Musculoskeletal and Integumentary

Question 1

Bone mass

Answer 1

There is a disturbance in the balance of osteogenesis and osteolysis and absorp/reabsorp with calcium that leads to dec in bone mass

Question 2

Bone growth vs loss

Answer 2

Growth until about 35 and then start slow loss

Question 3

Factors affecting bone aging

Answer 3

1. Need for calcium intake 
800 mg young F
1500 mg F over 50
Explained by absorption efficiency of upper GI
2. Hormones

Question 4

Factor affecting bone aging - Hormones

Answer 4

PTH
Calcitonin
Dehydroxycalcified (Vit D3)
Estrogen
Glucocorticoids
GH
Insulin

Question 5

Normal role of physical exercise with bone

Answer 5

Inc stress/strain on skeleton
Inc blood flow
Stimulate bone retention/deposition

Question 6

Aging bone has dec..

Answer 6

Calcium
Circulating levels of Vit D
Reserve to quickly accelerate the production of RBCs when needed
Bone strength

Question 7

Aging of joints -

Answer 7

Osseous outgrowths (osteophytes or bone spurs)
Dec proteoglycans in joints and structural alteration of them that leads to autoimmunity

Question 8

Aging of joints - cartilage

Answer 8

Thicker (except patella)
Dec elasticity
Inc pigmentation
Dec collagen

Question 9

Structural changes in the muscular system

Answer 9

Dec myocytes
Inc pigments, fat, CT
Atrophy in number of fibers
Dec alpha motor neurons
Dec size of motor units
Dec mm mass

Question 10

Functional changes in the muscular system

Answer 10

Dec enzyme concentrations + efficacy
Loss of mm strength - dec 20%
Impaired velocity of contraction and relaxation
Early onset of fatigue

Question 11

What is sarcopenia

Answer 11

Age related decline in lean body mass that affects the functional capacity

Question 12

Prevalence of sarcopenia

Answer 12

30%

Question 13

Sarcopenia M vs F

Answer 13

M experience 2X decline as F (maybe just cuz have more to begin with)

Question 14

Normal aging decline of strength is

Answer 14

10% per decade

Question 15

Causes of sarcopenia

Answer 15

Physical inactivity 
Loss of alpha motor neuron input to nerve
Decline in testosterone
Decline in growth hormone
Protein insufficiency

Question 16

Integumentary - aging nails

Answer 16

Slower growth
Dull appearance
Brittle
Color changes from translucent to yellow/opaque
Tips easily fragment
Longitudinal ridges

Question 17

Integumentary - aging of hair

Answer 17

Loss of facial and body hair
Color changes
Dec production of hairs
Individual hairs coarser

Question 18

Integumentary - aging of hair - Color is universal sign of aging - universal graying begins

Answer 18

at 30
40% by 40
Genetic influence

Question 19

Integumentary - aging of hair - Color due to pigment changes

Answer 19

Dec melanin production graying

Question 20

Integumentary - aging of hair - Dec production of hairs

Normal

Answer 20

4-5 year life cycle
Failure to replace hair by follicle 25% males by 30
66% by 60

Question 21

Integumentary - aging of hair - coarser

Answer 21

F = chin/lips more obvious
M = longer hairs in brow, ears, nose

Question 22

Skin changes with aging

Answer 22

Dec sweat glands
Dec sebaceous glands
Dec melanophores
Dec collagen
Thinning of epidermis
Loss of elasticity 
Loss of subQ adipose
Thinning of skin
Graying of hair

Question 23

COnsequences of skin changes with aging

Answer 23

Impaired temp regulation
Dry and flaky skin
Skin folds and wrinkles
Aging pallor
Coarser features
Bony appearance

Question 24

Clinical application

Answer 24

Puritis 2/3 of older adults
Bed sores more common
Inc skin cancers
Keratotic nodules on back of hands
Telanglectasis on face
Hyperplasia, leathery skin

Question 25

Why does skin wrinkle

Answer 25

``` Less water content Skin thinking Altered elastin - dec Less pliable Damaged collagen Dec fat ```

Question 26

What are liver spots

Answer 26

Uneven distribution of melanocytes and melanin | Deposition of aging pigments

Question 27

Why bruise more easily

Answer 27

``` Loss of sensation Water loss in skin Loss of fat Altered collagen Less compliant elastin Loss of BVs Slow healing Medications with anticoagulant properties ```

Question 28

Age effects on metabolism

Answer 28

Dec BMR which leads to limit in physical activity Dec liver blood flow (40-50%) - leads to drugs staying in blood longer)

Question 29

Temp regulation with age - net

Answer 29

Dec ability to maintain temp | Altered perception of environmental temp

Question 30

Explanations of temp reg dec

Answer 30

Altered shivering process Dec mm mass Dec BMR Less effective cutaneous vasomotor regulation of blood flow

Question 31

Consequences of altered temp regulation

Answer 31

At risk in temp extremes | Diminished ability to sense abnormal temp and to respond to altered temp