Term
|
Definition
random DNA errors
specific gene
mutations of cells c age
limited # of cell divisions possible
decr in cholinergic cells
damage from free radicals
hormonal alterations
cellular inflammation |
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|
Term
| Neurological Changes - neuroanatomy (3) |
|
Definition
15% wt loss of brain (age 80; mostly myelinated, not cells)
incr CNS fluid spaces
decr gyri bulk, incr sulci widening |
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Term
| Neurological Changes - histological (5) |
|
Definition
decr # of cortical neurons (37% decr in SC axons)
decr dendrite size/#
decr synaptic density (cortex)
decr myelination
neurofibrillary tangles & neuritic plaques |
|
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Term
| Implications of neuroanatomical changes |
|
Definition
| less functioning tissue >> decr CNS abilities in all areas |
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Term
| Implications of histological neurological changes (4) |
|
Definition
dementia
slower neural transmission
slower processing input
development of new patterns of mvmt |
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|
Term
| Prevalence of dementia, by age (4) |
|
Definition
>65yo 5%
>75yo 20%
>90yo 35%
Nrsg Hm 50% |
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|
Term
| Slower neural transmission (due to CNS histo changes) >> ... |
|
Definition
incr response time (sensory)
incr reaction time (neuromuscular) |
|
|
Term
| Slower processing input (due to CNS histo changes) >> ... |
|
Definition
| changed patterns of movement, lower degree of skill |
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|
Term
| Cardiovascular Changes (7) |
|
Definition
decr resting BMR
incr BP
decr VO2max
decr blood flow/O2 delivery
decr neurotransmitters
altered hormonal response (esp c exercise)
decr neuromuscular response |
|
|
Term
| decr resting BMR is due to... |
|
Definition
|
|
Term
|
Definition
| decr elasticity of vascular system |
|
|
Term
| decr VO2max is due to... (3) |
|
Definition
cellular changes in enzymes
decr ability to extract O2
loss of cells (& mitochondria) |
|
|
Term
| Neurotransmitters commonly decreased with aging |
|
Definition
|
|
Term
| Implications of cardiovascular changes (3) |
|
Definition
slowed response to training >> lower potential
slower healing (blood flow)
incr rxn time >> incr risk of falls, etc |
|
|
Term
| Musculoskeletal changes (7) |
|
Definition
decr Type II fibers (fast twitch)
decr mass
decr water in cells
decr CT elasticity
collagen alterations
bone density alterations
incr fat mass |
|
|
Term
| Implications of musculoskeletal changes (4) |
|
Definition
decr strength/power/fxn activity >> incr fall risk
decr mm strains
decr shock absorption
incr fx |
|
|
Term
| Loss of lean mm mass per decade... |
|
Definition
|
|
Term
| Loss of lean mm mass: gender prevalence |
|
Definition
|
|
Term
| changes in connective tissue elasticity |
|
Definition
| incr CT in endomysium/perimysium (skeletal mm) >> incr stiffness >> decr ROM |
|
|
Term
| Musculoskeletal changes - Collagen alterations (4) |
|
Definition
decr collagen in ligts
incr # of small diameter collagen fibrils
decr stability during high forces >> abnormal jt mech >> incr jt stress
ACL 3x more likely to be stiff |
|
|
Term
| Greatest rate of fat mass gain (age range) |
|
Definition
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|
Term
| Musculoskeletal changes - bone density alterations (2) |
|
Definition
ratio of inorganic to organic
bone mineral content |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| T-Score: less than -2.5, c hx of fx |
|
Definition
|
|
Term
| Amt of bone loss before visible on XRay |
|
Definition
|
|
Term
| Amt of bone loss possible by 85 y/o |
|
Definition
|
|
Term
| Loss of height/decade after age 40 |
|
Definition
3% loss of height per decade
(example:
40yo 5'6"
50yo 5'4"
60yo 5'2"
70yo 5'0"
80yo 4'10") |
|
|
Term
| Primary Osteoporosis: Type I |
|
Definition
postmenopausal
characterized by loss of trabecular bone
greatest loss FIRST FIVE YEARS |
|
|
Term
| Primary Osteoporosis: Type II |
|
Definition
| involutional or senile osteoporosis |
|
|
Term
| Uncontrollable risk factors for osteoporosis (5) |
|
Definition
fair-skinned, European woman
northern European ancestry
family hx of osteoporosis
small frame
post-menopausal, hysterectomy (before 45y/o increases risk) |
|
|
Term
| Controllable risk factors for osteoporosis (7) |
|
Definition
underweight/chronic dieter
smoking
inactivity
excessive alcohol intake
≥6 cans/day of carbonated beverages
high protein diet
caffeine |
|
|
Term
| Cause of effect on osteoporosis - underweight/chronic dieter |
|
Definition
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|
Term
| Cause of effect on osteoporosis - smoking |
|
Definition
| inhibits production of estrogen |
|
|
Term
| Cause of effect on osteoporosis - excessive alcohol intake (>2-3 oz/day) |
|
Definition
| interferes c Ca/hormones/vitamin intake |
|
|
Term
| Cause of effect on osteoporosis - excessive carbonated beverages |
|
Definition
| phosphorus in drinks >> decr Ca in bones |
|
|
Term
| Cause of effect on osteoporosis - high protein diet |
|
Definition
|
|
Term
| Cause of effect on osteoporosis - caffeine |
|
Definition
mild diuretic >> Ca loss
potential effect on osteoblast viability |
|
|
Term
|
Definition
| caused by meds, diseases, other conditions |
|
|
Term
| Causes of secondary osteoporosis (11) |
|
Definition
hyperparathyroidism
diabetes
liver disease
hypo/hyperthyroidism
RA
rickets
Paget's disease
polio
SCI
corticosteroid prescription drug use
anticonvulsants |
|
|
Term
| Cause of effect on osteoporosis - hyperparathyroidism |
|
Definition
|
|
Term
| Cause of effect on osteoporosis - diabetes |
|
Definition
| insulin >> bone demineralization & remodeling |
|
|
Term
| Cause of effect on osteoporosis - liver disease |
|
Definition
| liver synthesizes vitamin D >> absorption of Ca |
|
|
Term
| Cause of effect on osteoporosis - hypo/hyperthyroidism |
|
Definition
incr excretion of Ca & P in urinary tract/bowel
(e.g. Grave's disease) |
|
|
Term
| Cause of effect on osteoporosis - RA |
|
Definition
| meds = steroids >> demineralization |
|
|
Term
| Cause of effect on osteoporosis - rickets |
|
Definition
| bone fails to fully mineralize (vit D deficiency) |
|
|
Term
| Cause of effect on osteoporosis - Paget's disease |
|
Definition
| imbalance of osteoblast/osteoclast activity |
|
|
Term
| Major locations of Ca regulation (3) |
|
Definition
GI tract: parathyroid incr absoprtion of Ca
Kidneys: Ca & P reabsorption
Bone: Ca & P reabsorption |
|
|
Term
| Treatment/Prevention of Osteoporosis (3) |
|
Definition
weight-bearing exercise
nutrition
meds |
|
|
Term
| Most beneficial mode of weight-bearing exercise |
|
Definition
resistance training
(aerobic is beneficial, but not as beneficial as resistance) |
|
|
Term
| Suggestions for nutrition for osteoporotic individuals (3) |
|
Definition
Calcium (1200mg/day for 50+ y/o)
vitamin D (10µg/day 51-70 y/o; 15µg for 70+ y/o)
Ø caffeine |
|
|
Term
| Suggested amt of sun exposure fo vitamin D intake |
|
Definition
5-30 min, 2x/week
(400-600 units/day) |
|
|
Term
| Meds for osteoporosis (5) |
|
Definition
Biphosphanates (Fosamax)
Calcitonin (Miacalcin)
Raloxifene (SERM - selective HRT)
estrogen (HRT)
Zeldronic acid (Reclast, Zometa) (Paget's disease; not yet osteoporosis) |
|
|
Term
| Mech of action: biphosphanates |
|
Definition
slow rate of bone breakdown by inhibiting osteoclasts
(needs to be taken on empty stomach, then fast for 1/2 hr, remain upright) |
|
|
Term
| Mech of action: calcitonin |
|
Definition
inhibits osteoclasts
(nasal spray; naturally occurring hormone) |
|
|
Term
| Mech of action: Raloxifene |
|
Definition
incr bone mass, lower cholesterol;
reduced side-effects (no affect on uterine lining)
decr risk of breast CA(?) |
|
|
Term
| Mech of action: estrogen (HRT) |
|
Definition
maintains/INCREASES bone mass
lower cholesterol
decr risk of colon CA
(incr risk of uterine CA when used alone; risk eliminated when used c progesterone)
(slightly incr risk of embolism/CVA) |
|
|
Term
| Mech of action: Zeldronic acid |
|
Definition
similar to biphosphanates
15-minute yearly infusion
(significantly higher rate of serious a-fib) |
|
|
Term
| Osteoporosis Rx: acute phase (5) |
|
Definition
bed rest
bracing
pain relief (IFC/TENS)
posture training
reacher |
|
|
Term
| Osteoporosis Rx: subacute phase |
|
Definition
STRENGTHEN:
abs
back ext
scaps
hip ext |
|
|
Term
| Pulmonary changes - decreases (7) |
|
Definition
decreased:
vital capacity
maximal flow rates
strength of respiratory mm
elastic fibers in lungs
elastic recoil
alveolar surface area (60m2 = normal)
tidal volume |
|
|
Term
| Pulmonary changes - increases (3) |
|
Definition
increased:
chest wall stiffness
functional reserve capacity
respiratory rate |
|
|
Term
| Hormonal changes - decreases (4) |
|
Definition
estrogen, progesterone (women)
testosterone (men)
glucose tolerance
growth hormone |
|
|
Term
| Hormonal changes - increases (2) |
|
Definition
insulin concentration
hormonal response to stress |
|
|
Term
| Genito-urinary changes (3) |
|
Definition
decr vasopressin
decr glomerular filtration rate
incr atrial natriuretic peptide |
|
|
Term
| Implications of genitourinary changes |
|
Definition
|
|
Term
| integumentary changes (9) |
|
Definition
decreased:
fxn of protection, excretion, secretion, absorption, thermoreg
turnover of epidermal cells
# of keratinocytes & fibroblasts
hair/nail growth
vit D synthesis
density of Langerhans cells
production of epidermal thymocyte-activating factor
increased:
fibrosis
atrophy |
|
|
Term
| implications of decreased production of epidermal thymocyte-activating factor |
|
Definition
| decreased enhancement of T-cell response >> decr immune response |
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