Geriatric Patient

Question 1

6 important changes to MSK system that happens with aging?

Answer 1

Loss of muscle mass
Loss of bone mass
Decreased height
Decreased body water
Increased fat
Change in metabolism

Question 2

5 common MSK complaints by old people?

3 inflammatory complaints by old people?

Answer 2

Cervical stenosis, OA, OP, Low back pain, and Carpel tunnel.

RA, PMR, and psoriatic arthritis

Question 3

6 neck pain co morbidities?

Answer 3

CV disease
Dizziness
Low back pain
OA OA
Orthostatic hypotension
Shoulder pain

Question 4

What is the leading cause of LE disability in older adults?

What age do patients rapidly get OA or are at more risk?

Answer 4

OA

50

Question 5

1 common complaint of OA?
What does X ray commonly show?
Goal of medical treatment?

Answer 5

Night pain, its messing up my sleep
Narrowed joint space
Pain relief

Question 6

Because of the effects on the brain because of aging, what are 3 clinical signs we are worried about?

Answer 6

Memory gone, IQ down, and falls/accidents

Question 7

6 neurological complaints form old people?

Answer 7

MS, Parkinson, stroke, dementia, sciatic and vertigo.

Question 8

What reflex may be absent in older adults?

Answer 8

Ankle

Question 9

What is the fastest growing source of disability due to neurological disorders?
Onset of age?
Risk factor?

Answer 9

Parkinson
Over 40
Old age

Question 10

5 PE signs of Parkinson’s Disease?

Answer 10

Tremor, slow walk, rigidity, postural instability, shuffle walk

Question 11

4 meds to give for Parkinson’s?

Answer 11

Levodopa, amantidine, MAO blockers, and anticholinergics

Question 12

1 pulmonary condition and 1 CV condition to consider for the aging population?

Answer 12

Pneumonia

HTN

Question 13

HTN is present in most people suffering from what 3 conditions?
Also, what other condition is a major risk factor for HTN?

Answer 13

MI, stroke, and CHF

kidney disease

Question 14

Patients with Parkinson’s may be more susceptible to somatic dysfunction in what 2 areas?

Answer 14

Cranial/head and cervical regions

Question 15

What two areas of the body to treat for HTN?

Answer 15

Cervical and thoracic

Question 16

Talk about the goal of OMT in the elderly patient with pneumonia?

Answer 16

Old people with pneumonia, who can’t move or get out of bed, have a much higher risk of dying.

So we want to get them out of bed and moving, and if they cant get out of bed, then do different lymphatic pumps to mobilize fluid

Question 17

2 conditions to consider from the metabolic energetic immune model?

Answer 17

Infection and constipation

Question 18

What is one of the primary reasons why older people are more susceptible to infection and give 2 examples?

Answer 18

Immune system gets weaker as they get older

Declined T cell function and decline in antibody response

Question 19

What is a concerning fever in healthy older patients and more frail older patients?

Answer 19

100.4 or 38

100 or 37.8 or 1.1 above baseline

Question 20

Treatment plan for infection in an old person?

Answer 20

Antibiotics

OMT for lymphatic flow, fluid mobilization, and respiratory circulatory

Question 21

OMT and LT protocol with patients in nursing homes reduced two things?

Answer 21

Hospitalization and medications usage

Question 22

What was the result of OMT on blood cell counts? 1 thing.

Answer 22

Lowered platelet count

Question 23

For constipation in a patient, what will the viscerosomatic levels be and Chapman reflexes?

Answer 23

10-12 for colon

Lateral IT band anterior
And l2-l4 posterior

Question 24

4 things to include in the treatment plan for constipation?

Answer 24

Lifestyle mods, so exercise and fluid increase
Dietary changes, fiber
Laxatives
OMT, mesenteric release and normalize autonomics

Question 25

2 behavior conditions to consider for old people?

Answer 25

Fall risk and depression

Question 26

What is the fall risk assessment called?

2 things that reduced falls for treatment?

Answer 26

Get up and go, observe them get up from chair, walk and return to chair to sit down

Vitamin D and exercise/PT

Question 27

What is the score on the geriatric depression scale that is probable depression?

Answer 27

Over 5/15

Question 28

On the mini mental exam...
What is the max score?
score of mild impairment?
Score of moderate impairment?
Score of severe impairment?

Answer 28

30
21-29
10-20
Less than 10

Question 29

OMT for depression?

Answer 29

Can present just as atypical SDs so treat whatever is bothering them. LBP is common