Pulmonary Aging - Structural & Functional Changes Flashcards
what does the respiratory system functions in conjunction with
the cardiovascular system to determine functional capacity
what ages does pulmonary function and aerobic capacity each deline by 40%
between 30-80 YO
what are the different properties of the lung
- compliance
- elasticity
- alveoli
- chest wall
- structural proteins
- surfactant
what is lung compliance
when the lungs expand with minimal force
what is lung elasticity
the lungs can spring back after being stretched
what are alveoli
thin walls that are lined with a single layer of epithelial cells for efficient gas exchange
what is the chest wall
a compliant, aiding in expansion and alveoli support
what is strucutral properties of the lungs
collagen and elastin that provide compliance and elastance preventing airway collapse
what is lung surfactant
the fluid lining alveoli and reducing surface tension and aiding compliance
what are age-related changes of the lungs
- increased stiffness of chest wall
- decreased muscle mass
- reduced mucocilliary clearance
- decreased elastic fibers
- increased cross-linked collegan
- enlarger alveolar ducts and alveoli
what does increased stiffness of the chest wall result in
increased work of breathing
what does a decreae in elastic fiber and an increased cross-linked collagen result in
decreased elasticity
what are the structural changes to the lung with aging
increased collagen fiber crosslinking and elastic fiber fracture resulting in dilation of alveolar ducts and enlargement of air spaces
what are the different consequences of strucutral changes to the lung due to aging
- decreased surface area and efficiency of gas exchange
- decreased elastic recoil and surface tension
- decreased airway tehtering
what are the results from the consequences of structural changes to the lung due to aging
increased lung compliance, resistance to airflow during expiration and air trapping
what are the age-related extrapulmonary structural changes that affect lung function
- increased stiffness of the chest wall
- decreased curvature of the diaphragm
- increased stiffness of respiratory muscles
- loss of respiratory muscle mass and strength
what are the results of increased stiffness of the chest wall from age-related exrapulmonary structural changes of lung function
degenerative changes of the spine like kyphosis and calcification
what is the result of extrapulmonary structural changes to lung function with age
a decreased chest wall compliance
what is used to measure pulmonary function
lung volume and lung capacity
what are the lung volumes measurements
- tidal volume (TV)
- inspiratory reserve volume (IRV)
- expiratory reserve volume (ERV)
- residual volume (RV)
- forced expiration volume in 1 second (FEV1)
what are the lung capacitiy measurements
- vital capacity (VC)
- forced vital capacity (FVC)
- inspiratory capacity (IC)
- functional residual capacity (FRC)
- total lung capacity (TLC)
how do you calculate vital capacity
tidal volume + inspiratory reserve volume + expiratory reserve volume
how do you calculate inspiratory capacity
tidal volume + inspiratory reserce volume
how do you calculate function residual capacity
expiratory reserve volume + residual volume
how do you calculate total lung capacity
inspiratory reserve volume + tidal volume + expiratory reserve volume + residual volume
what are the changes in respiratory mechanics that lead to changes in pulmonary function in order
1) alveolar enlargement
2) reduced elastic recoil pressure of the lung
2a) decreaed FEV1 & FVC and increased FRC & RV
3) airway closure
3a) increased FRC and RV
4) reduced chest wall compliance and decreased respiratory muscle strength
4a) increased work of breathing (with exertion)
what are the changes in pulmonary function
- increased residual volume and functional residual capacity
- decreased vital capacity, inspiratory, and expiratory reserve volumes
- total lung copacity remains constant in normal aging
what is the result of a forced expiration test
decreased elastic recoil, increased resistance to airflow, and airway closure during expiration that results in decreased forced vital capacity and forced expiratory volume in 1 second
what does dynamic lung function decline show in older adults
expiratory limb of the flow volume loop are obstruction to airflow
what is V/Q inequality regarding to age-related changes in gas exchange
increased mismatch in ventilation and perfusion
what is decreased DLCO regarding age-related changes in gas exchange
reduced dissusion capacity due to decreased aveolar surface area and capillary density
what are the ventilation-perfusion ratios
low V/Q and high V/Q ratios
what is the low V/Q ratio
low ventilation to normal perfusion areas
what is the high V/Q ratio
high ventilation to areas with inadequate perfusion
does age-related respiratory changes affect everyday functioning
no but they do limit capacity during high-intensity activities
what increases the risk of age-related lung disease
age-related respiratory changes
what are the common age-associated lung pathologies
emphysema, fibrotic lung disease, and pulmonary edema
what is emphysema
alveoli destructuion and inflammation
what is emphysema due to
cigarette smoke or other airbone pollutants and genetics
what is fibrotic lung disease
scar tissue build-up arounf alveoli
what is fibrotic lung disease due to
particulate irritants like asbestos
what is pulmonary edema
increased interstitial fluid in the lungs
what is pulmonary edema due to
congestive heart failure
what is chronic obstructive pulmonary disease (COPD)
group of chronic respiratory disorders often emphysema and chronic bronchitis
how does COPD affect the lungs
progressive and irreversible damage caused by smoking
what are strategies for optimizing healthy lung aging
- avoid/quit smoking
- avoid severe illness
- maintain good air quality
- healthy diet with antioxidants
- regular PA (aerobic)
what are the results of pulmonary exercise physiology and aging
age-related decline in lung function becomes noticeable during exercise and increased expiratory flow limitation and functional residual capacity during exericse
what are factors impacting VO2
cardiac output, ventilation, and muscle metabolism
what is oxygen consumption rate dependent on
1) muscle metabolism
2) gas transport
3) blood flow matching
4) blood O2 and CO2 carrying capacity
5) cardiac output
6) pulmonary vascular function
7) pulmonary O2 and CO2 transport
8) ventilation regulation
how much does VO2 max decline per year after 30 YO
0.5%
what is a cardiopulmonary exercise test used for
to evaluate the cardiopulmonary response to exercise at varying intensities
what is the 6 minute walk test
assesses aerobic endurance
