Lecture notes & text book incorporated study guide

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1 Dec 2010
HLTB01H3Y: Health, Aging and the Life Cycle
Department of Health Studies
University of Toronto at Scarborough
Summer 2010
Instructor: Anna Walsh.
Term: Summer 2010 Mondays 10 a.m.-12 p.m.
Lecture Room: SW 319.
June 21/2010. A&G: Ch 6 - Aging of the Internal Organ Systems.
This chapter discusses aging of the cardiovascular, respiratory, gastrointestinal, and renal/urinary
systems. Normative age-related changes (i.e., changes common enough that most older adults
can expect to experience them) are examined, in addition to the common diseases and
malfunctions of the individual systems that can accelerate the aging process.
Cardiovascular System
Basic Anatomy and Physiology
x The cardiovascular system is the bodys main transportation system.
o sends antibodies, fluids, nutrients, hormones and oxygen to tissues in the body
while removing waste such as carbon dioxide and hydrogen ions
o composed of the heart, blood vessels and blood
o arteries take blood away from the heart and the veins carry blood back to the
x Blood is a highly complex fluid
o Composed of white blood cells, red blood cells, water, platelets, nutrients such as
fat globules, carbohydrates, and proteins
Carries electrolytes to help maintain the acid based balance of hormones,
neurotransmitters, other peptides necessary for homeostasis, cognition,
movement and every other function of the body
x The heart is the centre of the circulatory system.
- Behind the chest wall
- Enclosed in fibrous sac called the pericardium
- Left and right sides have 2 upper chambers (atria) which collect blood and
two lower chambers (ventricles) which serve as pumps
o Atria: thin walled
o Ventricles: walls are thicker and more muscular because of long
distance pumping
- Sympathetic NS: increase rate and strength of heartbeat
- Parasympathetic NS: decrease rate and strength of heartbeat
x The right and left sides of the heart each serve as a pump
- The rate of blood flow as we know is greatly determined by the physical
demands on the body
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x Veins are a huge reservoir for the bodys blood supply, as 64% of its volume is found in
its veins
Age-Related Changes
- Cant do much to prevent aging of internal organs
- Normative age changes related to the aging process that affects all of us
- Cosmetic surgery cannot do anything
- As we age there are changes in the cardiovascular system
o Normal enlargement of heart mass > increase in myocytes (muscle cells)
o Slowing of electrical activity of the heart
o Increase in amount of fat tissue around the sinoatrial node > can lead to slow
pulse called bradycardia
o Changes in collagen in the middle layer of the LARGE arteries cause them to
thicken and become stiff
o Heart function is less efficient
Decrease responsiveness during exercise, lower maximum HR, takes
longer to return to resting levels after stress
Disease-Related Processes
- Are diseases that will affect most of us as we age and some of these diseases are not
exclusive to people over the age of 67
- Is a reading of 140/90 or higher
- Hypertension: high BP > can reduce our BP by reducing salt in our diet
- We are starting to have companies reveal caloric intake in food. We should get them to
show sodium because it affects our BP
- 120/180 is the optimal BP level for those above 18 years
o White coat syndrome : once the person knows they are being monitored, they
become anxious and it affects the BP reading
o Essentially we dont get a realistic measure of what the individual BP really is
because they are anxious after seeing the doctor
o Become more at risk for high BP as we age
o High BP will affect the body in many ways
Damages lining of arteries by causing fast expansion and constriction
Damage to collagen in the arterial walls also makes them stiffer
Increase risk of heart and kidney disease, peripheral vascular disease,
cerebral vascular accidents/strokes, atherosclerosis
Can also lead to dementia > if you have high BP and the transportation of
blood is affected, you dont get sufficient oxygen to the brain
Damage from the disease occurs without symptoms showing
First step of managing hypertension: weight control, lifestyle changes,
decrease sodium intake, increase activity level
x Obesity related to hypertension
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Drugs to reduce hypertension:
x Diuretic: use cautiously because side effects are severe
o Should give the elderly half the dose that you would give
a middle aged person
Arteriosclerosis and Atherosclerosis
o Arteriosclerosis: thickening and loss of elasticity of arterial walls
o Stiffened arteries are contracted > raises BP > hypertension > damage to walls
o High BP will result from and is also a leading cause of this
o Common form of this is atherosclerosis: depletion of plaques in arterial wall,
which decreases the blood supply to the rest of the body
Plaques: sticky, attract more dead cells, blood clots, bacteria > further
narrow the artery and create an inflammatory process
High density lipoprotein (HDL) is a good form of cholesterol because it
is not sticky and is less likely to adhere to arterial walls
o Risk factors: being male, family history of the disease, smoking, diet high in
saturated fat, hypertension, obesity and leading a sedentary lifestyle
Peripheral Vascular Disease
- Atherosclerosis can also causes damage to the peripheral blood vessels
- Peripheral arterial occlusive disease (PAOD): affects arteries that carry blood to the legs,
blockage in the legs, decreases supply of oxygen and nutrients in legs and feet
- Symptoms: bluish leg or feet colour, lack of growth of hair, weak/non-existent arterial
pulse, pain when walking (pain can somehow be so bad that it can deter people from
walking > irony: treating illness involves walking and exercise)
- Walking improves blood circulation to the area, increases muscle strength
- PAOD can also be helped by stopping smoking and exercising
Coronary Heart Disease
- Results from atherosclerosis of the coronary arteries of the heart
- Leading cause of disease in the older population and is a major cause of disability and
- After the age of 65, 85% of deaths from heart disease are due to CHD
- Heart disease: will occur at earlier age for men, women start catching up after menopause
due to an decrease in estrogen levels
- Gender bias: when it comes to CHD, we are slower to recognize and appreciate it in
- Although the incidence is very similar when people are 65+, women are less likely to be
diagnosed and treated for it
- Beginning of 20th century: didnt hear about women in the med profession except for
nurses. When it came to being doctors, we never heard of it until the 1950s +. The
biomedical model diagnosed men as people and we were looking at healthcare problems
from a male perspective. We now understand that men and women are different, and it is
important to give a woman the same medical care
- Risks for CHD:
o Smoking, high BP, high cholesterol, being overweight, inactive lifestyle
- Angina pectoris
o Common symptom in CHD
o demand for heart muscle is greater than what can be supplied
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