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Lifespan Flashcards

1
Q

Gerontology

A

Study of normal aging process

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2
Q

Geriatrics

A

Branch of medicine concerned with the illnesses of old age

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3
Q

Categories of elderly
Young elderly_____
Old elderly_____
Old, old elderly

A

YE: 65-74 yo
OE: 75-84 yo
OOE: 85+

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4
Q

Leading causes of death in elderly (in order)

A 
CHD (31%)
CA (20%)
CVD
COPD
Pneumonia/flu
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5
Q

Leading causes of disability in elderly

A

Arthritis (49%)
HTN (37%)
Hearing impairment (32%)
Heart impairment (30%)

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6
Q

Genetic theory of aging

A

Aging is intrinsic.
No one gene is responsible
Premature aging syndromes are examples of faulty genetic programming

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7
Q

Hutchinson-Gilford Syndrome

A

Progeria (premature aging) in childhood

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8
Q

Werner’s Syndrome

A

Progeria of young adults

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9
Q

Doubling/biological clock theory of aging

A

Hayflick’s limit theory

Limited number of genetically planned cell replications

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10
Q

Free radical theory of aging

A

Free radicals damage cell membrane and DNA.

results in decreased O2 delivery and tissue death

Can lead to atherosclerosis, cell mutation, CA

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11
Q

Cell mutation theory of aging

A

errors in synthesis of DNA/RNA lead to aging changes

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12
Q

Hormonal theory of aging

A

Impaired hormonal functions lead to aging

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13
Q

Which 3 glands have the biggest impact on aging

A

Hypothalamus, pituitary, adrenal

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14
Q

Thyroxine (T4)

A

master hormone of the body.

controls protein synthesis

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15
Q

Increase of ______ hormones can damage the brain, including the memory center, the _____

A

stress (cortisol)
Hippocampus

Immune cells also affected

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16
Q

Immunity theory of aging

A

thymus size decreases, bone marrow efficiency decreases

These lead to impaired immune response

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17
Q

Environmental theory of aging

A

Aging is caused by accumulation of toxins such as UV light, saturated fats, heavy metals, etc

Impairs DNA synthesis

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18
Q

In the elderly, there is a selective loss of type (I/II) fibers

A

II

this leads to an increased proportion of type I (slow twtich) fibers, limiting power

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19
Q

Aging’s effect on collagen

A

Denser
More irregular
Lower water content
Lower elasticity

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20
Q

Can strength training positively impact older adults strength levels and fitness

A

You betcha

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21
Q

Which has been shown to produce quicker results in the elderly, moderate intensity or high intensity

A

High intensity (70-80% 1RM)

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22
Q

Common postural changes in the elderly

A

Forward head kyphotic T spine
Flat lumbar spine
hip/knee flexion contractures

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23
Q

What are lipofuscins?

A

finely granular yellow-brown pigment granules composed of lipid-containing residues of lysosomal digestion

increase with aging, and can cause detrimental aging effects

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24
Q

Age-related tremors (essential tremors)

A

Often in hands, head, or voice
Benign and slowly progressive
Often postural or kinetic
Rarely resting

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25
Presbyopia
Age related visual loss poor focus and blurry images Due to loss of accomodation and decreased elasticity of lens
26
Cataracts
Opaque lens due to change in proteins Central vision loss first
27
Glaucoma
Increased intraocular pressure, degneration of optic disc loss of peripheral vision first, can progress to total blindness
28
Macular degeneration
loss of central vision may progress to total blindness, or pt may retain peripheral vision
29
Diabetic retinopathy
Damage to retinal capillaries Central vision impairment, complete blindness rare
30
Homonymous Hemianopsia
loss of half of visual field of each eye cannot see one total half of the visual field (R/L)
31
Conductive hearing loss
mechanical Damage to middle ear ossicles or exterior structures All frequencies affected Tinnitus may be present
32
Sensorineural hearing loss
Central/neural
33
Meniere's disease
Episodic attacks of tinnitus and dizziness (pt may feel pressure in ears) sensorineural hearing loss possible
34
BPPV
``` Brief episodes (less than 1 min) associated with position change ```
35
Terminal drop
The most significant loss of cognitive function, generally occurs in years immediately proceeding death
36
Aging effects on pulmonary function
Decreased total lung capacity Increased residual volume Decreased vital capacity
37
Osteoporosis
BMD at hip/spine that is 2.5 SD or more below mean
38
Osteopenia
BMD at hip/spine that is 1-2.5 SD below mean
39
Diseases impacting bone health
``` Hyperthyroid DM Hyperparathyroid SLE Celiac disease gastric bypass pancreatic disease MM sickle cell ESRD Paget's CA ```
40
Medications affecting bone loss
``` Corticosteroids Chemo Thyroid hormone estrogen antagonists anticonvulsents ```
41
Risk factors for low BMD
``` Family history White/Asian Early menopause Smoking Small frame ```
42
Common locations of osteoporotic fx's
Vertebrae Femoral neck Radius Humerus
43
Medicine options for low BMD
Bisphosphonates Calcitonin Estrogens
44
Calcium and Vitamin D recommendations
Ages of 50: Calcium: 1200 mg Vit D: 800-1000 IU
45
Verbal ability peaks at____ but is well maintained until____
30, 60's
46
Numeric abilities peak _____ and are well maintained till _____
mid 40's, 60's
47
Intellect changes do not typically show until___. but declines are not significant in every day life until____
60's, 80's
48
Interventions for low BMD
``` weight bearing exercises postural corrections functional balance tai chi gait training education-fall risk, fracture prevention ```
49
Hip fracture mortality rate in the elderly
20%
50
What percent of elderly with hip fracture do not reach premorbid functional level
50%
51
vertebral fractures are often caused by (trauma, routine activity)
routine activity
52
Interventions for OA
``` ROM Strengthen support joints, limit imbalances Aerobic conditioning Aquatics Education AD training ```
53
What is the most common cause of adult disability in the US
Stroke
54
What percentage of stroke patients will die during acute phase?
30%, another 30-40% will have severe disability
55
Delerium
Acute, potentially reversible confusion and loss of mental function can be from drug toxicity, systemic illness, O2 deprivation, sensory deprivation alertness may be high or low
56
Dementia
Loss of intellect/memory | Alertness usually normal
57
Reversible Dementia
10-20% of dementias | d/t drugs, nutrition disorders, psychiatric disorders, or toxins
58
Primary degenerative dementia, Alzheimer's type
50-70% of dementias leading cause of institutionalization-up to 50% of nursing home. Generalized atrophy of brain with decreased neurotransmitters
59
Types of Alzheimer's dementia
Senile: over 60 yo at onset presinle: 40-60 at onset
60
Multi-infarct dementias
20-25% of dementias Sudden onset Patchy distribution of deficits Emotional lability often have hx of stroke
61
Dementia and Parkinsons
dementia can be seen in late stages of PD
62
MMSE
lower than 24/30 is indicative of mental decline/dementia
63
Geriatric Depression Scale
30 item yes/no. greater than 8=depression
64
Angina in elderly
anginal pain may not be best indicator of ischemia: shortness of breath and ST segment depression may be more reliable
65
Acute MI in elderly
may present with sudden dyspnea, acute confusion, syncope
66
Maturationist Hierarchical theory of development
- Genetically and biologically dertermined | - Aspects of behavior are inate
67
Empiricist theory of development
Source of behavior is the environment
68
Behaviorist theory of development
Environment reinforces cognitive and motor behavior Used in behavior modification
69
1 month development
Head turned to side | Hands fisted with indwelling thumb
70
2 months development
astasia/abasis | prone on elbows
71
3 months development
prone on elbows, wt on forearms coos and chuckles optical and labyrinthine head righting
72
4 months development
no head lag in pull to sit unsupported sit roll to sidelying ulnar palmar grasp
73
5 months development
rolls prone to supine | weight shift in prone
74
6 months development
rolls supine to prone
75
7 months development
trunk rotation in sitting pivot prone
76
8-9 months development
belly crawl transfer objects hand to hand cruises sideways unsupported stand
77
10-15 months development
unassisted walk creeps up/down stairs self feeding
78
20 months
step to pattern for stairs
79
2 years
runs well | reciprocal stair pattern
80
Piagetian theory of development
interaction of environment and neural maturation spiraling of development
81
Neuromaturation theory of motor development
CNS control
82
Dynamic Systems theory of motor control
varying control centers depending on task cocontraction decreases with maturation
83
Principles of motor development
- cephalocaudal, proximal to distal - unrefinded to refined - stability to controlled mobility - periods of equilibrium/disequilibrium
84
Normal gestation period
38-42 weeks
85
Gestational age
age of fetus/newborn from first day of mothers last normal menstrual period
86
TIMP
used for 32 weeks post conceptual age to 3.5 months postterm spontaneous and evoked movement
87
APGAR
``` Appearance Pulse Grimace Activity Respiration ``` checked at 1, 5, 10 and every 5 minutes after if having difficulty 7 or higher is considered good
88
Galant
stroke along paravertebrals causes lateral flexion toward | 0-2 months
89
Moro
sudden extension of neck=flexion and ABD of shoulder, extension of elbows, followed by shoulder ADD and elbow flexion 0-4 mo
90
Neonatal neck righting
neck on body-turn neck, body follows | 0-6 months
91
Rooting
0-3 mo
92
Sucking
0-6 mo
93
TLR
Prone=flexor tone, supine=extensor tone 0-6 mo
94
STNR
neck extension=UE extension, LE flexion neck flexion=UE flexion, LE extension 6-8 mo
95
Denver Developmental Screening Test II
birth to 6 yrs Screens for social, fine motor, gross motor, language
96
AIMS
observational gross motor milestones birth-walking independently
97
Movement Assessment of Infants
birth-1 year
98
PDMS
birth-42 months
99
GMFM
measure change in gross motor in CP, also used with Downs All items can be accomplished by typical 5yo
100
BOT2
4.5-21 yo | gross/fine motor
101
Sensory integration and praxis test
sensorimotor | 4-9 yo with mild/mod learning impairment
102
Bayley
motor/mental scores birth-42 months
103
Early intervention programs
0-3 years old
104
NDT utilizes what as primary intervention strategy?
therapeutic handling
105
Is advanced didactic and clinical experience required to work with premature infants
yup
106
Meconium Aspiration syndrome
near term or term infant inhales bowel movement. can cause respiratory distress 20% present with developmental delays up until age 3
107
Respiratory distress syndrome
aka hyaline membrane disease d/t atelectasis may lead to bronchopulmonary dysplasia may require O2 supplementation and surfactant administration
108
Bronchopulmonary dysplasia
Chronic | Predisposes child to frequent respiratory infections
109
Periventricular leukomalacia
necrosis of white matter may result in CP
110
Periventricualar-intraventricular hemorrhage
graded I-IV Grades II-IV may result in CP
111
Retinopathy of prematurity
combination of low birthweight and high O2 levels Can range from insignificance to blindness
112
Necrotizing enterocolitis
ischemia results in inflammatory, infected bowel
113
Patent ductus arteriosis
Temporary vessel b/w aorta and pulmonary artery fails to close nonO2 blood is circulated
114
Intervention guidelines for peds
supervised SL and tummy time sleep in supine to avoid SIDS avoid activities that may increase extensor tone (infant jumpers/walkers
115
CP
group of disorders non-progressive encephalopathy associated with pre-term birth
116
Spastic CP
increased tone-lesion of motor cortex or projections from mass flexion/extension patterns imbalance of tone may cause contractures (hip FADIR, knee flexion, PF) Crouched gait
117
athetosis
Lesion of basal ganglia, writhing movements with fluctuating tone generalized low tone poor visual tracking ATNR
118
Ataxia
lesion of cerebellum ataxia follows initial hypotonia
119
dystonia
involuntary movements
120
Gross motor classification for CP
1: walk without restriction 2: walk without AD 3: walk with AD 4: use power chair outdoors 5: mobility severely limited

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