The Aging Patient

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The Aging Patient by Mind Map: The Aging Patient

1. CARDIOVASCULAR

1.1. AGE-RELATED

1.1.1. Increased systolic pressure

1.1.1.1. Over 140 mmHg

1.1.2. Decreased systolic pressure

1.1.2.1. Under 90mmHg

1.1.3. Arterial wall thickening/stiffening

1.1.3.1. causes decreased compliance

1.1.4. LV/Atrial hypertrophy

1.1.5. Sclerosis of atrial/mitral valves

1.1.6. strong arterial pulses

1.1.7. diminished peripheral pulses, cool extremities

1.1.8. decreased cardiac reserve

1.1.9. no change in HR or cardiac output at rest

1.1.10. decreased max. HR during activity

1.1.10.1. causes fatigue, SOB, slow recovery from tachycardia

1.1.11. Risk of arrhythmia

1.1.11.1. can cause syncope

1.1.12. risk of postural/diuretic induced hypotension

1.2. PATHOLOGIES

1.2.1. Hypertension

1.2.2. Hyperlipidemia

1.2.2.1. Stroke, CAD

1.2.3. Cardiomyopathy

1.2.4. CHF

1.2.5. Hypotension

1.2.6. Pulmonary Emboli

1.2.7. PAD/PVD

2. PULMONARY

2.1. AGE-RELATED

2.1.1. Decreased respiratory muscle strength

2.1.1.1. stiffer chest wall, reduced compliance

2.1.2. Ciliary and macrophagic activity decreases

2.1.3. Mucus membranes become more dry

2.1.4. Decreased cough reflex

2.1.4.1. decreased foreign matter clearance

2.1.4.1.1. at risk of infection

2.1.5. Decreased autonomic response

2.1.5.1. i.e. hypoxia and hypercapnia

2.1.6. Reduced pulmonary functional reserve

2.1.6.1. causes dyspnea and decreased exercise tolerance

2.1.7. decreased respiratory excursion

2.1.8. decreased chest/lung expansion

2.1.8.1. less effective exhalation

2.1.9. increased risk of bronchospasm and airway obstruction

2.2. PATHOLOGIES

2.2.1. COPD

2.2.2. Emphysema

2.2.3. Higher risk of CAP

2.2.4. Bronchitis

2.2.5. lung cancer

2.2.6. URI

2.2.7. Asthma

2.2.8. Lung abscesses

3. RENAL/GU

3.1. AGE RELATED

3.1.1. Decreased kidney size

3.1.2. Decreased drug clearance

3.1.2.1. risk of nephrotoxic drug injury, adverse drug reactions

3.1.3. decreased renal blood flow

3.1.4. Reduced bladder elasticity

3.1.5. Reduced bladder elasticity, muscle tone, capacity

3.1.6. Increased post-void residual

3.1.7. Nocturesis

3.1.8. MALES: prostate enlargement, risk of BPH

3.1.9. Risk of volume overload --> heart failure

3.1.10. dehydration, hyponatremia, hypernatremia, hyperkalemia

3.2. PATHOLOGIES

3.2.1. Urinary Incontinence

3.2.1.1. Stress, urgency, overflow, neurogenic (reflex), functional, mixed

3.2.2. bladder cancer

3.2.3. Renal calculi (kidney stone)

3.2.4. Glomerulonephritis

4. GASTROINTESTINAL/DIGESTIVE

4.1. AGE RELATED

4.1.1. Muscle atrophy

4.1.1.1. in chewing muscles for instance

4.1.2. Decreased taste sensation/thirst perception

4.1.3. Decreased gastric motility

4.1.3.1. causes delayed gastric emptying

4.1.4. atrophy of protective mucosal layer

4.1.5. malabsorption of carbohydrates, vitamin B12, D, folic acid, calcium

4.1.6. Impaired sensation to defecate

4.1.7. Reduced hepatic reserve, decreased metabolism of drugs

4.1.8. Decreased elasticity of stomach

4.1.8.1. means smaller amount of food at one time

4.1.9. decline in HCl and pepsin, resulting in a higher pH

4.2. PATHOLOGIES

4.2.1. Xerostomia

4.2.1.1. (dry mouth)

4.2.2. Dental problems

4.2.2.1. enamel wasting away

4.2.3. Dysphagia

4.2.4. GERD

4.2.5. Hiatal hernia

4.2.6. Esophageal cancer

4.2.7. Peptic ulcer disease

4.2.8. Stomach cancer

4.2.9. Diverticulitis/Diverticular disease

4.2.10. Colorectal cancer

4.2.11. Chronic constipation and flatulence

4.2.12. Intestinal obstruction

4.2.12.1. can be an EMERGENCY

4.2.13. Bowel incontinence

4.2.14. Acute appendicitis

4.2.15. Pancreatic cancer

5. MUSCULOSKELETAL

5.1. AGE-RELATED

5.1.1. Sarcopenia

5.1.2. poor exercise tolerance

5.1.3. atrophy of lean muscle mass

5.1.3.1. replaced with redistribution of fat

5.1.4. bone loss

5.1.5. decreased ligament/tendon strength

5.1.6. Intervertebral disc degeneration

5.1.7. kyphosis

5.1.8. height reduction

5.1.9. limited ROM

5.1.10. Joint instability

5.2. PATHOLOGIES

5.2.1. Fractures

5.2.1.1. brittle bones

5.2.2. osteoarthritis

5.2.2.1. progressive

5.2.3. rheumatoid arthritis

5.2.4. osteoarthritis

5.2.4.1. metabolic disease, most prominent condition of bone

5.2.5. gout

5.2.5.1. excess uric acid

5.2.6. calluses, corns, bunions

5.2.7. plantar fasciitis

5.2.8. ingrown nails

5.2.8.1. alterations in nail growth/calcification

6. NEUROLOGIC/SENSATION

6.1. AGE-RELATED

6.1.1. decrease in neurons and neurotransmitters

6.1.2. loss of nerve cell mass

6.1.3. brain weight decreases

6.1.4. number of dendrites decline

6.1.5. demyelinization

6.1.6. slower nerve conduction

6.1.7. response time/reaction times are slower

6.1.8. weaker reflexes

6.1.9. plaques/tangles/atrophy in brain

6.1.10. decrease in cerebral blood flow

6.1.11. decline in function of cranial nerves affecting taste and smell

6.1.12. Reduced elasticity/stiffening of lens

6.1.13. Presbyopia

6.1.14. Reduced pupil size

6.1.15. opacification of the lens

6.1.16. loss of photoreceptor cells in retina

6.1.17. increased sensitivity to glare

6.1.18. impacted cerumen

6.1.19. sensorineural hearing loss

6.1.20. olfactory sensation loss

6.2. PATHOLOGIES

6.2.1. Parkinson's

6.2.2. deafness, ringing in ears

6.2.3. altered personality

6.2.4. TIA

6.2.4.1. from reduction in cerebral perfusion

6.2.5. CVA

6.2.6. Paresthesias of extremities

6.2.7. Glaucoma

6.2.8. Cataracts

6.2.9. Macular degeneration

7. INTEGUMENTARY

7.1. AGE-RELATED

7.1.1. Flattening of the dermal-epidermal junction

7.1.2. Reduced thickness and vascularity of the dermis

7.1.3. reduction of epidermal turnover

7.1.4. degeneration of elastic fibers

7.1.5. increased coarseness of collagen

7.1.6. reduction in melanocytes

7.1.7. atrophy of hair bulbs

7.1.8. decreased hair/nail growth

7.1.9. changes in body image

7.1.10. increased fragility of the skin

7.2. PATHOLOGIES

7.2.1. Pruritus

7.2.1.1. most common issue

7.2.2. keratosis

7.2.3. skin cancer

7.2.3.1. basal cell carcinoma

7.2.3.1.1. squamous cell

7.2.4. vascular lesions

7.2.5. stasis dermatitis

7.2.5.1. chronic venous insufficiency

7.2.6. decubitus ulcers