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WEEK 7 SEM 4 > The ageing heart and lungs > Flashcards

The ageing heart and lungs Flashcards

1
Q

What does a normal artery consist of?

A

intima, media, adventitia

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2
Q

What happens to arteries when ageing?

A

artery becomes thicker and less compliant:

increased collagen
less elastin
calcification
endothelium becomes more permeable= blood and leucocytes can go under endothelial layer
leukocytes secrete cytokines= change interaction in intima and media

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3
Q

Where do smooth muscle cells migrate during ageing and what do they become?

A

to the intima

they become fibroblasts

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4
Q

What can happen to large arteries when ageing?

A

become elongated and tortuous (twisted)

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5
Q

If large arteries become elongated and twisted, what happens as a result?

A

reduced baroreflex sensitivity= leads to sympathetic activation

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6
Q

What is endothelial dysfunction?

A

NO = vasodilator, relaxes VSMC, lowers risk of atheroma

after 20 years, NO decreases

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7
Q

What does NO do?

A

vasodilator and relaxes VSMC

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8
Q

What happens as a result of arterial wall thickening and endothelial dysfunction?

A

atherosclerosis

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9
Q

Why does ventricular hypertrophy happen?

A

because the heart is working against high afterload
fibrosis
hypertrophy of cardiac myocytes
addition of sarcomeres
left ventricle is thicker
and left ventricle volume is smaller compared to normal heart

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10
Q

because of left ventricular hypertrophy, why will there be changes in diastole?

A

bc in early diastole, filling or the ventricle occurs bc the heart is relaxed
later diastole there is atrial contraction which fills ventricle even more
when the heart is stiff, it cant relax
so filling can only occur in late diastole (when atria contracts)

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11
Q

Which function of the heart is most affected in ageing- systolic or diastolic?

A

diastolic

systolic rises more though

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12
Q

What is a risk for atrial fibrillation?

A

increased atrial contractions bc it leads to hypertrophy and fibrosis of the atria

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13
Q

What happens to heart rate as we age?

A

max heart rate in stress/ exercise is LOWER

RESTING HR IS SAME THROUGHOUT

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14
Q

Why does heart rate for stress/exercise decrease with age?

A

autonomic dysfunction

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15
Q

What happens to cardiac output in elderly at rest?

A

AT REST: no change bc HR and SV normal at rest

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16
Q

What happens to cardiac output in elderly under stress/exercise?

A

CO= HR X SV
less max heart rate at exercise so cant increase CO by heart rate
low ventrical filling bc of hypertrophy and increased HR (bc of exercise) so SV is less
so CO will be less at exercise

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17
Q

What happens to the SAN with ageing?

A

fibrosis
less SAN cells
so less SAN function

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18
Q

What happens to the conduction system of the heart?

A

slower

bc fibrous, fatty and amyloid infiltration

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19
Q

How is slower conduction shown on an ECG?

A

prolonged QRS complex

prolonged PR interval

20
Q

wHAT HAPPENS TO AGEING mitral valve?

A

mixomatous changes= fibrous and mucosal deposition

21
Q

What does mixomatous changes to the mitral valve lead to?

A

a floppy mitral valve so mitral regurgitation

pan systolic murmur

22
Q

What happens to the aortic valve?

A

calcification= aortic stenosis

will hear systolic murmur

23
Q

What happens in between vertebraes?

A

degenerating intervertebral discs= leads to kyphosis

24
Q

What does kyphosis lead to?

A

less space between ribs
smaller chest cavity
so less FEV1 and FVC

25
Q

What happens to the respiratory muscles when ageing?

A

become weaker
diaphragm flattens
inspiratory and expiratory muscles weaken
less ATP in resp muscles mitochondria

26
Q

Why, in elderly, is there poor airway clearance?

A

decreased cough strength

less mucociliary clearance

27
Q

Why is there less mucociliary clearance in elderly?

A

less cilia

slow and less effective cilia beatig

28
Q

What happens to alveoli in ageing?

A

less elastin fibres in alveoli ducts= become thinner

less gas exchange

29
Q

What happens to carbon dioxide excretion with age?

A

doesn’t change

30
Q

What happens to chemoreceptor function?

A

less respiratory response to hypercapnia and hypoxia

31
Q

What happens to the veins of the ageing heart?

A

dilate and have less elastin

intima and muscle wall thicken

32
Q

What do stiffer arteries lead to?

A

increased TPR
increased systolic BP
diastolic pressure decrease

33
Q

What is isolated systolic hypertension?

A

raises systolic BP contributes to further systolic BP increase

34
Q

Where is NO produced?

A

endothelial cells that line the lumen

35
Q

What happens to the afterload in the left ventricle?

A

increases

36
Q

With age, by how many beats per minute does the intrinsic heart rate (HR NOT AFFECTED BY ANS) reduce every decade?

A

5-6 bpm

37
Q

What happens to cardiac reserve as we age?

A

reduces- so we have less ability to compensate

38
Q

Why do we have a reduced cardiac reserve when we age?

A

less contractility
less blood volume in LV
less max heart rate

39
Q

What can a slow conduction system of the heart cause?

A

premature atrial beats
ventricular ectopics
high risk of arrhythmias

40
Q

What happens as a result of less gas exchange in the lungs?

A

increase V/Q mismatch

41
Q

What is a pulmonary function test?

A

Pulmonary function tests are a group of tests that measure how well the lungs work in ventilation and they are good at diagnosing obstructive and restrictive illnesses

42
Q

What happens to total lung capacity, FVC, FEV1 as we age?

A

total lung capacity stays same
FVC reduces
FEV1 reduces

43
Q

Why do older people have reduced cough strength?

A

weaker muscles

less sensitive cough reflex

44
Q

How does surfactant composition change with age?

A

increased proinflammatory proteins

45
Q

What is primary ageing?

A

genetically pre-programmed limit on cellular longevity

46
Q

What is secondary ageing?

A

environment insults, trauma and disease

47
Q

What can irritability of the myocardium lead to?

A

extra systoles, sinus arrhythmias and sinus bradycardia

WEEK 7 SEM 4 (7 decks)

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