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HLTB01 Notes II
Chapter 6: Aging of the Internal Organ Systems
Cardiovascular System
Basic Anatomy and Physiology:
- Venous pump ± flapper valve to keep it flowing one direction, squeezing of veins by walking or other
movement
Age-Related Changes:
- Normal enlargement of the heart mass, slowing of electrical activity, fat tissue around sinoatrial node,
interferes with conduction system, thicker and stiff arteries
- Bradycardia ± abnormally slow pulse, only 10% of pacemaker cells remain
Disease-Related Processes:
- Hypertension ± optimal 120/80, normal 130/85, hypertension 140/90 or greater
- Arteriosclerosis ± thickening and loss of elasticity of arterial walls
o Atherosclerosis ± build up of plague inside arterial wall (LDL-bad, HDL-good)
o Risk factors: male, family history, smoking, diet, diabetes, hypertension, sedentary lifestyle,
obesity, high levels of homocystine
- Peripheral arterial occlusive disease (PAOD)- arteries that carry blood to the legs and feet are blocked due
to atherosclerosis
- Coronary heart disease (CHD) ± results from atherosclerosis of the coronary arteries of the heart, arteries of
women are smaller, protection estrogen
o Angina pectoris ± a common symptom for CHD, demand for blood in heart muscles is greater than
supplied, temp pain, impending heart attack, dyspnea (difficultly breathing) coughing or confusion
o Myocardial Infarction (MI) ± heart attack, occurs when artery in the heart is blocked because of a
blood clot
- Heart Failure ± when the heart is no longer able to pump blood to meet metabolic needs of the body,
cessation of a heartbeat, with death imminent, fluid build up in left ventricle
Promoting Optimal Aging:
- Changes in diet, not smoking, aerobic exercise, alleviating stress, social support
Respiratory System
Basic Anatomy and Physiology:
- Mast cells ± OLQHVWKHUHVSLUDWRU\WUDFWLPPXQHV\VWHPVILUVWOLQHRIGHIHQFH
- lung volume(amount of air expired), tidal volume (when a person is resting)
- total lung capacity = vital capacity + residual volume
Age-Related Changes:
- intercostals and diaphragm become weaker and atrophy with age, chest wall stiffer, reduced ability for
lungs to expand and contract, changes in collagen and elastin, alveoli become enlarged and flatten,
bronchioles collapse, normal decrease in cough reflex, decreased ciliary function
Disease-Related Processes
- Lung Cancer ± small cell(grow rapidly, high metastasis/spread), non-small cell(slower growing, less likely
to metastasize, more common in older adults)
- Pneumonia ± inability to maintain homeostasis, aspiration (inhale food)
o Risk factors: crowded housing
- Chronic Obstructive Pulmonary Disease (COPD) ± several diseases of the respiratory tract, two of the most
common are chronic bronchitis and emphysema
o Chronic Bronchitis ± cells of respiratory tract are inflamed and secret copious amounts of
thickened mucus. A crackling sound can be heard in chest
o Emphysema ± abnormal and permanent deterioration of tissue at the end of the respiratory tract, in
smallest bronchiole and alveoli, over time alveoli become less elastic, flattened and unusable.
Shortness of breath, excess mucus, hard to exhale
- Tuberculosis ± bacterial infection, nonspecific symptoms, multi-drug treatment
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Gastrointestinal System
Basic Anatomy and Physiology:
- Mouth, esophagus, stomach, small intestine (duodenum, jejunum, villi), large intestine
- Pancreas secretes enzymes for digestion and insulin, Liver blood clotting and makes cholesterol,
Gallbladder secretes and stores bile
Age-Related Changes
- Changes in ability to absorb nutrients in small intestine, lining of large intestine thins, less mucus and
slower motility, risk of gallstones
- Liver decrease in weight, hepacytes(liver cells) and ability to regenerate
Disease-Related Changes
- Periodontal Disease ± disease of structures that support the teeth, damage to bone that anchors teeth, gums
(gingivitis), roots of teeth eaten away
- Constipation ± bowel movement that is hard and dry, diet low in fibre, inadequate fluid
- Diverticular Disease ± presence of diverticula (outpouching) in the colon lining, caused by long term lack
of fibre, can develop into diverticulitis (stool trapped in diverticula)
- Gallbladder Disease ± gallstones are mostly asymptomatic, can cause backup of bilirubin,
- Cancer ± colorectal cancer usually asymptomatic in very early stages, appear vague in later stages, partial
or complete blockage of colon
- Under nutrition ± having a diet low in calcium, protein and calories and inadequate fluid intake.
- Obesity ± BMI = (weight in lbs)/(height in inches)2 x 703
o BMI index b/w 25-29.99 is overweight, index over 30 is obesity
o J-shaped curve b/w weight and mortality, underweight and very overweight people showing the
worst longevity, slightly overweight the best
Promote Optimal Aging:
- Slight increase in protein to help maintain muscle mass, calcium, vitamin K & B12, zinc, fibre and
sufficient water intake, regular screening
Renal/Urinary System
Basic Anatomy and Physiology:
- Kidneys, ureter leading from kidney to bladder, urethra empties urine outside
- Glomerular filtration rate (GFR) ± DPHDVXUHRINLGQH\VDELOLW\WRULGRIZDVWHSURGXFWV
- Management of fluids and electrolytes (sodium), acid/base balances, blood pressure (vasoactive rennin),
oxygen levels (erythropoietin), elimination of waste products
- Kidneys maintain specific minerals: potassium, magnesium, calcium, and phosphorus
Age-Related Changes:
- Atherosclerosis affects arterial blood supply to organ, decreased renal mass and nephron count, changes in
glomeruli filtration rate (sclerotic hardened), increase in creatinine is marker for renal failure
- Slower response rate and adaptability to change, regulation of homeostasis
Disease-Related Changes:
- Urinary Incontinence ± Urge (inability to delay), Functional (inability to control due to physical or
cognitive limitations), Stress (estrogen deficiency, vaginal childbirth, sphincter weakness), Overflow
(benign prostatic hyperplasia)
- Benign Prostatis Hyperplasia (BPH) ± a major cause of incontinence, enlargement of prostrate, compress
opening to urethra at bladder, almost universal disorder in older men
- Prostate Cancer ± age as a major risk factor for men, Prostatic-specific antigen (PSA) normal 2.5 or less,
@70 6.5 or less, higher can mean prostate cancer
Promoting Optimal Aging:
- Vitamin D & E, tomatoes (lycopene), protect normal functioning of kidneys
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Chapter 7: Aging and the Regulatory System
Sensory System:
- sensory organs allow nervous system to gain info about external environment
Age- and Disease-Related Changes:
- Touch ± change in touch UHFHSWRUV0HLVVQHUVFRUSXVFOHVDQGSUHVVXUHUHFHSWRUV3DFLQLDQFRUSXVFOHV
decrease in number and sensitivity
- Smell ± GHFOLQHGHFUHDVHLQVPHOOLVDQLQGLFDWRURI$O]KHLPHUVROIDFWRU\EXOE
- Taste ± from smoking, periodontal disease, illness and medications, can lead to anorexia
- Hearing ± earwax, stiffer eardrum, weaker sensors that detect gravity and head position
o Prebycusis ± hearing loss, men lose 80% women 30%, high pitch sounds lost first, dose-response
curve ± hearing loss can have profound effect on quality of life
o Tinnitus ± ringing in the ears, ear infections, medications, high blood pressure, diabetes, tumors,
atherosclerosis, manutrition
- Vision ± presbyopia (less elasticity in lens, difficulty focusing on close objects), curvature of cornea
becomes more irregular, reduce ability of pupil to enlarge, cry less (lacrimnal gland), cones and rods lose
sensitivity, optic nerve fibres loss
o Photoreceptors: Cones ± color vision, center, Rods ± black &white, more sensitive to light,
peripheral regions of retina
o Humor ± gel-like substance, supports structure, transports nutrients and wastes, along with
conjunctiva(clear mucus membrane) provides protection
o Retina detach ± vitreous humor becomes more liquid and moves about, creating tension on retina,
can cause flashes and blindness
4 most common serious diseases of the eye:
1) Cataracts ± cloudiness in eyes, painless. Risk: low levels of antioxidants. Treatable: artificial lens,
corrective eyeglasses
2) Glaucoma ± increased build up of aqueous humor, intraocular pressure, damage to retina and optic nerve.
Risk: black, family, high blood pressure, diabetes
3) Macular Degeneration (AMD) ± leading cause of severe vision loss, free radicals damage supply of
nutrients to retina, macula degenerates, destroys central vision
o Wet (exclusive) ± can be sudden, responsible for severe vision loss,
o Dry (Atrophic) ± gradual onset, most common,
o Risk: low antioxidants (E), UV rays, smoking, ingestion of vegetable fats
4) Diabetic Retinopathy ± discussed in endocrinology
Nervous System:
Basic Anatomy and Physiology:
- provides communication b/w systems, regulates homeostasis, allow voluntary movement
- Central nervous system (CNS) ± brain and spinal cord
- Peripheral nervous system (PNS) ± sensory and motor neurons
- Autonomic nervous system (ANS) ± regulatory functions, blood pressure, digestion, respiration, and
temperature. Sub-divided: Sympathetic (SNS) and Parasympathetic
Age-related changes:
- Brain mass decreases, not process glucose as effectively, changes in neurotransmitters, decrease in number
of motor neurons, speed of transmission to muscle cells
- Blood-Brain Barrier (BBB) ± composed primarily of glial and other supporting cells, that serves as a buffer
between the nerve cells and circulating blood, protect brain from toxins, with age BBB become more
porous
- Brain reserve capacity hypothesis ± brain can absorb fair amount of damage and still function relatively
normally, with age reserve capacity decreases, become vulnerable
Disease-Related Processes:
- Cerebro-vascular accidents (CVA) ± strokes, brain attacks, temporary ischemic blockages (transitory
ischemic attacks TIA, ministrokes), CVA results from permanent blocks
- Aneurism ± weakened areas of blood vessels can also cause vessels to rupture
- Dementia ± cognitive impairment, PicNV&UHX]WIOGW--DNRE$O]KHLPHUVGLVHDVH
o Vascular dementia ± caused by a series of ministrokes
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