Geriatrics- Ch. 5

Question 1

The leading causes of death in persons over 65 in order of frequency

Answer 1

1. Coronary heart disease (CHD)- 31%
2. Cancer- 20%
3. Cerebrovascular disease (Stroke)- 20%
4. Chronic obstructive pulmonary disease (COPD)
5. Flu/Pneumonia

Question 2

Decreased activity levels are referred to as _____ and causes muscular system changes in older adults more so than the aging process itself

Answer 2

Hypokinesis

Question 3

___ help enable long-endurance feats such as distance running, while ____ fatigue faster but are used in powerful bursts of movements like sprinting. Older adults have changes in muscle fiber composition which causes a decrease in Type II with an increase in Type I.

Answer 3

Slow-twitch muscles (Type I)

Fast-twitch muscles (Type II)

Question 4

To improve the muscular system, we can 1) improve health by ____, ____, and ____ 2) increase levels of physical activity while ____ and _____ 3) provide strength training by ____ and ___ 4) provide flexibility training and ROM exercises by ____ and ____.

Answer 4

Correcting medical problems that may cause weakness
Improving nutrition
Addressing alcoholism and substance abuse

Gradually increasing intensity
Including adequate warm ups/cool downs

Using isometric, progressive resistive exercises
Using high intensity training programs.

Using slow, prolonged stretch
Using heat prior

Question 5

Age is not a limiting factor when it comes to strength training! However, ____ gains are slower with older adults.

Answer 5

mobility

Question 6

You always want to maintain ____ and ____ within functional activities

Answer 6

strength and ROM

Question 7

Neurological changes include slowed nerve conduction where the _____ loss is greater than ____

Answer 7

Sensory

Motor

Question 8

Types of tremors include rest tremors, action tremors consisting of ____, ____ and ____.

Answer 8

Postural, kinetic and intention

Question 9

___ is present while voluntarily maintaining a position against gravity, i.e. arm outstretched.

Answer 9

Postural tremor

Question 10

____ occurs during movement of a body part.

Answer 10

Kinetic Tremor

Question 11

Age related tremors affect the ____, ____ and ____. They are _____.

Answer 11

hands, head and voice

progressive

Question 12

Neurological system changes negatively affect ___ and movement, specifically decreased _____ , ____ and ____.

Answer 12

Strength
Speed and coordination
Fine motor control
Reaction time

Question 13

To improve the neurological system, we can 1) improve health by ____ and ____ 2) increase levels of physical activity to ____ 3) improve motor learning and control by ____, ____ and ____.

Answer 13

Correcting medical problems, e.g. improving cerebral blood flow
Improving diet, smoking cessation

Improve cerebral circulation

Allowing for increased reaction and movement times to improve motivation/accuracy
Allowing for limitations of memory avoiding long movement sequences
Stressing familiar well learned skills using repetitive movements

Question 14

In terms of skeletal system changes, ______ changes occur in more than 60% of older adults.

Answer 14

degenerative joint

Question 15

____ occurs in the thoracic spine and ___ occurs in the lumbar spine

Answer 15

Kyphosis

flattening

Question 16

Maintenance of _____ is important for joint health and mobility since there is an increased risk of ___.

Answer 16

Weight bearing

Falls/fractures

Question 17

Strategies to improve skeletal system are ____, ____ and ____.

Answer 17

Postural exercises (decreases intervertebral disk flattening)
Weight bearing exercises (decreases bone loss)
Nutritional/hormonal/medical therapies

Question 18

Farsightedness caused by loss of elasticity in the lens

Answer 18

Presbyopia

Question 19

Vision related changes include decreased ____ in corneal reflex and _____ responses that cause ____, ___ and ____.

Answer 19

sensitivity
oculomotor
Ptosis, restricted upward gaze, reduced pursuits

Question 20

The number one cause of vision loss in adults over 60 years of age. A progressive and irreversible loss of central vision causing central scotomas (dense localized visual deficit that creates a blind spot) due to degeneration of the macula.

Answer 20

macular degeneration

Question 21

Caused by clouding over the lens of the eye, decreasing the amount of light passing through the lens and limiting vision. The most common form of cataracts affects distant vision, then near vision, eventually causing blurriness and muted colors throughout the entire visual field. Affects central vision first and then peripheral

Answer 21

Cataracts

Question 22

Caused by an increase in intraocular pressure due to fluid buildup in the eye, resulting in compression of and damage to the optic nerve. Causes peripheral vision loss (tunnel vision) and in end stages, may impact central visual field as well. The most frequent cause of visual field damage and the second leading cause of blindness; is commonly referred to as “the silent thief” since peripheral field loss is harder to notice.

Answer 22

Glaucoma

Question 23

Affects ~40% of all individuals with diabetes. Affects the small blood vessels in the retina, causing floaters from blood leakage and can result in impairment ranging from mild to total blindness. Vision may fluctuate based on dysregulated sugar levels, and the field of view that is affected depends on the areas of the retina that are affected so can have loss of central or peripheral vision.

Answer 23

Diabetic Retinopathy

Question 24

Sensory cues to assist someone with vision difficulties include ____ and ____.

Answer 24

Verbal descriptions

Touching to convey listening

Question 25

____ hearing loss occurs when there is damage along the route through the outer ear, tympanic membrane (eardrum), or middle ear (ossicles). Along with hearing loss it can also cause ___.

Answer 25

Conductive

Tinnitus

Question 26

____ hearing loss is caused by damage to the inner ear or the nerve from the ear to the brain.

Answer 26

Sensorineural

Question 27

___ is usually a sensorineural hearing disorder associated with middle/older age that causes ___ hearing loss, auditory discrimination problems and ____. It is most commonly caused by gradual changes in the inner ear.

Answer 27

Presbycusis
bilateral
tinnitus

Question 28

Immobility of stapes causing conductive hearing loss

Answer 28

Otosclerosis

Question 29

___ AND ___ can also result in hearing loss

Answer 29

Paget’s disease (bone disorder)

Hypothyroidism (low thyroid hormone production)

Question 30

Sensory cues to assist someone with hearing difficulties include ____ and ____.

Answer 30

non-verbals

written and demonstrated instructions

Question 31

Episodic attacks of tinnitus, dizziness and pressure in ears causing vestibular/balance loss

Answer 31

Menieres disease

Question 32

A very common vestibular disorder causing brief episodes of vertigo

Answer 32

Benign paroxysmal positional vertigo

Question 33

Other causes for vestibular loss include __, __, and __

Answer 33

Cerebrovascular disease (TIA, stroke)
Cardiac disease (heart conditions that include diseased vessels, structural problems, and blood clots.)
Cerebellar dysfunction (controls coordination and balance)

Question 34

Somatosensory changes include decreased sensitivity to touch and joint receptor sensitivity, especially in ___..

Answer 34

lower extremities

Question 35

Conditions that cause sensation loss include:

Answer 35

Peripheral neuropathy in diabetes
Central sensory loss in CVA
Peripheral vascular disease (A circulatory condition in which narrowed blood vessels reduce blood flow to the limbs)

Question 36

Those with decreased sensation have increased thresholds (point at which they feel sensation) for __ and ___. Therefore, they may benefit from extra time for responses during treatment

Answer 36

pain and vibration

Question 37

Sensory cues to assist someone with sensory difficulties include ____.

Answer 37

Using touch to communicate by maximizing physical contract (rubbing, stroking, tapping) -_-

Question 38

Conditions that result in loss of taste and smell

Answer 38

Smoking
Chronic allergies
Respiratory infections 
Dentures
CVA that involves hypoglossal nerve

Question 39

___ and __ are usually harder to remember

Answer 39

Short term memory

Novel tasks

Question 40

To improve cognition, we can 1) improve health by ____ and ____ and ____ 2) increase levels of physical activity 3) increase mental activity by __ and ____.

Answer 40

Correcting nutritional deficiencies
Decreasing use of multiple drugs, tobacco and alcohol
Keeping mentally engaged/cog training
Maintaining social life

Question 41

MULTIPLE sensory cues to assist someone with cognitive difficulties include ____, ____ and ___.

Answer 41

Visual discriminations
Written instructions
Verbal cues

Question 42

Cardiopulmonary changes are more due to ____ and ____ than old age.

Answer 42

Inactivity

Disease

Question 43

Common cardio changes include __, __ and ___.

Answer 43

Orthostatic hypotension (Decreased BP within 3 minutes of standing)
Systolic ejection murmur
Anemia

Question 44

Respiratory responses to exercise is similar to younger adults at ___ and ___ intensities

Answer 44

low

moderate

Question 45

Strategies to improve cardiopulmonary changes include an ____ and ____.

Answer 45

Developing individualized exercises prescription

Developing aerobic training programs

Question 46

Heat, cold, excess exercise can be life threatening due to decreased ____ and _____.

Answer 46

sweat production

homeostasis