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Flashcards in Geriatrics Deck (79):
1

aging is characterized by a varying, progressive loss of functional reserve in what organs

ALL

2

CV function declines ___% from 20-80yo

50%

3

peripheral vasculature has increased wall thickness, increased diameter, and consequent stiffening of the aorta and large arteries, leading to less ability to vasodilator. this all means what

arteries are less compliant

4

_______ is common d/t poorly complaint blood vessels, decreased CO, and increased Peripheral vascular resistance

Systemic HTN

5

Myocardial changes include what?

increased LV wall thickness
decreased myocardial compliance
thickening of aortic valve cusps

6

LV hypertrophy results from increased ______, secondary to elevated peripheral vascular resistance

Afterload

7

impaired myocardial pump function and reduced CO will prolong what?

circulation time (that is circulation time increases)

8

increased circulation time causes a decreased perfusion to the vessel rich group such as the

brain
heart
liver

9

what happens to the lung volume and capacity in the elderly:
RV

INCREASE

10

what happens to the lung volume and capacity in the elderly:
ERV

DECREASE

11

what happens to the lung volume and capacity in the elderly:
FRC

INCREASES

12

what happens to the lung volume and capacity in the elderly:
CC

INCREASES

13

what happens to the lung volume and capacity in the elderly:
IC

DECREASED

14

what happens to the lung volume and capacity in the elderly:
VC

DECREASED

15

what happens to the lung volume and capacity in the elderly:
TLC

NO CHANGE

16

the reduction in elastic tissue along with an increased amount of college equals a ___% reduction in functional alveolar surface area by age 70

15%

17

what happens to CBF and brain mass

decrease about 20-30% (by age 80)

18

what happens to cerebral auto regulation of blood flow

nothing-it is preserved

19

what happens to intracranial volume?

decreases
- the most rapid reduction occurring in gray matter

20

what happens to sensory block with spinals

increases

21

Do you need to increases or decrease the dosing for epidural segmental dosing

decrease

22

what happens to the doses for local and general anesthestics

decrease

23

epidural volume tends to result in more extensive ___ spread

cephalad

24

epidural volume tends to result in more extensive cephalad spread, but accompanied by a shorter _______ and _____

duration
motor block

25

what happens to spinal anesthetics duration of action

longer

26

what happens to MAC requirements

decreased MAC requirements

27

what happens to the dose requirements of opioids, bento's, barb's, LA

all decreases

28

what are 2 complications the elderly may face postop

POCD
Postop delerium

29

Pharmacology:
administration of a ___-soluble drug may lead to a concentrated drug and quick effects, bc the Vd is SMALL

water

30

Pharmacology:
if you admits a ____-solube drug you will get a lower plasma concentration and a decreased rate of elimination

Lipid

31

Pharmacology:
I'll state the change and you give the anesthetic consequence:
Decreased/contracted vascular volume

high initial plasma concentration

32

Pharmacology:
I'll state the change and you give the anesthetic consequence:
decreased protein binding

increased availability of free drug

33

Pharmacology:
I'll state the change and you give the anesthetic consequence:
increased body lipid storage sites

prolonged action of lipid soluble drugs

34

Pharmacology:
I'll state the change and you give the anesthetic consequence:
decreased renal and hepatic blood flow

prolonged action of drugs dependent on kidney and liver for elimination

35

Pharmacology:
what are the only 2 real drugs that you have to increase the dose of and why

atropine- d/t increased vagal tone
isoproterenol (beta agonist)- adrenergic sensitivity decreases

36

CV summary: increase or decrease
LV thivkness

increase

37

CV summary: increase or decrease
LV hypertrophy

increase

38

CV summary: increase or decrease
cardiac reserve

decrease

39

CV summary: increase or decrease
cardiac output

decrease

40

CV summary: increase or decrease
cardiax index

decrease

41

CV summary: increase or decrease
resting HR

decrease

42

CV summary: increase or decrease
LV wall tension

increase

43

CV summary: increase or decrease
afterload

increase

44

CV summary: increase or decrease
CV workload

increase

45

CV summary: increase or decrease
SYSTOLIC bp

increase

46

CV summary: increase or decrease
LV compliance

decrease

47

CV summary: increase or decrease
stroke volume

decrease

48

CV summary: increase or decrease
perfusion to vital organs

decrease

49

CV summary: increase or decrease
peripheral vascular resistance

increases

50

CV summary: increase or decrease
circulation time

increases

51

CV summary: increase or decrease
chronotropic and inotropic effects

decreases

52

CV summary: increase or decrease
conduction fibrosis and SA node cell loss

increases

53

CV summary: increase or decrease
incidence of dysrhythmias

increases

54

CV summary: increase or decrease
Vagal tone

increases

55

CV summary: increase or decrease
Baroreceptor fiunction

decreases

56

CV summary: increase or decrease
Adreergic sensitivity

decreases

57

CV summary: increase or decrease
systolic HTN

increases

58

Pulmonary summary: increase or decrease
vocal cord stimulation for closure

increases

59

Pulmonary summary: increase or decrease
elastin fiber elasticity

decreeases

60

Pulmonary summary: increase or decrease
tissue elasticity

decreases

61

Pulmonary summary: increase or decrease
Lung recoil

decreases

62

Pulmonary summary: increase or decrease
Airway obstruction

increases

63

Pulmonary summary: increase or decrease
risk of aspiration

increases

64

Pulmonary summary: increase or decrease
Pulmonary compliances

increases

65

Pulmonary summary: increase or decrease
Physiological deadspace

increases

66

Pulmonary summary: increase or decrease
alveolar functional surface area

decreases

67

Pulmonary summary: increase or decrease
ability to cough

decrease

68

Pulmonary summary: increase or decrease
chest wall compliance

decrease

69

Pulmonary summary: increase or decrease
Vital Capacity (VC)

decreases

70

Pulmonary summary: increase or decrease
work of breathing

increaes

71

Pulmonary summary: increase or decrease
hypoxia potential

increases

72

Pulmonary summary: increase or decrease
FRC

increases

73

Pulmonary summary: increase or decrease
Hypoxia and hypercapnia responses

decreases

74

Pulmonary summary: increase or decrease
protective reflexes

decreases

75

Pulmonary summary: increase or decrease
Closing volume and closing capacity

increases

76

Pulmonary summary: increase or decrease
Alveolar compliance

increases

77

Pulmonary summary: increase or decrease
opiod respiratory depression

increases

78

Pulmonary summary: increase or decrease
Cervical spine and TMJ mobilty

decreass

79

Pulmonary summary: increase or decrease
ease of mask ventilation

decreases