1. Chapter Two: The Systems of the Body

2. The Brain
( Source: Lankford, 1979, p. 232)

3. Brain- Structure Cortex: Interpret Threat Mid Brain: “mammalian”
Frontal Lobe: Modulates, Plans, Decides
Role of Trauma: bypass cortex, irrational
Mid Brain: “mammalian”
Hypothalamus: Primitive Stress Response
Limbic System: “Emotional Center”
Amygdala: anxiety; threat sensitive
Hippocampus: memory consolidation

4. Case of Trauma
Annie suffers from PTSD after watching her best friend die from a severe anaphylactic shock at school. She developed avoidance of anything resembling school and would have intense panic attacks at the sight of medics.
Stress Response is irrational, by-passes the thinking brain, imprinted in lower areas of brain.
Side note on PTSD: Most individuals facing life-threatening stressors never develop PTSD.

5. How does the body handle stress?
Brain : “The Master Gland”
Interprets threat in the Cortex: “Rational”
Reflexive/Reactive Fear: “Irrational”
Hypothalamus: The 4 Fs (fight, flight, fear, sex)
Responds to frontal lobe signal or to trauma stimuli
Pituitary: Releases hormones to start the stress response in the rest of the body

6. Figure 2.1 - The Components of the Nervous System

7. Stress Pathway Hypothalamus: Corticotropin Releasing Factor (CRF)
Pituitary: Vasopressin (Cardiac Response)
Endorphins : Dulls Pain Perception
Why is this adaptive?
Adrenals: Epinephrine (Adrenaline)
Increases Blood Pressure
Dilates Pupils and Constricts Blood Vessels
Mobilizes Muscles to react

8. Acute Stress Response Sympathetic Nervous System: Inhibits salivation
Accelerate heartbeat
Inhibits digestion
Stimulates epinephrine (adrenaline)
Stimulates arousal and orgasm
Reproductive Hormones Suppressed
Growth Hormones Suppressed
Insulin Suppressed

9. Figure 2.3 - The Endocrine System

10. How does stress make us sick?
The Stressed Body
How does stress make us sick?

11. Cardiovascular Disease
Main Idea: Heart Overused Wears Out
Increasing the force of fluid through vessels harm arteries: tears, scars, pits
Atherosclerosis: fat deposits accumulate in the pits and tears
Animal Studies: Stressed monkeys given betablockers, no plaques formed

12. Heart Disease Continued
Angina Pain: Stress constricts not dilate blood vessels
Damaged Cardiovascular system becomes over responsive to acute stressors
Sudden Cardiac Death: Fibrillation/over- reactive heart is heart attack prone

13. Stress and Metabolism Huge Meal -> (normal response)
Insulin Pours out of pancreas to blood ->
Purpose to store storage of energy
Fatty Acids go into fat cells ->
Stimulate Glycogen and Protein Synthesis ->
(Glycogen: strings of glucose)

14. Stress and Metabolism cont
Stress -> Triggers Sympathetic NS
Sympathetic NS -> Secrete Glucocorticoids
Glucocorticoids blocks energy storage
Leaves Glucose in blood available for energy
Energy available for quick response: brain and muscles

15. Stress and Metabolism cont
Sustained Stress -> Expend excessive energy
Fatigue (muscles do not repair)
Diabetes Type II:
Glucose builds up in blood vessels,
Insulin not effective in storing glucose
Glucose plaque in arteries:chronic pain/heart disease
Necrosis in tissue: amputation danger
Kidney damage (dialysis prone)
Eye damage (danger of blindness)

16. Stress and Metabolism Chronic Stress:
Glucocorticoids and Epinephrine: creates insulin ineffectiveness and instability
Diabetes: Body incapable of properly using insulin
Type I Diabetes: Autoimmune; Genetic/viral
Type II Diabetes: Disease of Lifestyle

17. Stress and GI Disease Conditions to consider: Ulcer, Colitis, IBS
Stress -> Shuts down digestion –
Normal Stomach Response?
Case of Ulcer: Chronic Stress stomach lining not rebuilt -> walls of stomach thin out
Prostaglandins rebuild lining but inhibited by stress
-> H-Pylori Bacteria cause infections in the small holes in stomach walls

18. Stress and GI Disorders
Stress diverts energy away from digestion to brain and muscles: Large intestines empties and small intestines stop the absorption
IBS: “spastic colon” too sensitive to stress
Intestines stop and start erratically
Constipation: small intestines stop erratically
Diarrhea: large intestines empty erratically

19. Stress and Appetite CRF (Corticotropin Factor) hypothalamus
Suppresses Appetite: short stressful events
Responding to acute demands of body
Stimulates Appetite: Glucocorticoids released during chronic stress after acute stressor resolves

20. Stress and Growth Growth Hormones (Testosterone/Estrogen)
Suppressed during Stress
Estrogen facilitates new bone growth
Testosterone facilitates new bone growth and muscle development
Side note: Excess Testosterone can speed up fusing of bones as well

21. Stress and Growth Neglect, Abuse, Insufficient Nurturance
Overactive sympathetic system
Dwarfism in children
Recover if stress removed before Puberty; Stress during Puberty reduces bone growth
Case Example:
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22. Stress and Bone Mass Adulthood: Bone mass decreases normally with age
Growth hormones repair cells
Glucocorticoids block calcium
Aging with Stress: Excessive Glucocorticoids & Reduced growth hormones
Accelerates Bone loss
Greater risk for Bone Fracture, Hip Fractures, Fatal complications; Fractures not healing

23. Stress and Memory Acute Stress: Increase STM storage
Chronic Stress: Glucocorticoids
Reduce concentration
Increase forgetting
Hippocampus shrinks (permanent damage)
Children under Chronic Stress?
Aging: Increased Glucocorticoids natural
Severe stress and Aging: Speeds up aging and memory problems

24. Summary The Stress Response:
Sacrifice long-term welfare for immediate physical survival
Avoid physical threat or physical predators
Dysregulates body systems: hyperactive sympathetic response (constant body stress)
Stress response evolved early in our evolutionary development. What would a more modern stress response look like?

25. Disorders of Nervous System
Epilepsy: seizures, stress link, medication managed
Cerebral Palsy: child birth trauma, O2 loss to brain
Parkinson’s Disease: Progressive degeneration of smooth muscle nerves
Multiple Sclerosis: Degeneration of Myelin, motor then cognitive
Huntington’s Chorea: Degeneration of Motor/Cogn
Paraplegia/Quadriplegia: perm motor nerve damage
Dementia: Progressive Cognitive Decline
Short-term > longterm memory

26. Case Analysis
“John”
A 12-year-old has a history of physical abuse and neglect. He was removed from his biological parents who were heroine users and was found filthy, starving, and chronically truant from school at the age of 8. He was placed in foster care and group homes alternatively for the past four years. He is currently placed with a new foster parent who has two other foster children. He attends the 6th grade but physically appears frail and much younger than his age. He also suffers from irritable bowels and has had accidents at school. The teacher mentions that he has trouble retaining any information.
What are important considerations in this case. What might be important interventions? What is John’s prognosis?

27. Case Analysis
“Cindy”
A 30-year-old female share with you that she was recently involved in a car accident. Since then, she has had recurrent nightmares, avoids driving, and experiences severe panic attacks at the sound of cars skidding or braking. She also mentions that her appetite has increased significantly and finds herself snacking far more than typical. She is otherwise high functioning and currently works as an executive secretary to a company CEO. She tells you that she is finding it very difficult to reconcile her anxious behavior with her very rational self.
What do you tell her? How do you help her understand her anxiety?