CVP ISSUES- OLDER ADULT Flashcards
What happens to FEV1 as we age?
at about 10 years–> dramatic increase in FEV1
increase from 10 -20 years
gradual decline in FEV1 after age 20 ish
What happens to various lung volumes as we age?
DECREASED:
-IRV
-ERV
INCREASED
-residual volume (amount of air that cannot be expelled from the lungs)
Aging and the alveolar-arterial gradient
is the difference between the alveolar concentration (A) of oxygen and the arterial (a) concentration of oxygen.
NORMAL: 0 cmH2O
100-100 = 0
normally increases with age –> gas exchange gets more difficulty the older we get
the measurement of o2 in the blood decreases with age
Oxygen saturation and living in elevation:
-air pressure is reduced at higher elevations–> the amount of o2 is the same, what differs is the atmospheric pressure –> less pressure pushing oxygen gas into the bloodstream
-a pulse ox reading may be lower for someone in denver–> may be more reliant on supp oxygen
Normal relationship between PaO2 and SpO2:
PaO2 > 80 mmHg –> SpO2 >93%
PaO2:< 60 mmHg –> SpO2 <88%
What happens to common PFTs with aging?
FEV1: decreased
FVC: dec
TLC : unchanged
VITAL CAPACITY: dec
FRC: inc.
RV: inc.
GAS EXCHANGE: dec
Aging and the MSK pump (MIP and MEP)
MIP:
-maximal inspiratory pressure
MEP
-maximal expiratory pressure
** overtime, inspiratory and expiratory muscle strength decreases
MVV- max voluntary ventilation changes with aging
(measure of respiratory muscle endurance)
-decrease in resp muscle endurance with aging
Aging and diaphragm
-decreased diaphragm strength/force generation
-increased rigidity
-age related decline in Type II fibers combined with ms. atrophy
-dec MIP
-dec MEP
-dec MVV (endurance)
Aging and chest wall
Decreased chest wall compliance
-Thoracic rigidity
–> kyphoscoliosis
–> calcification and intercostal cartilage
–>arthritis of costovertebral joints
–> alteration of chest wall mechanics –> decreased compliance
-increased contribution of intercostal muscles (accessory muscles) for effective ventilation
–> due to thoracic rigidity
Aging and pulmonary changes:
-increased accessory ms. use
-increased WOB
-decrease gas exchange efficiency
–> increased risk of hypoxemia (desat)
-increased ventilation compared to younger at same work loads
-diminished cough reflex
–> increased susceptibility to resp infections
Aging and arteriosclerosis:
-with aging, vasculature gets stiffer
-our aorta and blood vessels stiffen
-increased LV afterload
-increased LV pumping work
-increased LV hypertrophy
–> can lead to heart failure
** with aging, CV decline looks like heart failure
What type of pulmonary condition do the aging lungs look like?
obstructive pulmonary disease
Improvement in carotid artery compliance in late middle aged adults that underwent aerobic exercise program for 12 weeks:
30% increase after 12 week of mod intensity aerobic ex
previously sedentary later middle-aged men and women
Collagen changes in vasculature:
ANIMAL STUDY:
-collagen I expression greater in older mice compared with younger controls–> stiffer arteries
-wheel running for 10-14 weeks reverses carotid artery collagen to levels at or below those of young controls