Which of the following occurs in acute trauma?
CSDT says "following injury, neural impulses carried spinothalamic pathways activate the brain stem and thalamic and coical centres, which stimulate the hypothalamus. Hypothalamic stimulation triggers combined neural and endocrine discharges. Norepinephrine is released sympathetic nerve endings, epinephrine from the adrenal medulla, aldosterone from the adrenal coex, ADH from the adrenal coex, ADH from the posterior pituitary, glucagon from the pancreas, and ACTH, TSH and growth hormone from the anterior pituitary. These hormones produce secondary elevation of coisol, thyroid hormone and somatomedins. Hormones Increased In Response to Surgical Stress Catecholamines: The plasma catecholamines increase immediately after trauma and acheive peak concentration in 24-48 hours depending on the severity. Glucagon: Glucagon along with catecholamine and coisol promotes and prolongs the liver glycogenesis. Coisol: Hypothalamus during stress secretes ACTH, which in turn initiates sudden increase in coisol levels. Growth hormone: The secretion of GH is governed by hypothalamic factors, autonomic stimulation and non-hormonal signals. The primary metabolic action of GH during stress is to promote protein synthesis and enhance lipid breakdown, and glucose stores. Vasopressin (ADH) Aldosterone Renin-Angiotensin Plasma concentration of insulin during stress has been noted to be biphasic, characterized by the suppression of insulin secretion followed by a normal secretion. Ref: Bailey 27th edition, Pgno: 7 CSDT 11th edition pgno: 103-105
Increase in Insulin
Decrease in glucagon
Decrease in coisol
Increase in thyroxine
Trauma