This document discusses stress and its effects on the body. It describes the body's immediate and long-term responses to stress, including increased heart rate and sweating in the short term and high blood pressure in the long term. It also discusses the types of stress including psychological, chronic, and acute stress and their symptoms. Chronic stress can negatively impact health over time if left untreated. The document outlines how the hypothalamic-pituitary-adrenal axis responds to regulate stress hormones like cortisol and how acute stress causes a short-term physical adaptation through hormone release and redirection of resources.

1. STRESS & INJURY
Raja Mohamed
Kushagra Sisodiya
Aadhav Ardha Narish Srinivasan

2. Stress is the feeling of being
overwhelmed or unable to cope
with mental or emotional pressure.
STRESS

3. BODY RESPONSES TO STRESS
IMMEDIATE RESPONSE
● Sweating
● Tremors
● Nausea
● Vomiting
● Stomach cramps
● Irritability
● Trouble concentrating
LONG-TERM RESPONSE
● Chronic fatigue
● High blood pressure
● Infertility
● Asthma
● Trouble falling asleep
● Stroke
● Fibromyalgia

4. INJURY CAUSED BY STRESS
● There are various medical
conditions.
● Stress can lower immunity.
● Cascade of poor health.
● Cancer is also triggered by
stress.
● High blood pressure.

5. ● Psychological Stress.
● Chronic Stress.
● Acute Stress.
TYPES OF STRESS

6. PSYCHOLOGICAL STRESS
● There’s a good chance we can
all identify negative stress, but
did you know that stress can
also be positive?
● Good Stress (Eustress)
● Bad Stress (Distress)

7. PSYCHOLOGICAL STRESS SIGNS
● There are any number of
situations that can cause
stress.
● Relationship conflicts at home.
● Increasing work responsibilities.
● Financial strain
● Loss of a loved one
● Health problems
● Exposure to one or more
traumatic incidents.

8. WAYS TO MANAGE STRESS
● Practice relaxation exercises.
● Get plenty of rest.
● Eat well-balanced meals.
● Exercise regularly.
● Talk to the people you trust.
● Keep a journal

9. ● Chronic stress is a
prolonged and constant
feeling of stress that can
negatively affect your
health if it goes untreated.
● It can be caused by the
everyday pressures of
family and work or by
traumatic situations.
CHRONIC STRESS

10. SYMPTOMS AND TREATMENT
Symptoms
• Aches and pains
• Decreased energy
• Difficulty sleeping
• Disorganized thinking
• Fatigue
• Feeling a loss of control
● Headaches
Treatment
• Psychotherapy: cognitive behavioral
therapy (CBT) can help you learn to
identify negative thought patterns
that contribute to chronic stress.
• Mindfulness-based stress
reduction (MBSR) is another
approach that can help people utilize
mindfulness and meditation to cope
with chronic stress.
• Medications: Different medications
to help you manage some of the
symptoms of stress.

11. Chronic Stress
Pituitary
Adrenal Axis
Hyperactivity
(HPA)
Hypothalamus
HPA Axis
Hypoactivity

12. HYPOTHALAMIC PITUITARY RESPONSE
● Norepinephrine considers as a neurotransmitter in the brain that knows as
adrenalin; a hormone initiated during the activation of the stress response.
● During stress, the hypothalamic-pituitary-adrenal (HPA) axis is activated.
Hypothalamic neurons within the HPA axis secrete corticotropin-releasing
hormone that causes the release of adrenocorticotrophic hormone (ACTH)
from the pituitary. The ACTH causes the adrenal gland to secrete cortisol (a
stress hormone).

13. HYPOTHALAMIC ADRENAL RESPONSE
● The hypothalamic–pituitary–adrenal axis among three components:
the hypothalamus, the pituitary gland and the adrenal.
● Release of corticotropin-releasing hormone (CRH) from the hypothalamus is
influenced by stress, physical activity, illness, by blood levels of cortisol and by
the sleep/wake cycle. In healthy individuals, cortisol rises rapidly after wakening,
reaching a peak within 30–45 minutes.
● During stress, the hypothalamic-pituitary-adrenal (HPA) axis is activated.
Hypothalamic neurons within the HPA axis secrete corticotropin-releasing
hormone that causes the release of adrenocorticotrophic hormone (ACTH) from
the pituitary. The ACTH causes the adrenal gland to secrete cortisol
(a stress hormone).

15. HARMFUL EFFECTS OF CHRONIC STRESS
● Change in regulatory actions of mood, aggression, appetite, and sleep,
and it synthesis from tryptophan.
● Cortisol modulation change and led to cortisol deregulation
consequences
● The balance between anti-inflammatory and proinflammatory cytokines
is altered
● Stress can alter memory functions, reward, immune
function, metabolism and susceptibility to diseases.

16. LONG-TERM EFFECTS OF CHRONIC STRESS.
● Prolonged or extended exposure to stress causes long-term upregulation of the HPA
axis, characterized by reduced thymus weight.
● Increased adrenal size.
● Increased adrenal sensitivity to ACTH.
● Facilitated HPA axis responses to novel stressors.
● In addition, chronic stress increases glutamatergic and noradrenergic terminal
abutting PVN CRF neuronal somata and dendrites, consistent with enhanced
excitatory synaptic drive.

17. ACUTE STRESS
 Most common types of stress
 Least damaging types of stress
 We experience acute stress multiple
times throughout the day as immediate
perceived threat;
• Physical
• Emotional
• Psychological

18. WHAT ARE THE RESPONSES TO ACUTE STRESS?

19. WHAT ARE THE SYMPTOMS OF AN ACUTE STRESS REACTION?
settle quickly
last for several days or weeks.
• Anxiety
• Low mood
• Irritability
• Palpitations
• Nausea
• Chest pain
• Headaches
• Abdominal pains.
• Breathing difficulties
PHYSICAL SYMPTOMS
Caused by
STRESS HORMONES
Adrenaline
PSYCHOLOGICAL SYMPTOMS
• Emotional ups and downs
• Poor sleep
• Poor concentration

20.  Redirection of energy and body resources.
 INCREASES IN;
• Cardiovascular Tone
• Respiratory Rate
• Intermediate Metabolism
i. gluconeogenesis
ii. Lipolysis
 While energy consuming functions;
• Digestion
• Reproduction
• Growth
• Immunity
PHYSICAL ADAPTATION DURING ACUTE STRESS
Oxygen and nutrients are primarily shunted to CNS & to stressed body site, where they’re needed the most.
Promote redirection of vital substrates
Temporally suppressed

21. HOW IS HYPOTHALAMIC-PITUITARY-ADRENAL (HPA) AXIS AFFECTED IN ACUTE STRESS
 Increase in PVN CRH and AVP secretion.
 Secretion of;
• Angiotensin II
• Various cytokines
• Lipid mediators of inflammation
Act on various levels of the HPA axis to mainly stimulate its activity

22. WHY DOES ACUTE STRESS CAUSE LOSS OF APPETITE?
Acute stressful situations are frequently associated
with anorexia and marked suppression of food intake.
CRH stimulates the POMC neurons of the arcuate
nucleus via α-MSH release, & it elicit anorexigenic
signals and increase thermogenesis.
Anorexia nervosa represents an interesting example
of the implication of the stress system in the regulation
of appetite and energy intake

23. AFFECT OF ACUTE STRESS IN GASTROINTESTINAL FUNCTION
During acute stress, PVN CRH, induces both inhibition of gastric emptying and stimulation of colonic motor function by alterations in
the ANS activity
inhibition of the vagus nerve activity at the dorsal vagal complex results in selective inhibition of gastric motility,
stimulation of the sacral parasympathetic system activity results in selective stimulation of colonic motility
At the receptor level, it appears that stress-induced delayed gastric emptying involves the central medullary CRH-R2 receptors and
also the peripheral CRH-R2 receptors in the gastrointestinal tract, whereas the CRH-R1 subtype seems to mediate the colonic
motor responses
CRH may play a role in mediating the gastric stasis which is associated with the stress of surgery and the increased IL-1 levels
during surgery and the immediate postoperative period, whilst it is also implicated in the stress-induced colonic hyper-motility of the
irritable bowel syndrome (IBS)
Although acute stress stimulates colonic motor function via a central CRH, it seems that colonic motility is decreased following
chronic stress through an adaptation mechanism which does not implicate reduced sensitivity to central CRH

24. ● A beta-blocker is one medicine that can help relieve some physical symptoms that are caused by the
release of stress hormones.
● Diazepam, a benzodiazepine tranquilliser
MEDICATIONS

25. https://patient.info/mental-health/stress-management/acute-stress-reaction
REFRENCE
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860392/
• http://medcraveonline.com/PPIJ/PPIJ-06-00181.pdf
• https://en.wikipedia.org/wiki/Hypothalamic%E2%80%93pituitary
%E2%80%93adrenal_axis
• https://www.sciencedirect.com/topics/agricultural-and-biological-
sciences/hypothalamic-pituitary-adrenal-axis
• https://patient.info/mental-health/stress-management/acute-
stress-reaction

26. THANK YOU