Geriatrics Flashcards
aging is characterized by a varying, progressive loss of functional reserve in what organs
ALL
CV function declines ___% from 20-80yo
50%
peripheral vasculature has increased wall thickness, increased diameter, and consequent stiffening of the aorta and large arteries, leading to less ability to vasodilator. this all means what
arteries are less compliant
_______ is common d/t poorly complaint blood vessels, decreased CO, and increased Peripheral vascular resistance
Systemic HTN
Myocardial changes include what?
increased LV wall thickness
decreased myocardial compliance
thickening of aortic valve cusps
LV hypertrophy results from increased ______, secondary to elevated peripheral vascular resistance
Afterload
impaired myocardial pump function and reduced CO will prolong what?
circulation time (that is circulation time increases)
increased circulation time causes a decreased perfusion to the vessel rich group such as the
brain
heart
liver
what happens to the lung volume and capacity in the elderly:
RV
INCREASE
what happens to the lung volume and capacity in the elderly:
ERV
DECREASE
what happens to the lung volume and capacity in the elderly:
FRC
INCREASES
what happens to the lung volume and capacity in the elderly:
CC
INCREASES
what happens to the lung volume and capacity in the elderly:
IC
DECREASED
what happens to the lung volume and capacity in the elderly:
VC
DECREASED
what happens to the lung volume and capacity in the elderly:
TLC
NO CHANGE
the reduction in elastic tissue along with an increased amount of college equals a ___% reduction in functional alveolar surface area by age 70
15%
what happens to CBF and brain mass
decrease about 20-30% (by age 80)
what happens to cerebral auto regulation of blood flow
nothing-it is preserved
what happens to intracranial volume?
decreases
- the most rapid reduction occurring in gray matter
what happens to sensory block with spinals
increases
Do you need to increases or decrease the dosing for epidural segmental dosing
decrease
what happens to the doses for local and general anesthestics
decrease
epidural volume tends to result in more extensive ___ spread
cephalad
epidural volume tends to result in more extensive cephalad spread, but accompanied by a shorter _______ and _____
duration
motor block
what happens to spinal anesthetics duration of action
longer
what happens to MAC requirements
decreased MAC requirements
what happens to the dose requirements of opioids, bento’s, barb’s, LA
all decreases
what are 2 complications the elderly may face postop
POCD
Postop delerium
Pharmacology:
administration of a ___-soluble drug may lead to a concentrated drug and quick effects, bc the Vd is SMALL
water
Pharmacology:
if you admits a ____-solube drug you will get a lower plasma concentration and a decreased rate of elimination
Lipid
Pharmacology:
I’ll state the change and you give the anesthetic consequence:
Decreased/contracted vascular volume
high initial plasma concentration
