1.  Provide body support

2.  attachment for muscles (movement)

3.  Protection of internal structures (brain, spinal cord, chest and abdominal organs)

4.  Communication (ossicles)

5.  Mineral storage

6.  Blood cell production 

Postmenopausal hormone replacement therapy and diet also play a big role in ____ __________ and ___________.

There is a genetic link to bone strength.  Excess protein, sodium, caffeine, alcohol, smoking, or excess fiber in diet (increases calcium excretion), sodas?

Weight bearing exercise slows calcium loss and can increase bone production.  Hip replacement - need to get back up on feet quickly - avoiding falls.

1.  Collagen becomes cross-linked (less flexible) and shorter (range of motion) - minimized by stretching

2.  Reduction in blood supply to joints, including vertebrae.

3.  Vertebral disk degeneration or herniation

4.  Arthritis - inflammation of the joint. 

What is Rheumatoid Arthritis?  Who is more likely to get it men or women?  How many people have it?  

1.  acidifies food to continue digestion

2.  secretes pepsin to begin protein break down - to amino acids

3.  Stores food and doles it out to the intestine

4.  produces intrinsic factor to aid in vitamin B12 uptake. 

1.  Liver - forms the bile, detoxifies and stores toxin and rids bilirubin and detoxifies ammonia (urea).

2.  Pancreas - produces digestive enzymes (insuline and enzymes)

3.  gall bladder - stores bile between meals 

Proteins are broken down into _____ ______.

Complex carbohydrates are broken down into _______________. 

Fats are broken down into ____ _____ and ______________. 

amino acids

monosaccharides

fattyacids and monoglycerides 

Mucosa (epithelial) - contains glands that secrete digestive enzymes. Breaks down and is replaced regularly)

Submucosa - provides blood, nervous control and physical support to mucosa

Muscularis - muscles that keep things moving through

Serosa - provides covering, blood and nervous control. (helps reduce friction)

Some loss of taste buds - many elderly like spicier foods. 

Decrease in saliva production - dehydration. 

Tooth decay/periodontal disease. 

Over half of of those over 65 years have no teeth.  More difficulty healing and more susceptible to infection.

Poor motor function - uncoordinated movement of food to stomach peristalsis weaker and slower.

Esophageal rings and strictures may develop, blocking food passage.

Reflux - heart burn - sphincter can become damaged and not close well ulceration is a problem

Hiatial Hernias (stomach slipping up through the diaphragm) frequently occurs

GERD - Gastroesophogeal reflux disorder, chronic irritation, can lead to cancer. 

Antacids - neutralize acids

Acid channel blockers.

The problem is that if you block acid prodction, you will have problems breaking down the food you eat. 

Wall thinning

Irritation from gastric acid (antacids: neutralizers, H+ production blockers), aspirin (Cox2 Inhibitors help), stress, caffeine, Helicobacter pylori bacteria.

Peptic Ulcers (hole in the lining)

Atrophic Gastritis - thinning, irritation, inflammation

Acute Gastritis - reduced acid -> infections and pain medications. 

-Gallstones - (mostly cholesterol) 55% of those over 80, requires minor surgery.

-Blockage of bile duct by gallstones can lead to pancreatitis and jaundice (inflammation of the liver

-Liver size and its enzyme production reduced (not big problem for most)

-less lipid digestion enzymes

-Pancreatic cancer - 4th most common cause of cancer deaths (5%), painful, correlated with smoking, high animal fats, nitrates, coffee, and diabetes. 

-Liver detoxifies alcohol but is also damaged in the process over years leads to Liver Cirrhosis (scarring) - 7th leading cause of death in the USA. 

reduced absorption of key vitamins and minerals including: calcium, iron, zinc, and vitaimn A, D, K, B1, and B12.

Affecting skin, bone, clotting, healing, immune, rbc problems.

Small intestine ulcers (stress, caffeine)

Sometimes can become twisted. 

-Poor muscle function leads to longer transit time, drier stools (constipation), damage to mucosal lining.

-Constipation - result of poor liquid intake, longer transit time, inactivity, voluntary retention, low fiber, chronic laxative use.

-Diarrhea - food toxins, drugs, viruses

-Fecal incontinence - loss of sphincter control - surgery, injurty, diabetes, et al.

-Diverticulosis - (out pouches) from refined/processed diet (50% of over 70)

-Diverticulitis - inflammation of diverticula

-Inflammatory Bowel Disease - irritation of rectum

-Benign polyps - raised areas of cells inside colon (like raised moles)

-Colorectal cancer - (starting as benign polyps) easily (yet luckily) detected sphigmoidoscopy, colonoscopy, fecal analysis for blood.  2nd leading cancer in incidence, 3rd leading in fatalities.  Correlated with low fiber, high animal meats fats and sugars.

Hemorrhoids - varicose veins of the anus (itchy to painful) result from constipation and straining during defecation. 

Fiber loosens stools to aid in transport of excrement - protecting intestines from diverticulosis, constipation, appendicitis, hemorrhoids, colon cancer, hernias, varicose veins, gall stones.

Also provides bulk to diet to reduce calorie intake, also reduces fat, calcium, iron, magnesium and water absorption, flatulence. 

Alcohol can be used as a source of calories (and has been for several millennia).  These are empty calories, that is, few nutrients but many calories.  At high levels it is toxic (in-toxi-cated), mostly to liver, pancreas and brain.  Liver detoxifies alcohol but is also damaged in the process.  Over years leads to Liver Cirrhosis - 7th leading cause of death in the USA.  Scar (connective) tissue build up, blood supply blocked .

Pancreatitis, gallstones, hepatitis, toxic chemicals.  Brain tissue loss, leading to problems with all the things the brain does.  Drug interactions common.   

High: saturated fat, high cholesterol, smoking

Low: folic acid, antioxidants, exercise 

Increased risk: animal fat, red meats, salt, tobacco, white flour, etc.

Decreased risk: plant foods, fruits and vege's, whole grains, etc. 

Moderate reduction in testosterone level and increase in dihydroxy-testosterone (DHT).

Sperm production may diminish

Sperm ducts may narrow or be blocked preventing sperm flow

Increased voluntary control of orgasmic phase (prolonged) - good change

Declining intensity of ductal muscle contraction - less forceful ejaculation

Declining intensity of pleasureable snesation - not the lack thereof

Longer refractory phase (time before another erection possible) - may be several days 

(benign prostate hypertrophy) - most men, unknown cause but may result from increased binding of testosterone.  Places increased pressure on urinary system (frequent urination, overflow incontinence, blood in urine) may lead to impotence.  Detected early by "digital" exam.

Treatment - surgery (enlarge ureter), radiation if necessary. 

36% of cancers in men, 3rd leading cause of death from cancer in old men 72 years old is average age of diagnosis.  Detected by prostate specific antigen analysis (unreliable)

Risk factors - obesity, lack of exercise 

inability to obtain/maintain erection.  Atherosclerosis and Fibrosis in the penis slows blood flow slowing or preventing erection and decreasing maximal firmness.  Incidence increases from about 10% at age 40 to 50% at age 80. 

Causes - neural or circulatory (ED a risk factor for heart attack) in nature.   Poor circulation - atherosclerosis, lack of exercise, overeating, diabetes, prostate enlargement.  Drug causes - anti-hypertensives, antihistamines.  Neural - psychological factors, anxiety, depression, dementia, etc.

Prostate surgery clips key nerves.

Drug causes - alcohol, antidepressants, tranquilizers, appetite suppressants, ulcer drugs, etc) "sexual side effects"

Intervention: Prosthetic devices (rigid rods, bands, vacuum, pumps)

Drugs: (injectable meds, Viagra, Cialis, Levitra)

Permanent fixes - Exercise Diet and the Goat Gland man. 

Menopause is the cessation of menstruation for 1 year.  The onset is 45-55 years old, average age of 51.  Stage in life referred to as Pre- Peri- or Postmenopausal.  Associated with cessation of ovulation.  Hysterectomy causes eary menopause.

Postmenopausal decline in estrogen production leads to many changes

Symptoms:  Hot flashes (varying intensity and duration), Sleep disruption and Mood swings, Atrophy of Breast, Uterus, Vagina, Labia, sagging breasts.  Vagina becomes smaller, thinner and less elastic - more fragile.  Production of antibacterial compounds and lubricants diminishes, less acidic.  Increasing the risk of infection in vagina and nearby urethra/bladder.  Increasing the risk of injury during intercourse - commercial lubricants can help a lot.  Dryness can lead to itching.  Frequent sexual intercourse (male ED) and estrogen therapy can slow vaginal changes.  Uterine prolapse - organ attachments relax and uterus sags into vagina

Each of the intercourse phases takes longer - Excitement, Plateau, Orgasm, Resolution. 

Positives: Reduces hot flashes, vaginal dryness and itching, bone loss.  May improve brain function, and reudce Alzheimer's.

Negatives:  Significant increase in cancers of breast and uterus especially with progesterone.   

2nd leading casue of cancer death in women, 10% of women will get this.

Risk factors: Oral contraceptives (estrogen), estrogen replacement therapy, alcoholism, no children (breast feeding), high fat diet, inherited genes (BRCA1+2, HER2.

Detected early by breast self exam (lumps and enlargements), mammogram (x-ray)

Treatment: surgery (lumpectomy, mastectomy), chemotherapy, radiation 

occurs in about 2-3% of women by age 80.

Risk factors: Having sexual intercourse early after maturation, oral contraceptives, smoking, STDs