Geriatrics Flashcards
If weakness/decreased power fit patterns of _______ = positive prognosis for recovery
patterns of inactivity
If weakness does not fit w/ ___________, consider additional pathology
weakness does not fit w/ disuse and aging
What type of training programs produce quicker and more predictable results?
high-intensity and power training programs (70-80% of 1-rep max) produce quicker and more predictable results than moderate intensity program
What should postural exercise focus on?
strengthening postural extensors and scapular stabilizers
presbyopia
visual loss characterized by inability to focus properly and blurred images due to loss of accommodation, elasticity of lens
glaucoma
increased intraocular pressure, w/ degeneration of optic disc, atrophy of optic nerve
- leads to loss of peripheral vision and progresses to total blindness
senile macular degeneration
loss of central vision associated w/ age-related degeneration of macula (caused by decreased blood supply or abnormal growth of blood vessels under the retina)
diabetic retinopathy
damage to retinal capillaries
- leads to retinal scarring and finally retinal detachment
- central vision impairment (complete blindness is rare)
conductive hearing loss
mechanical hearing loss from damage to external auditory canal
sensorineural hearing loss
central or neural hearing loss
presbycusis
sensorineural hearing loss associated w/ middle and older ages
- characterized by bilateral hearing loss, especially at high frequencies at first
otosclerosis
immobility of stapes results in profound conductive hearing loss
lateralization to the right during Weber test means what?
conductive hearing loss on right OR
sensorineural hearing loss on left
Negative Rinne test result
- pt can hear tunning fork when placed on mastoid process but does not hear it when placed next to ear OR sound is not as loud when next to ear compared to when held at mastoid process
= conductive hearing loss
Positive Rinne test
- tuning fork sound is louder when held next to ear compared to when held at mastoid process
(air conduction is intact)
= sensorineural hearing loss
Weber test - lateralized to right
Rinne test - + bilaterally
L sensorineural hearing loss
- Weber test indicates either conductive hearing loss on R or sensorineural hearing loss on L
- Rinne test determines that air conduction is > than bone conduction so it rules out conductive hearing loss
Weber test - lateralized to right
Rinne test - (-) to R
R-sided conductive hearing loss
- Weber test indicates either conductive hearing loss on R or sensorineural hearing loss on L
- Rinne test determines that air conduction is < than bone conduction on R side so it rules out sensorineural hearing loss
Weber test - no lateralization
Rinne test - (+) bilaterally
normal hearing or bilaterally = sensorineural hearing loss
- Weber test = normal hearing or bilateral conductive or hearing loss
- Rinne test - air conduction > than bone conduction which rules out conductive hearing loss bilaterally
Weber test - no lateralization
Rinne test - (-) bilaterally
symmetrical conductive hearing loss
- Weber test = normal hearing or bilateral conductive or hearing loss
- Rinne - air conduction < bone conduction indicating conductive hearing loss
At what age is there accelerated vestibular decline?
ages 55-60
VOR decreases begin at 30
What provides a better indication of hypoxia during exercises w/ older adults?
changes in mentation and affect
- clinical signs of hypoxia may be blunted
urinary stress incontinence is related to what?
- how is it managed
weakness of the pelvic floor muscles
- managed through pelvic floor strengthening/motor control exercises
urge incontinence is related to what?
- how is it managed
bladder problems
- managed through medications, behavioral change, and pelvic floor exercise
Bone mineral density for osteoporosis
> /= 2.5 standard deviations
bone mineral density for osteopenia
BMD between 1 and 2.5 SD
medications that affect bone loss
- corticosteroids
- thyroid hormone
- anticonvulsants
- catabolic changes
- some estrogen antagonists
- chemotherapy
Other risk factors that may affect bone loss
- family hx
- Caucasion/asian race
- late menopause
- thin/small build
- smoking
What areas are more affected w/ bone loss
Trabecular bone more involved than cortical bone
- vertebral column
- femoral neck
- distal radius/wrist, humerus
common fx areas of spine
How do they occur?
lumbodorsal junction
- T8-T12 and L4
typically from routine activity - bending, lifting, rising from chair
acute phase treatment after fracture of spine
- horizontal bed rest, out of bed 10 min every hour
- isometric extension exercises in bed
- emphasis on proper posture, extension in sleeping, sitting, and standing
chronic phase treatment after fracture of spine
- strengthening regimen for postural extensors and scap stabilizers
- avoid flexion activities
- decrease vertebral loading (trial lying down 15-30 min after prolonged upright activities)
mini mental score that is indicative of mental decline/dementia
< 24 out of 30
Geriatric depression score indicative of depression
> 8
hypothyroidism is associated w/ what in older adults?
memory loss
- important to rule out w/ progressive decline
