GERIATRIC AND END OF LIFE Flashcards
The inflammatory phase of wound healing in elderly patients is characterized by:
vascular permeability reduced by a nitric oxide
leads to a decrease in neutrophil, lymphocyte, and macrophage infiltration.
macrophage function is reduced
changes are counterbalanced by an increased secretion of inflammatory mediators by these cells in the wound.
Ventilatory responses to hypoxia and hypercapnia in elderly
fall by 50% and 40%, respectively, with aging.
likely involves reduced chemoreceptor function.
at the peripheral or central nervous system level.
The subjective feeling of dyspnea in response to bronchoconstriction may also decline
During aging, pulmonary changes
decline in
vital capacity
forced expiratory volume
because of decreasing
muscle strength,
oss of functional alveolar units
decrease in functional alveolar units and thickening of the interstitium account for the decrease in compliance and a decreased diffusion capacity. T
relative increase in
functional residual capacity.
Total lung capacity (TLC) remains unchanged
Because TLC remains unchanged, the increase in RV results in a decrease in vital capacity (VC).
only a mild increase in resting lung volume, or functional residual capacity (FRC).
balance between elastic recoil and chest wall compliance affects lung volumes and ventilatory flow rates in the elderly
loss of elastic inward recoil of the lung with aging (CAREFUL - INCREASED compliance - think of this as floppy is bad)
countered somewhat by decline in outward forces of chest wall (decreased compliance).
pao2 pco2 changes in elderly
Arterial oxygen tension falls by approximately 5 mm Hg per decade from age 20.
The partial pressure of CO2, however, does not change in spite of an increase in dead space.
BUT CAREFUL - Ventilatory responses to o2 and co2 drop by 40-50%!
glucose intolerance in elderly
yes
level of activity and body composition, with increased adipose tissue and decreased lean muscle mass, rather than direct effects of age on insulin action.
decrease in insulin-mediated muscle glucose metabolism and an increase in intracellular lipid accumulation that may be a direct effect of changes in mitochondrial function that accompany aging.
These changes may likewise be compounded by comorbidity, medications, and genetic factors
Cardiac changes in elderly
diminished compliance (less stretchable - fibrotic),
reduction in maximal heart rate,
diminished early left ventricular diastolic filling.
kidneys demonstrate an age-related decrease in
dcr glomerular filtration rate
dcr excretory capacity because of loss of functional glomerular units.
Orthopedic fractures are frequently caused by what factors in elderly
osteoporosis, increased bone reabsorption, loss of estrogenic hormones, diminished physical activity, age-related impairment in calcium absorption by the intestine.
