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Geriatrics > cardiopulm > Flashcards

cardiopulm Flashcards

1
Q

for a conditioned older adult is there normally a chnage in resting heart rate

A

no

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2
Q

what chnage in heart rate do we expect as we age

A

max heart rate

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3
Q

why does max heart rate change as we age

A

90% of the SA cells are gone

the cells are less responsive the hormones that tell the heart to speed up

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4
Q

what makes up CO

A

SV and Max HR

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5
Q

how are work load and CO related

A

increase in workload requires a increase in CO

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6
Q

in the young how does the heart react to increased workload

A

the HR will increase rapidly

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7
Q

in the old how does the heart react to increased workload

A

the heart rate increase less rapid and there is instead a marked increase in SV

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8
Q

what does chrotropic mean

A

timing

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9
Q

what does inotropic mean

A

contratibility

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10
Q

what is the chrotropic response to aging

A

contractility slowed

myocardium pumping ability changes
- decreased SV
- decreased CO

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11
Q

what is the inotropic response to aging

A

the cardiac vavles of the traffic directiors of the heart

control the flow of blood, can become to complient or stiff

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12
Q

what does aortic valve degeneration lead to

A

too much blood is left in the heart

greater end systolic voume

more blood is left in the left ventricle

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13
Q

what does mirtrial valve degeneration lead to

A

too little blood is returned to the heart

less end systolic volume

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14
Q

chronotropic - conduction system

A

decreased responsiviness to changes in the level of activties

fibrosis in manin bundle branches

decreased number of the pace maker cells

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15
Q

chronotropic - cardio relfexes

A

decrease baroreceptor activity

  • lag in the response times
  • rhythm problems common
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16
Q

inotropic - peri vascularture

A

thickening of vessel walls

stiffness leads to increase BP and ESV

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17
Q

what si decreased pre load

A

there is not enough blood in the heart to start with

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18
Q

how can we combat decreased pre-load

A

try to increase blood return to the heart
- LE exercises
- working larger groups of muscles

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19
Q

what is increase afterload

A

this is when there is too much blood in the heart following contraction

20
Q

how can we combat increased after load

A

improve per resistance
- low to mod instensity, consider HITT, may improve autonomic sensitivity
- avoid UE exercises and breath holding

21
Q

what does ESV mean

A

end systolic volume

greater ESV - too much blood is left in the heart

22
Q

what does EDS mean

A

end diastolic volume

lesser end diastolic volume - returns too little blood to the heart

23
Q

what is the overall change occured with chrontropic and inotropic changes

A

reduced left ventrical ejection fracture

24
Q

a LVEF of what is considered compromised

A

<30%

25
Q

what are some age related chnages that we see with the lungs

A

reduced elasticity of the lungs

less alveoli

increased stiffness of the rib cage

26
Q

what are the functional consequence of:
reduced elasticity of the lungs

less alveoli

increased stiffness of the rib cage

A

reduced vital capacity

reduced forced expiatory volume

increased functional residual capacity

27
Q

what are is the response to these changes in structure and function of the lung

A

increase cost of breathing - seen in increased RR

28
Q

what is functional residual capacity

A

the amount of air that is left in your lungs after normal passive exhalation

29
Q

what is vital capacity

A

maximum amount of air a person can expel from the lungs after a maximum inhalation

30
Q

what is forced expiatory volume

A

the volume of air that an individual can exhale during a forced breath in t seconds.

31
Q

what is the overall effect of the age changes of lungs

A

more air is left in the lungs with each breath the usual

32
Q

what is tidal volume

A

the amount of air that moves in or out of the lungs with each respiratory cycle

33
Q

with reduced tidal volume what happens to the rate of breathing

A

the freq of breathing increases

this has an energy cost impact

34
Q

exercise older adults - what HR do we want to get to

A

55-70%

70-90 for high instensity

35
Q

exercise older adults - what do we want the staring heart rate to be

A

<100 bpm

36
Q

exeercise older adults - HR and sedentary and cardiac history patients

A

take a more conservative approach 20-30 BPM above resting HR

37
Q

exercise older adults - SBP

A

15 - 20 increase

start <180 (suggest poorer health)
limit: 220 or a drop of >10

38
Q

exercise older adults - DBP

A

min rise or slight decrease

start: <95
limit: >110

39
Q

what are the goals for cardiac rehab in older adults

A

increase SV

improve O2 extraction

(decrease HR at rest)

improve resitory muscle function

general body conditioning

40
Q

what is the target HR when working with older adults

A

55-70% of max

max: 220-age

41
Q

how do we calculate the max heart rate reserve

A

220-resting HR

target HR : 55-70 of HR reserve - resting HR

42
Q

what is the max safe range of the borg and the mBORG

A

17 borg
7/9 mBORG

43
Q

tachypnea - what is a high rate

A

> 20 breath per min

44
Q

what are some signs to stop exercise in an older adult

A

HR does not increase

VO2 plateuas are workload increases

RER >1.01

45
Q

what is respiratory exchange ratio

A

the ratio between the volume of CO2 being produced by the body and the amount of O2 being consumed.

Geriatrics (11 decks)

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