1a. Geriatrics Flashcards
Frailty
slowness, grip weakness, weight loss, exhaustion, decrease in physical activity
why are older adults at risk of airway obstruction?
decrease in laryngeal and pharyngeal support
why are older adults at increased risk of pulmonary aspiration?
decreased protective airway reflexes
how does HTN contribute to perioperative risk?
perioperative risk doubles for every 20-mm Hg systolic/10-mm Hg diastolic increase in blood pressure
effects of aging in geriatrics: pulse pressure … why?
widens d/t greater/disproportionate % increase in SBP
what happens to the regulation of Ca2+ in the elderly patient?
impaired Ca2+ homeostasis. leads to myocardium generating force over a longer period after excitation (AKA reduced LV relaxation) and contributes to diastolic dysfunction.
what causes stiffening of arteries in geriatric patients?
loss of elastin and increased collagen
stiff arteries leads to …
systolic HTN
myocardial hypertrophy
impaired diastolic relaxation
what are the anesthetic consequences of stiffening arteries in geriatric patients?
labile BP, diastolic dysfunction, and sensitivity to volume status
what is the most common conduction abnormality in geriatric patients and what is the mechanism?
atrial fibrillation
calcification of pacemaker and His-bundle cells
failure of the geriatric patient to maintain preload l/t to what?
what is the pt dependent on as a result? hint: HR
an exaggerated decrease in CO; the geriatric patient is dependent on NSR and low-normal HR
effects of aging in geriatrics: lung compliance
(parenchyma)
INCERASES
effects of aging in geriatrics: chest wall compliance
DECREASES
effects of aging in geriatrics: physiologic shunt
INCREASES
effects of aging in geriatrics: oxygen exchange
inc/dec at what level?
decreases at the alveolar level
increased compliance causes…
what happens to the small airways?
small airway diameter to narrow, eventually increasing CLOSING VOLUME
closing volume exceeds FRC at approximately what ages according to position?
SUPINE: 45 years
STANDING: 65 years
effects of aging in geriatrics: vital capacity
DECREASES
what lung volumes are increased in geriatrics?
residual volume
FRC
closing volume
effects of aging in geriatrics: total lung capacity
unchanged