What effect will this initial increase in cortisol cause? Immunosuppression Elevation in RBC number Decreased urine output Increased WBC response
Increased WBC response Acute rises in cortisol levels, as seen in Jennifer's case, results in enhancement of the immune response. WBC number and activity increase as a result of short-term cortisol elevations. Prolonged elevation in cortisol induced the opposite effect, causing immunosuppression. Cortisol does not directly affect RBC number or urine output.
n response to the car accident, Jennifer's sympathetic nervous system was activated. Which of the following clinical signs may the clinician expect to observe in Jennifer based on activation of this system? Select all that apply. Increased heart rate Suppressed ventilation rate Pupil dilation Hypotension Increased urine output
Increased heart rate pupil dilation The sympathetic nervous system stimulates an increase in heart rate, respiration, and blood pressure to deal with stressors. This system also causes pupil dilation. Activation of the sympathetic nervous system decreases renal perfusion, reducing urine output.
Jennifer's vital signs include a heart rate of 130 bpm and a blood pressure of 96/58 mm Hg. Which of the following explains this response? Jennifer has handled the stressor adequately as these are normal heart rate and blood pressure readings. The parasympathetic nervous system is suppressing the sympathetic nervous system, keeping blood pressure lower than normal. Jennifer's sympathetic nervous system has been activated, as indicated by the increased heart rate. However, blood pressure is still lower than normal due to possible internal bleeding. Jennifer's lower than normal blood pressure will likely cause the heart rate to decrease in compensation.
Jennifer's sympathetic nervous system has been activated, as indicated by the increased heart rate. However, blood pressure is still lower than normal due to possible internal bleeding. In response to the car accident, the sympathetic, not parasympathetic, system is activated. Normally, activation of the sympathetic nervous system results in an increase in heart rate and blood pressure. However, in Jennifer's case, the internal bleeding results in a drop in blood pressure, despite activation of the sympathetic nervous system.
If Jennifer's adrenal cortex had been damaged by the accident, which hormonal response may appear on a blood laboratory sample? Lower than expected cortisol levels Suppressed epinephrine levels Elevated aldosterone levels Suppressed antidiuretic hormone levels
Lower than expected cortisol levels Cortisol is produced by the adrenal cortex. Elevated cortisol levels are expected in response to a stressor. If Jennifer's adrenal cortex was damaged, then cortisol levels would likely be less than expected. Epinephrine is produced by the adrenal medulla and would not be affected by adrenal cortex damage. Aldosterone is produced by the adrenal cortex and the levels would thus likely be low if adrenal cortex damage occurred. Antidiuretic hormone is produced by the posterior pituitary, not the adrenal medulla.
