NRS 232 Final Exam Questions and Answers
New Update 2026 Success Top Rated A+
Reticular Activating System (RAS)
-Sensory input recognized by thalamus and cerebral cortex, which
activates RAS
-RAS communicates to the skeletal muscles via gamma neurons to cause
increased muscle tension (explains why chronic stress may lead to muscle
soreness)
-RAS also increases alertness and arousal
Anterior Pituitary Gland Vs. Posterior Pituitary Gland
Anterior Pituitary: Releases Adrenocorticotropic hormone (ACTH), which
acts on the adrenal cortex to release cortisol
Posterior Pituitary: Releases ADH in response to high blood sodium (main
stimulus) and decreased perfusion to kidneys (lesser stimulus). ADH acts
on the kidneys to retain water only.
Consequences of Chronic Stress
-Chronic stress inhibits the negative feedback loop and causes constant
release of cortisol. Constant release of cortisol suppresses the immune
system and increases blood sugar. This increases the risk of diabetes,
infection, and poor wound healing. Increased cortisol also increases
stomach acid production, fat redistribution, sodium and water retention
(ECV excess, edema, and hypokalemia), and increased calcium release
from bones (increased risk of osteoporosis among post-menopausal
women)
-Muscle wasting
-Difficulty regulating emotions (labile emotions)
-Increased epinephrine and norepinephrine leads to hypertension,
endothelial cell dysfunction, vasoconstriction, and tachycardia. All of this
increases the risk of coronary artery disease, myocardial infarction, kidney
,disease. and stroke.
-Constant activation of the reticular activating system (RAS) causes
prolonged muscle tension and soreness. Muscle soreness is a stressor as
well, so it amplifies the body's stress response
How to Treat Patient Stress After Experiencing a Traumatic Event
-Provide insulin to lower blood sugar and risk of infection
-Address increased stomach acid by providing a proton pump inhibitor,
which will help lower the risk of stomach ulcers
-Monitor and intervene for constipation, increased blood pressure, and
increased heart rate
Stretch Reflex
-Also called myotatic reflex
-Muscle spindles detect stretch of a muscle, and afferent sensory neurons
conduct action potentials to the spinal cord. Afferent neurons synapse with
alpha motor neurons at the spinal cord. Alpha motor neurons carry action
potentials back to the muscle to cause contraction and to prevent further
stretching.
-The reticular activating system (RAS) also prevents stretch by sending
signals to gamma motor neurons. Gamma motor neurons conduct signals
from the spinal cord to the muscle fibers and help regulate muscle tension
involuntarily. This causes increased contractility of the muscle.
What causes you to suddenly become wide awake and oriented when
being woken up from an alarm?
The reticular activating system (RAS), which is aroused by the limbic
system in response to the alarm
What are some additional responses to stress?
-Increased ADH and aldosterone, which can lead to ECV excess and
edema
-Growth and reproduction impairment
Can the effects of stress be passed on to offspring?
,Yes! Chronic stress alters the expression of multiple genes in the HPA axis,
and can lead to epigenetic changes (changing how genes are expressed)
that are passed onto offspring.
What happens if there is an obstructed artery?
-Arteries carry blood away from the heart
-Ischemia and reversible cell swelling
-Irreversible cell swelling may occur if ischemia is not treated
What happens if there is an obstructed vein?
-Veins carry blood to the heart
-Venous congestion and fluid buildup can cause increased hydrostatic
pressure and edema
-Less blood flow to the heart
Virchow's Triad
-Factors that increase risk of thrombus formation in arteries, veins, and
within heart chambers:
1. Stasis (pooling) of blood
2. Endothelial injury (this can lead to atherosclerosis)
3. Hypercoagulability
Arteriosclerosis versus Atherosclerosis
-Arteriosclerosis is hardening of the arteries that can occur through many
different physiological processes
-Atherosclerosis is a specific pathophysiological process involving large
and medium-sized arteries. It leads to obstructed arterial flow, which can
cause ischemia and eventual necrosis.
Normal Endothelial Function
-Lines arteries and secretes nitric oxide (NO)
-NO acts as a vasodilator to relax smooth muscles. NO also calms White
Blood Cells and makes them "less sticky" and inhibits platelet
aggregation/secretion
Endothelial Dysfunction
, -Endothelial dysfunction is a key contributor to atherosclerosis, which is a
high risk factor for heart attack and stroke.
-Endothelial damage may be caused by chronic conditions such as
hypertension and diabetes. Exercise is a protective factor against
endothelial damage since it increases nitric oxide (NO) production of
endothelial cells over time.
-When damaged, endothelial cells produce less NO, which causes:
1. Decreased dilation of blood vessel...decreased space for blood to flow.
2.Increased stickiness of endothelium...endothelium becomes more
permeable to LDL cholesterol, which moves from the arterial space into the
tunica intima. The endothelium also allows more White Blood Cells to
adhere and transmigrate from blood into the tunica intima.
3. LDL is engulfed by resident macrophages within the tunica intima, which
signal an alarm by sending cytokines and other proinflammatory mediators.
These mediators cause upregulation of selectin and integrin on the
endothelium, which captures monocytes in the blood and causes them to
roll, adhere, and transmigrate into the tunica intima.
4. Monocytes become macrophages within the tunica intima and engulf
more LDL. As they engulf more LDL, they become foam cells and form fatty
streaks.
5. Macrophages release cytokines and growth factors, which induces
smooth muscle cell migration into the intima lamina. Macrophages also
attract fibroblasts that produce collagen. Fibroblasts produce a collagen
cap on fatty streaks. This causes obstructed blood flow in the vessel!
6. At this point, the fibrous plaque is stable, but has a necrotic core.
7. As the plaque grows, the arterial space becomes more obstructed.
8. Macrophages produce enzymes to break down the plaque, which causes
it to rupture and spill its necrotic core.
New Update 2026 Success Top Rated A+
Reticular Activating System (RAS)
-Sensory input recognized by thalamus and cerebral cortex, which
activates RAS
-RAS communicates to the skeletal muscles via gamma neurons to cause
increased muscle tension (explains why chronic stress may lead to muscle
soreness)
-RAS also increases alertness and arousal
Anterior Pituitary Gland Vs. Posterior Pituitary Gland
Anterior Pituitary: Releases Adrenocorticotropic hormone (ACTH), which
acts on the adrenal cortex to release cortisol
Posterior Pituitary: Releases ADH in response to high blood sodium (main
stimulus) and decreased perfusion to kidneys (lesser stimulus). ADH acts
on the kidneys to retain water only.
Consequences of Chronic Stress
-Chronic stress inhibits the negative feedback loop and causes constant
release of cortisol. Constant release of cortisol suppresses the immune
system and increases blood sugar. This increases the risk of diabetes,
infection, and poor wound healing. Increased cortisol also increases
stomach acid production, fat redistribution, sodium and water retention
(ECV excess, edema, and hypokalemia), and increased calcium release
from bones (increased risk of osteoporosis among post-menopausal
women)
-Muscle wasting
-Difficulty regulating emotions (labile emotions)
-Increased epinephrine and norepinephrine leads to hypertension,
endothelial cell dysfunction, vasoconstriction, and tachycardia. All of this
increases the risk of coronary artery disease, myocardial infarction, kidney
,disease. and stroke.
-Constant activation of the reticular activating system (RAS) causes
prolonged muscle tension and soreness. Muscle soreness is a stressor as
well, so it amplifies the body's stress response
How to Treat Patient Stress After Experiencing a Traumatic Event
-Provide insulin to lower blood sugar and risk of infection
-Address increased stomach acid by providing a proton pump inhibitor,
which will help lower the risk of stomach ulcers
-Monitor and intervene for constipation, increased blood pressure, and
increased heart rate
Stretch Reflex
-Also called myotatic reflex
-Muscle spindles detect stretch of a muscle, and afferent sensory neurons
conduct action potentials to the spinal cord. Afferent neurons synapse with
alpha motor neurons at the spinal cord. Alpha motor neurons carry action
potentials back to the muscle to cause contraction and to prevent further
stretching.
-The reticular activating system (RAS) also prevents stretch by sending
signals to gamma motor neurons. Gamma motor neurons conduct signals
from the spinal cord to the muscle fibers and help regulate muscle tension
involuntarily. This causes increased contractility of the muscle.
What causes you to suddenly become wide awake and oriented when
being woken up from an alarm?
The reticular activating system (RAS), which is aroused by the limbic
system in response to the alarm
What are some additional responses to stress?
-Increased ADH and aldosterone, which can lead to ECV excess and
edema
-Growth and reproduction impairment
Can the effects of stress be passed on to offspring?
,Yes! Chronic stress alters the expression of multiple genes in the HPA axis,
and can lead to epigenetic changes (changing how genes are expressed)
that are passed onto offspring.
What happens if there is an obstructed artery?
-Arteries carry blood away from the heart
-Ischemia and reversible cell swelling
-Irreversible cell swelling may occur if ischemia is not treated
What happens if there is an obstructed vein?
-Veins carry blood to the heart
-Venous congestion and fluid buildup can cause increased hydrostatic
pressure and edema
-Less blood flow to the heart
Virchow's Triad
-Factors that increase risk of thrombus formation in arteries, veins, and
within heart chambers:
1. Stasis (pooling) of blood
2. Endothelial injury (this can lead to atherosclerosis)
3. Hypercoagulability
Arteriosclerosis versus Atherosclerosis
-Arteriosclerosis is hardening of the arteries that can occur through many
different physiological processes
-Atherosclerosis is a specific pathophysiological process involving large
and medium-sized arteries. It leads to obstructed arterial flow, which can
cause ischemia and eventual necrosis.
Normal Endothelial Function
-Lines arteries and secretes nitric oxide (NO)
-NO acts as a vasodilator to relax smooth muscles. NO also calms White
Blood Cells and makes them "less sticky" and inhibits platelet
aggregation/secretion
Endothelial Dysfunction
, -Endothelial dysfunction is a key contributor to atherosclerosis, which is a
high risk factor for heart attack and stroke.
-Endothelial damage may be caused by chronic conditions such as
hypertension and diabetes. Exercise is a protective factor against
endothelial damage since it increases nitric oxide (NO) production of
endothelial cells over time.
-When damaged, endothelial cells produce less NO, which causes:
1. Decreased dilation of blood vessel...decreased space for blood to flow.
2.Increased stickiness of endothelium...endothelium becomes more
permeable to LDL cholesterol, which moves from the arterial space into the
tunica intima. The endothelium also allows more White Blood Cells to
adhere and transmigrate from blood into the tunica intima.
3. LDL is engulfed by resident macrophages within the tunica intima, which
signal an alarm by sending cytokines and other proinflammatory mediators.
These mediators cause upregulation of selectin and integrin on the
endothelium, which captures monocytes in the blood and causes them to
roll, adhere, and transmigrate into the tunica intima.
4. Monocytes become macrophages within the tunica intima and engulf
more LDL. As they engulf more LDL, they become foam cells and form fatty
streaks.
5. Macrophages release cytokines and growth factors, which induces
smooth muscle cell migration into the intima lamina. Macrophages also
attract fibroblasts that produce collagen. Fibroblasts produce a collagen
cap on fatty streaks. This causes obstructed blood flow in the vessel!
6. At this point, the fibrous plaque is stable, but has a necrotic core.
7. As the plaque grows, the arterial space becomes more obstructed.
8. Macrophages produce enzymes to break down the plaque, which causes
it to rupture and spill its necrotic core.
