Guccione - Chapter 1

Question 1

Specific elements of successful aging

Answer 1

Absence of disease or disability
High cognitive and physical functionin
Active engagement with life

Question 2

“the capacity to function across many domains—physical, functional, cognitive, emotional, social, and spiritual—to one’s satisfaction and in spite of one’s medical conditions.” (Brummel-Smith)

Answer 2

Optimal aging

Question 3

domains that are essential to cross for optimal aging

Answer 3

physical
functional
cognitive
emotional
social
spiritual

Question 4

Four distinctive functional levels of the slippery slope of aging

Answer 4

Fun
Function
Frailty
Failure

Question 4

continues to accomplish most work and home activities but may need to modify performance and will substantially self-restrict leisure activities (fun) because of declining physiological capacity.

Answer 4

Function

Question 4

the highest level, represents a physiological state that allows unrestricted participation in work, home, and leisure activities.

Answer 4

Fun

Question 4

occurs when managing basic activities of daily living (BADLs; walking, bathing, toileting, eating, etc.) consumes a substantial portion of physiological capacity, with substantial limitations in ability to participate in
community activities and requiring outside assistance to accomplish many home or work activities.

Answer 4

Frailty

Question 4

Major role of PT in Geriatrics

Answer 4

maximize older pts’ vigor and keep them at their optimal functional level

Question 5

reached when an individual requires assistance with BADLs as well as instrumental
daily activities and may be completely bedridden.

Answer 5

Failure

Question 5

Four stages of clinical expertise

Answer 5

student
novice
competent
master

Question 6

One of the three anchors of EBP

Answer 6

clinical expertise

Question 7

Types and sources of knowledge

Answer 7

mentors
patients
students
education

Question 8

Philosophy of practice

Answer 8

decision-making
physicality
community
teaching

Question 9

common themes when considering an answerable question related
to older adults

Answer 9

patient
intervention
comparison of intervention
outcomes

Question 10

continuum of evidence

Answer 10

foundational concepts and theories
initial testing of foundation concepts
definitive testing of clinical applicability
aggregation of the clinically applicable evidence

Question 11

Key journals particularly relevant to Geriatric PT

Answer 11

Journal of American Geriatric Society
Journal of Gerontology: Series A; Medical and Biological Sciences
Journal of Geriatric Physical Therapy
Physical Therapy

Question 12

+7

Answer 12

a very great deal better

Question 13

+5

Answer 13

a good deal better

Question 13

+6

Answer 13

a great deal better

Question 14

+4

Answer 14

moderately better

Question 15

+3

Answer 15

somewhat better

Question 16

+2

Answer 16

a little better

Question 17

+1

Answer 17

almost t he same

Question 18

0

Answer 18

no change

Question 19

-1

Answer 19

almost the same, hardly any worse at all

Question 20

-2

Answer 20

a little worse

Question 21

-3

Answer 21

somewhat worse

Question 22

-4

Answer 22

moderately worse

Question 23

-5

Answer 23

a good deal worse

Question 24

-6

Answer 24

a great deal worse

Question 25

-7

Answer 25

a very great deal worse

Question 26

reasonably consistent findings from several high-quality definitive studies of clinical applicability

Answer 26

good evidence

Question 27

reasonably consistent findings from several moderate-quality studies of clinical applicability

Answer 27

fair evidence

Question 28

reasonably consistent findings from primarily foundational studies with finding not yet rigorously tested on relevant pt groups

Answer 28

weak evidence

Question 29

there is insufficient or markedly conflicting evidence that does not allow a recommendation to be made for or against intervention

Answer 29

inconclusive evidence

Question 30

clinical consequence of decline in VO2max

Answer 30

smaller aerobic workload

Question 30

clinical consequence of decline in MHR

Answer 30

smaller aerobic workload

Question 31

clinical consequence of stiffer and less compliant vascualr tissues

Answer 31

higher BP slower ventricular filling time

Question 32

clinical consequence of loss of cells from the SA node

Answer 32

slower heart rate lower MHR

Question 33

clinical consequence of reduced contractility of the vascular walls

Answer 33

slower HR lower VO2max smaller aerobic workload

Question 34

clinical consequence of thickened basement membrain in capillary

Answer 34

reduced arteriovenous O2 uptake

Question 35

clinical consequence of loss of water from the matrix

Answer 35

shrinkage of articular cartilage, vertebral discs decreased ability to absorb shock decreased ROM

Question 36

clinical consequence of increase in number of collagen crosslinks

Answer 36

stiffer tissues grater passive tension within tissues more effort required to move loss of end ROM

Question 37

clinical consequence of loss of elastic fibers

Answer 37

sagging of skin and organs

Question 38

clinical consequence of myelin axonal loss

Answer 38

slower nerve conduction fewer ms fibers loss of fine sensation

Question 39

clinical consequence of ANS dysfunction

Answer 39

slower systemic function w altered sensory input

Question 40

clinical consequence of loss of sensory neurons

Answer 40

reduced ability to discern hot, cold, or pain

Question 41

clinical consequence of slowed response time

Answer 41

increased risk of falls

Question 42

non-modifiable risk factors for bone loss

Answer 42

women w small frames caucasian hispanic women > 50 y/o FHx of osteoporosis premature @ birth low estrogen childhood malabsorption disease seizures

Question 43

modifiable risk factors for bone loss

Answer 43

1200 mg/day intake of calcium smoking drinking low BMI low estrogen: anorexia, amenorrhea inactivity substituting soda for milk insufficient protein inadequate vit D hpyerthyroidism