Musculoskeletal and Integumentary Flashcards
Bone mass
There is a disturbance in the balance of osteogenesis and osteolysis and absorp/reabsorp with calcium that leads to dec in bone mass
Bone growth vs loss
Growth until about 35 and then start slow loss
Factors affecting bone aging
1. Need for calcium intake 800 mg young F 1500 mg F over 50 Explained by absorption efficiency of upper GI 2. Hormones
Factor affecting bone aging - Hormones
PTH Calcitonin Dehydroxycalcified (Vit D3) Estrogen Glucocorticoids GH Insulin
Normal role of physical exercise with bone
Inc stress/strain on skeleton
Inc blood flow
Stimulate bone retention/deposition
Aging bone has dec..
Calcium
Circulating levels of Vit D
Reserve to quickly accelerate the production of RBCs when needed
Bone strength
Aging of joints -
Osseous outgrowths (osteophytes or bone spurs) Dec proteoglycans in joints and structural alteration of them that leads to autoimmunity
Aging of joints - cartilage
Thicker (except patella)
Dec elasticity
Inc pigmentation
Dec collagen
Structural changes in the muscular system
Dec myocytes Inc pigments, fat, CT Atrophy in number of fibers Dec alpha motor neurons Dec size of motor units Dec mm mass
Functional changes in the muscular system
Dec enzyme concentrations + efficacy
Loss of mm strength - dec 20%
Impaired velocity of contraction and relaxation
Early onset of fatigue
What is sarcopenia
Age related decline in lean body mass that affects the functional capacity
Prevalence of sarcopenia
30%
Sarcopenia M vs F
M experience 2X decline as F (maybe just cuz have more to begin with)
Normal aging decline of strength is
10% per decade
Causes of sarcopenia
Physical inactivity Loss of alpha motor neuron input to nerve Decline in testosterone Decline in growth hormone Protein insufficiency
Integumentary - aging nails
Slower growth Dull appearance Brittle Color changes from translucent to yellow/opaque Tips easily fragment Longitudinal ridges
Integumentary - aging of hair
Loss of facial and body hair
Color changes
Dec production of hairs
Individual hairs coarser
Integumentary - aging of hair - Color is universal sign of aging - universal graying begins
at 30
40% by 40
Genetic influence
Integumentary - aging of hair - Color due to pigment changes
Dec melanin production graying
Integumentary - aging of hair - Dec production of hairs
Normal
4-5 year life cycle
Failure to replace hair by follicle 25% males by 30
66% by 60
Integumentary - aging of hair - coarser
F = chin/lips more obvious M = longer hairs in brow, ears, nose
Skin changes with aging
Dec sweat glands Dec sebaceous glands Dec melanophores Dec collagen Thinning of epidermis Loss of elasticity Loss of subQ adipose Thinning of skin Graying of hair
COnsequences of skin changes with aging
Impaired temp regulation Dry and flaky skin Skin folds and wrinkles Aging pallor Coarser features Bony appearance
Clinical application
Puritis 2/3 of older adults Bed sores more common Inc skin cancers Keratotic nodules on back of hands Telanglectasis on face Hyperplasia, leathery skin
Why does skin wrinkle
Less water content Skin thinking Altered elastin - dec Less pliable Damaged collagen Dec fat
What are liver spots
Uneven distribution of melanocytes and melanin
Deposition of aging pigments
Why bruise more easily
Loss of sensation Water loss in skin Loss of fat Altered collagen Less compliant elastin Loss of BVs Slow healing Medications with anticoagulant properties
Age effects on metabolism
Dec BMR which leads to limit in physical activity
Dec liver blood flow (40-50%)
- leads to drugs staying in blood longer)
Temp regulation with age - net
Dec ability to maintain temp
Altered perception of environmental temp
Explanations of temp reg dec
Altered shivering process
Dec mm mass
Dec BMR
Less effective cutaneous vasomotor regulation of blood flow
Consequences of altered temp regulation
At risk in temp extremes
Diminished ability to sense abnormal temp and to respond to altered temp
