Week 12

Question 1

With ageing, the number of alveoli and corresponding capillaries _____

Answer 1

decrease

Question 2

With ageing there is an _____ in size of surviving alveoli

Answer 2

increase

Question 3

With ageing, elastic properties comprised due to changes in collagen (which ______) and elastin (which _____)

Answer 3

increases, decreases

Question 4

With ageing, bronchioles _____ which increases ______ to airflow

Answer 4

narrowing, resistance

Question 5

With age, Increased ______ of peripheral airways which can reduce expiratory flow rates

Answer 5

collapsibility

Question 6

With age, there is a ______ of larger pulmonary arteries

Answer 6

thickening

Question 7

Residual volume—>

Answer 7

amount of air in lungs after forced exhalation

Question 8

Functional residual capacity —>

Answer 8

volume of air in lungs after a passive exhalation

Question 9

Compliance of chest wall _____ with ageing

Answer 9

decreases

Question 10

Lung elastic recoil _____ with ageing (i.e. increase in compliance)

Answer 10

decreases

Question 11

Calcifications of the costal cartilages and chondrosternal junctions, and degenerative joint disease of dorsal spine contribute to …?

Answer 11

Chest wall stiffening

Question 12

Structural changes of chest wall and lung elastic recoil lead to:

Answer 12

• static air trapping (increased residual volume)
• Increased functional residual capacity
• Increased work of breathing

Question 13

Residual volume can increase by as much as ___%

Answer 13

30%-50%

Question 14

By age 70, vital capacity may decrease by as much as ____%

Answer 14

40-50%

Question 15

Intercostal muscle mass and force are _____ with ageing. __ _____ in diaphragm thickness but a decrease in the curvature and this its force-generating capacity

Answer 15

reduced, no change

Question 16

Possible reasons for decline in respiratory muscle function:

Answer 16

• Changes in shape of rib cage
• Nutritional status
• cardiac function
• sarcopenia

Question 17

Ability to perform spirometry to test pulmonary function can be comprised by reduced cognitive function, such as with dementia. This can lead to…??

Answer 17

underdiagnosis and undertreatment of chronic obstructive pulmonary disease in older people
- Measurement of airway resistance using the forced oscillation technique (FOT) is an alternative for assessing COPD in older patients with cognitive disorders

Question 18

Total lung capacity increase/decreases/remains constant with ageing

Answer 18

remains fairly constant

Question 19

The increase in residual volume with ageing means there is a progressive ____ in vital capacity to approx 75% with ageing

Answer 19

decrease

Question 20

flow volume curves and peak expiratory flow with ageing….?

Answer 20

• Reduced peak expiratory flow in older individuals
• Changes in expiratory flow volume curve with ageing suggest obstruction to airflow
• Likely due to changes in small peripheral airways and loss of supporting tissue

Question 21

The ageing respiratory system is associated with:

Answer 21

• decreased cough reflexes
• an increased likelihood of sleep apnoea
• Increased susceptibility to pulmonary inflammation

Question 22

Decreased cough reflexes are due to…?

Answer 22

• less forceful and productive in swallowing and cough reflexes in ageing
• This lack of sensitivity may change at level of bronchioles, nerves or brain
• Airway clearance less effective due to less strength in muscle

Question 23

An increased likelihood of sleep apnoea is due to…?

Answer 23

• % of time in REM is less, light sleep more frequent, circadian rhythms are weaker
• melatonin decreased
• Defective chemical feedback control has been suggested to contribute
• Some evidence suggests that ventilatory drive to the pharyngeal muscles is reduced, leading to narrowing of the airways

Question 24

The Increased susceptibility to pulmonary inflammation is due to….?

Answer 24

• weaker immune system

- reductions in ciliary motility and mucous cel production

Question 25

Ageing is associated with reduced alveolar surface area, fewer pulmonary capillaries and mismatches between _____ and ____.

Answer 25

ventilation and perfusion

Question 26

High ventilation, low perfusion =

Answer 26

wasted ventilation/physiologic dead space

Question 27

Low ventilation, high perfusion =

Answer 27

wasted perfusion of blood/'venous admixture'/'physiological shunt'

Question 28

How do the elderly compensate for altered compliance and gas exchange?

Answer 28

By breathing more rapidly at lower tidal volume to maintain alveolar ventilation - Greater ventilatory response to CO2 during exercise to compensate for greater dead space - During hypercapnea the CO2 threshold for increased inspiratory effort is reduced

Question 29

VO2 max generally ____ with age

Answer 29

declines

Question 30

What factors affect decline in vo2max most?

Answer 30

Circulatory factors (decreased max HR, muscle mass) > pulmonary factors

Question 31

The expiratory flow limitation and concomitant increase in expiratory resistance (flow resistive work) in the older subject cause the ventilatory work to ___ curvilinearly with exercise.

Answer 31

increase

Question 32

Compliance of chest wall and lung elastic recoil decrease with age, resulting in static air trapping (increased residual volume), _____ functional residual capacity, and ____ work of breathing

Answer 32

increased

Question 33

Reduced alveolar surface area and greater mismatching of ventilation and perfusion may jeopardise ___ _____, although mechanisms exist to compensate for this.

Answer 33

gas exchange

Question 34

Older people tend to breathe at higher lung volume--> inspire the same volume but it is closer to total lung capacity because their residual volume is _____

Answer 34

greater

Question 35

What increases with ageing during adulthood?

Answer 35

Residual volume

Question 36

Which of the following changes to the respiratory system does NOT typically occur with ageing during adulthood? - A reduction in size of alveoli - A decrease in the compliance of the chest wall - Reduced elastic recoil - A decline in respiratory muscle strength

Answer 36

A reduction in size of alveoli (FALSE) | - decrease number, not size