PN 2003 Final Exam 2025

Changes to the respiratory system with age - - -PO2 reduced as much as 15% between ages 20-80 -loss of elasticity and increased rigidity -decreased ciliary action -forced expiratory volume reduced -blunting of cough and laryngeal reflexes -by age 90 approx 50% increase in residual capacity -alveoli fewer in nuber and larger in size -thoracic muscles more rigid -reduced basilar inflation -lungs become smaller in size and weigh with age -trachea stiffens due to calcification of its cartilage -nose experiences connective tissue changes reduce support -gag reflex weaker -alveoli are less elasic, develop fibrosis tissue and contain fewer functional capillaries -kyphosis - Changes to the cells of the body - --number of cells gradually reduced -leaving fewer functional cells in the body -lean body mass reduced -fat tissue increase s until the sixth decade of life -total body fat as a porpotion of the body composition increases. -Cellular solids and bone mass are decreased -Extracellular fluid remains failry constant -where as intracellular fluid is decreased -resulting in less total body fluid -This decrease makes dehydration a significant risk to older adults Gastroinstestinal System age changes - --decreased taste sensation -esophagus more dilated -reduced saliva and salivary ptyalin -liver smaller in size -reduced instestinal blood flow -decreased esophageal motility -atrophy of gastric mucosa -decreased stomach motility, hunger contractions, and emptying time -less production of hydrochloric acid, pepsin, lipase, and pancreatic enzymes - fewer cells on absorbing surface of intestines -slower peristalisis -tongue atrophies PN 2003 PN 2003 -there is thinning of oral mucosa and a weakening of the muscles involved in mastication Reduced elasticity of stomach Stomach has a higher ph Urinary System aging - --decreased size of renal mass -decreased tubuler function -decreased bladder capacity -decrease in nephrons -betweenages 20 and 90, renal blood flow decreases 53% and glomerular filtration rate decreases 50 -weaker bladder muscles -nocturia -weak bladder muscles Ageing of the female reproductive system - --fallopian tubes atrophy and shorten -ovaries become thicker and smaller -cervix becomes smaller -drier less elastic vaginal canal -flattening of labia -endocervical epithelium atrophies -uterus becomes smaller in size -endometrium atrophies -more alkaline vaginal environment -loss of vulvar subcutaneous fat and hair -vulva atrophy -vaginal epithelium becomes thin -cervix, uterus, fallopian tubes, ovaries atrophy -uterus and overies decrease in size - breasts sag and less firm -some retraction of nipples -fibrosis and calcification of the terminal ducts Aging of the male reproductive system - - -fluid-retaining capacity of seminal vesicles reduces -possible reduction in sperm count -venous and arterial sclerosis of penis -prostate enlarges in most men -seminal vesicles having a thinner epithelium -replacement of muscle with connective tissue -structural changes in the seminiferous tubules include fibrosis, thinning of epithelium,thickening of the basement membrane -narrowing of the lumen -atrophy of the testes -reduction is testicular mass -more time required for an erection PN 2003 PN 2003 Aging musculoskeletal system - --muscle mass, muscle strength, muscle movements decreased -age related loss of muscle mass, strength and function= sarcopenia - tendons shrink and harden -reflexes are lessened in the arms and nearly lost in abdomen -shortening of vertebrae -between 20 and 70 height decreases approx 2 inches -bones more brittle -slight knee flexion -decrease in bone mass and bone mineral -slight kyphosis -slight hip flexion -slight wrist flexion - impaired flexion and extension movements. -grip strength decline -decrease body strength -decreased calorie intake -poor blood flow Aging nervous system - - -Decrease in brain weight -blood flow to brain -conduction velocity -response and reaction time -changes in sleep pattern -decreased conduction velocity -slower response and reaction time -decreased brain weight -reduced blood flow to brain -changes in sleep pattern -atrophy of brain and spinal cord and brain weight decreases -# of nerve cells decline -each cell has fewer dendrites -cerebral blood flow decreases by 20% Aging endocrine system - --Decreased acth,glucocorticoids, estrogen, testosterone -delayed and insufficienct release of insulin, decreased tissue -sensitivity to insulin -reduced ability to metabolize glucose higher blood glucose -thyroid gland undergoes fibrosis, cellular infiltration and increased nodularity -lower metabolic rate -reduced radioactive iodine uptake -less thyrotopin secretion and release -thyroid gland progressively atrophies PN 2003 PN 2003 What is parkinsons disease - -progressive degeneratoin of neurons in basal ganglia resulting in the reduced production of dopamine What are the symptoms of parkinsons - -affects the ability of the CNS to control body movements, tremor in hands and feet that progresses over time, tremor reduced when the patient attempts purposeful movement, muscle rigidity, weakness, drooling, difficulty swallowing, slow speech, monotone, face masklike appearance, skin moist, bradykinesia, poor balance, appetite increases, emotional instability, postural instability, shuffling gait, may not be able to stop walking voluntarily. Secondary symptoms depression, anxiety, sleep disturbances dementia, forced eyelid closure, decreased blinking, dysphagia, constipation, shortness of breath, urinary hesitancy urgency and reduced interest in sex What are the treatments for Parkinsons - -carbidopa/levodopa ( sinemet), anticholinergics, amantadine, monooxidase inhibitors and catechol-o-methyltransferase inhibitors, deep brain stimulation What should be avoided while taking levadopa - -foods high in vitamin B 6 such as avocado, lentils and lima beans. What is a macule? - -a flat lesion that differs in color from surrounding skin (1 cm in diameter) AKA freckle What is a papule? - -palpable, circumscribed, solid elevation in skin, smaller than 1 cm (elevated nevus) What is a nodule? - -elevated solid mass; deeper and firmer than papule,o.5 to 2 cm(o.2 to 0.8 inch) (eg wart) What is a tumor? - -solid mass that may extend deep through the subcutaneous tissue; 1 to 2 cm (0.4 to 0.8 inch) ( e.g epithelioma) What is a wheal? - -Irregularly shaped, elevated area or superficial localized edema; varies in size (hive, mosquito bite) What is a vesicle? - -circumscribed elevation of skin filled with serous fluid; 0.5 cm (0.2 inch) (herpes simplex, chickenpox) What is a pustule? - -circumscribed elevation of skin similar to vesicle but filled with pus varies in size. (acne, staphlyococcal infection) What is an ulcer? - -deep loss of skin surface that may extend to dermis and frequently bleeds and scars , varies in size. What is atrophy? - -thinning of skin with loss of normal skin furrow with skin appearance shiny and translucent, varies in size ( arterial insufficiency) PN 2003 PN 2003 What is deep vein thrombosis? - -a serious condition that occurs when a blood clot forms in a vein located deep inside your body. A blood clot is a clump of blood that's turned to a solid state. Deep vein blood clots typically form in your thigh or lower leg, but they can also develop in other areas of your body. Other names associated with this condition may include thromboembolism, post-thrombotic syndrome, and postphlebitic syndrome. What are symptoms of Deep vein thrombosis - -Swelling in feet, anlke or leg on one side, cramping pain in affected leg beginning in calf, severe unexplained pain in your foot or ankle, an area of skin that feels warmer than surrounding areas, skin over affected area turning pale or reddish blue What are causes deep vein thrombosis - -injury, surgery, reduced mobility or inactivity, certain medications What are the treatments for Deep vein thrombosis - -heparin, warfarin, enoxaparin, fondaparinux, compression stockings, filter, surgery What are risk factors for deep vein thrombosis - -injury that damages veins, being overweight, family history of DVT, catheter in vein, birth controls, hormone therapy , smoking. How to diagnose DVT - -ultrasound, venogram, D-dimer blood test What is COPD - -chronic obstructive pulmonary disease What diseases are included in COPD - -chronic bronchitis, asthma, emphysema What are treatments for COPD - -bronchodilators, corticosteroids, phosphodiesterase-4 inhibitors, theophylline, antibiotics, antivirals, vaccines oxygen What are symptoms of COPD - -harder to breath, intermittent coughing shortness of breath, wheezing, tightness in chest or have excess sputum production acute exacerbations which are flare-ups of severe symptoms. Needing to clear throat often, need to clear mucus from lungs every day , frequent colds flu or respiratory infections, lack of energy, fatigue, swelling of feet, ankles or legs, weight loss, bluish or gray fingernails or lips, trouble catching your breath or cannot talk, confused muddled or faint, heart racing What causes COPD? - -cigarette smoking How to diagnose COPD - -based on symptoms, spirometry, xray, ct scan , arterial blood gas. What are cataracts? - -clouding of the crystalline lens of eye PN 2003 PN 2003 What is glaucoma - -eye disease involving increased intraocular pressure What is macular degeneration? - -loss of central vision due to the development of drusen deposits in the retinal pigmented epithelium What is presbycusis - -age related high frequency sensorineural hearing loss Presbyopia - -the inability to focus or accomodate properly due to reduced elasticity of the lens What nutrients are beneficial to vision - -essential fatty acids, flavonoid, vitamin A, vitamin b complex, vitamin c, vitamin E, selenium, zinc What causes cataracts? - -The lens becomes cloudy or darkened (with proteins) Aging, disease, UV rays, smoking, medications What are the symptoms of cataracts - -vision distorted, night vision decreased, objects appear blurred, signs may be hard to see while driving may feel a film over eye. Glare rom sunlight and bright lights, nuclear sclerosis, Treatment of cataracts and cataract surgery - -surgery only cure. Ways to decrease development of cataracts - -sunglassesm sheer curtains over windows, furniure placed away from bright light, soft lights Cause of glaucoma - -unknown but associated with increased size of lens, iritis, allergy, endocrine imbalance,emotional instability, family history What are the types of glaucoma - -Open-angle (chronic), closed angle (acute) Acute glaucoma - -severe eye pain, headache nause and vomiting. Rapid increased tension, edema of ciliary body and dilation of pupil occur, vision blurred blindness may occur within a day if no dealt with. Medications used for acute glaucoma - -carbonic anhydrase inhibitors, which reduce the formation of aqueous solution; mannitol, urea, and glycerin which reduce fluid because of their ability to increase osmotic tension in the circulating blood. Chronic Glaucoma - -occurs so gradually that affected indivu=iduals are unaware of vision problems, peripheral vision becomes slowly but increasingly impaired so that people may not realize for a long time why they bump or knock over items at their side, tired feeling in their eyes , headaches, misty vision, seeing halos around lights, cornea may be cloudy, iris fixed and dilated, usually