Anatomy of ageing

Question 1

average loss of height per decade

Answer 1

1cm

Question 2

why do we lose height as we age (5)

Answer 2

narrowing of inter-vertebral discs
Osteoporosis
Vertebral collapse
Kyphosis
Loss of arches of foot

Question 3

what is osteoporosis

Answer 3

loss of bone density

Question 4

Tx for osteoporosis

Answer 4

oestrogen replacement

bisphosphonates

calcium supplements

exercise

decreased alcohol and smoking

Question 5

risks associated with osteoporosis

Answer 5

fractures- NOF, colles

Question 6

characteristic sign of a NOF fracture

Answer 6

shortened, externally rotated leg due to psoas major traction

Question 7

what is Pagets disease aka osteitis deformans

Answer 7

Excessive breakdown and formation of bone.

Disorganised remodelling of bone

Question 8

consequences of paget’s disease

Answer 8

weakness and fractures

pain/pressure on nerves

Question 9

what is osteoarthritis

Answer 9

age related joint degeneration

Question 10

symptoms of osteoarthritis

Answer 10

Causes pain, stiffness, loss of function.

Question 11

define valgus

Answer 11

joint deviating away from midline eg. genu valgus

Question 12

define varus

Answer 12

joint deviated towards midline

Question 13

what is a hallux valgus?

Answer 13

bunion

Question 14

describe skin changes

Answer 14

Loss of collagen & elastin.
Causes wrinkles & sagging.
↑ fragility & injury.
Fragile vessels= purpura
↓ sebum production= dryness
↓ melanocytes= pallor.
↓ sub-cutaneous fat= loss of padding and insulation
↓ production of sweat
↓ Thermo-regulatory control
Pigmentation

Question 15

describe facial changes

Answer 15

Loss of pigment from hair
Hair loss from scalp
Excess hair (nose/ears)
Skin wrinkles
Laxity of skin
Lengthening of ears & nose
Lengthening of nose
Sunken eyes
Reduced jaw mass (bone/gum)
Prominent forehead

Question 16

describe changes in eyes

Answer 16

cataracts
gradual loss of vision
corneal arcus
xanthalasma

Question 17

what is ectropion

Answer 17

Out-turning of lower eyelid due to weakness of palpebral ligaments.

Question 18

what is entropion

Answer 18

Inward turning of lower eyelid due to weakness of peri-orbital muscles.

Question 19

what can cause long-sightedness

Answer 19

Weakening of ciliary muscle.

Loss of elasticity of lens.

Question 20

what is presbyopia

Answer 20

long-sightedness

Question 21

what is glaucoma

Answer 21

Raised intra-ocular pressure, that damages retina & optic nerve and leads to loss of vision.

Obstruction of the trabecular network in the ‘canal of Schlemm’
Aqueous humour absorbed slower than it is formed.
Pressure on lens, then vitreous humour, then choroid & retina.

Question 22

what can cause cerebral atrophy?

Answer 22

Injury: Cerebral palsy, CVA, trauma, steroids.
Infection: Encephalitis, syphilis, AIDS.
Metabolic: Diabetes mellitus, malnutrition, anorexia, vitamin deficiency.
Degenerative: Multiple sclerosis, Alzheimer’s, vascular, Pick’s disease.
Genetic: Huntingdon’s chorea.
Epilepsy
Alcohol.

Question 23

consequences of atheroma

Answer 23

Rupture of plaques.
Clot formation.
Narrowing of lumen.
Thrombosis.
Embolism
Thrombosis of anterior inter-ventricular (Left Anterior Descending) artery is commonest cause of myocardial infarction

Question 24

common valvular changes in ageing

Answer 24

Stenosis
Incompetence
Murmurs
Thrills
Bruits
Ventricular hypertrophy

Question 25

what causes varicose veins

Answer 25

Incompetent valves lead to retrograde flow.

Veins become dilated & tortuous

Question 26

describe some age related pulmonary changes

Answer 26

Loss of elasticity
Narrowing of airways.
Reduced ciliary activity & secretion of mucous membranes.
Collapse of alveoli.
Reduced surface area of alveoli.
‘Senile emphysema’
Reduced compliance of thoracic cage: -Loss of elasticity -Calcification of ribs -Loss of respiratory muscle mass

Question 27

what is a volvulus?

Answer 27

mal rotation of a loop of bowel

Question 28

consequences of volvulus

Answer 28

obstruction and ischaemia

Question 29

what is a cystocoele

Answer 29

Prolapsed bladder

Question 30

what is a rectocoele

Answer 30

prolapsed rectum