Age Related Changes

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Age Related Changes by Mind Map: Age Related Changes

1. Reproductive- Women

1.1. Vulva atrophy

1.1.1. Senile Vulvitis

1.2. Flattening labia

1.3. vaginal epithelium thins

1.3.1. less lubrication May lead to painful intercourse

1.4. Cervix, uterus, ovaries and Fallopian tubes atrophy

1.4.1. Increased risk for cervical cancer

1.5. decreased estrogen production

1.5.1. more alkaline pH

1.6. Breast cancer risk increases

2. Reproductive- Men

2.1. seminal vesicles develop thinner epithelium

2.1.1. less live sperm in ejaculation

2.2. Muscle tissue replaced with connective tissue

2.3. Testicle atrophy

2.4. Prostate enlargement

2.4.1. BPH hard time initiating flow of urine Increased risk for prostate cancer Frequent digital rectal exams

3. Circulation

3.1. Valves become thick and rigid

3.2. Aorta dilation

3.2.1. Ventricular hypertrophy

3.3. Myocardial tissue less effective

3.3.1. Decreased cardiac output

3.4. decreased baroreceptor sensitivity

3.4.1. blood pressure less regulated Hypertension Older adults have a higher risk for adverse effects from antihypertensives Hypotension can increase risk of falls

3.5. Congestive Heart Failure

3.5.1. related to coronary artery disease

3.5.2. Contributing factors: diabetes, dyslipidemia, albuminuria, anemia, chronic kidney disease, substance abuse, stress and sedentary lifestyle

3.5.3. other causes: decreased elasticity of vessels, and increase in BP

3.6. Hyperlipidemia

3.6.1. can contribute to plaque build up in the heart dietary factors

3.6.2. Diabetes, hypothyroid, uremia, nephrotic syndrome can contribute

3.7. Arrhythmias

3.7.1. can be caused by low potassium, infection, hemorrhage, and coronary insufficiency

3.7.2. Atrial Fibrilation

3.8. Peripheral vascular disease

3.8.1. Diabetics most affected Affects small vessels furthest from heart Daily foot inspection

3.9. Pulmonary embolism

3.9.1. Risk with fractured hip, CHF, arrhythmias, hx of thrombosis,immobilization, and malnutrition

3.10. Coronary artery disease

3.10.1. Angina

3.10.2. Myocardial infarction hx of hypertension and arteriosclerosis

4. Urinary Elimination

4.1. hypertrophy of bladder muscle

4.1.1. increase in frequency

4.2. Urinary retention

4.2.1. prostatic hypertrophy in men

4.3. Insufficient neurological control of bladder

4.4. Filtration efficiency of kidneys decreases

4.4.1. hard to eliminate drugs Increased risk for toxic levels of medications

4.5. Reduced ability to concentrate and dilute urine

4.6. UTIs

4.6.1. risk factors: neurogenic bladders, arteriosclerosis, diabetes Foley catheters increase risk

4.7. Incontinence

4.7.1. Stress weak pelvic muscles, obesity

4.7.2. Urgency UTI, BPH, diverticulitis, irritation or spasm

4.7.3. Overflow Bladder neck obstruction, medications

4.7.4. Neurogenic cerebral cortex lesions, MS

4.7.5. Functional Dementia, or disability

4.7.6. Mixed

4.8. Bladder cancer

4.8.1. Chronic irritation, exposure to dyes, and cigarettes

4.9. Renal Calculi

4.9.1. Immobilization, infection, change in pH, diarrhea, dehydration, hypercalcemia

5. Neuro

5.1. Loss of nerve cell mass

5.1.1. atrophy of brain and spinal cord

5.2. number of nerve cells decline

5.2.1. slower nerve conduction response time decreases

5.3. free radicals accumulate

5.4. cerebral BF decreases

5.4.1. increase risk for stroke Increased risk with diabetes and HTN

5.5. Ability to come back after injury decreases

5.5.1. making brain or spinal injuries hard to come back from

5.6. number and sensitivity of sensory receptors, dermatomee and neurons decrease

5.6.1. Decreased sensation

5.7. Decline in function of cranial nerves

5.7.1. Affects taste and smell perception

5.8. Neurovascular disease

5.8.1. RF: diabetes, hypertension, smoking, obesity, high stress, high cholesterol

5.9. Parkinson’s

5.9.1. cause: Impaired basal ganglia Dopamine producing neurons die or are impaired more common in men

5.9.2. RF: exposure to toxins, encephalitis, cerebrovascular disease, and arteriosclerosis

5.10. Transient Ischemic Attacks

5.10.1. hyperextension and flexion of head

5.10.2. Impaired cerebral BF

5.10.3. reduced blood pressure

5.10.4. anemia

5.10.5. some medications

5.10.6. Cigarette smoking

5.11. Cerebrovascular Accidents

5.11.1. RF: HTN, arteriosclerosis, diabetes, gout, anemia, hypothyroidism, silent myocardial infarction, TIAs, dehydration and cigarette smoking

5.11.2. Ischemic from a thrombus

5.11.3. hemorrhagic ruptured cerebral blood vessels

6. Vision and hearing

6.1. Reduced elasticity, stiffening of muscle fibers of lens

6.1.1. Inability to focus Begins in fourth decade Need for corrective lenses

6.2. Decrease pupil size, loss of photoreceptors cells

6.2.1. Visual acuity declines

6.3. light perception decreases

6.3.1. Difficulty seeing at night

6.4. Sensitivity to glare

6.4.1. Cataract formation Clouding of lens Causes: exposure to UV rays, diabetes, smoking, alcohol, eye injury Importance of wearing sunglasses

6.5. inaccurate depth perception

6.5.1. Increased risk for injuries/falls

6.6. Decreased peripheral vision

6.7. Eyes produce fewer tears

6.7.1. Dry eyes

6.8. Arteriosclerosis, and diabetes can damage the retina

6.9. Glaucoma

6.9.1. Optic nerve damage results from increased intraocular pressure

6.9.2. Occurs in fourth decade Women more affected

6.9.3. assoc. with: increased lens size, iritis, allergy, endocrine imbalance, emotional instability and family hx

6.9.4. Acute Closed angle/ Narrow angle Medical emergency

6.9.5. Chronic Open angle Gradual

6.10. Macular degeneration

6.10.1. Most common cause of blindness over 65 damage of macula loss of central vision

6.11. Detached retina

6.11.1. Prompt treatment required

6.12. Corneal ulcer

6.12.1. RF: fever, irritation, nutrition deficiency, and stroke

6.13. Hearing loss

6.13.1. long time exposure to loud noises: music, jets, machinery, etc.

6.13.2. Ototxic drugs

6.13.3. Recurrent infection/irritation

6.13.4. diabetes, tumors of nasopharyngeal, hypothyroidism, and syphillis

6.14. Inner ear damage

6.14.1. Vascular problems, viral infections, presbycusis

6.15. Otosclerosis

6.15.1. Middle ear problem Affects more women Osseous growth

6.16. Tinnitus

6.16.1. Ringing in ears Hearing loss, ear injury, medication, cardiovascular disease

7. Skin

7.1. long term exposure to UV rays

7.1.1. Skin cancer

7.1.2. Photoaging

7.1.3. Skin spots

7.2. increased fragility of skin

7.2.1. increased risk for pressure injuries, infection, tears

7.3. Reduced thickness and vascularity

7.3.1. Vascular lesions

7.3.2. Varicose veins

7.3.3. Stasis dermatitis

7.3.4. Stasis ulcers

7.4. Increased coarseness of collagen

7.5. Decreased epidermal turnover

7.5.1. Delayed wound healing

8. Sleep

8.1. Phase advance

8.1.1. less REM sleep

8.2. Nocturnal myoclonus

8.2.1. related to use of anti depressants & renal failure

8.3. Restless leg syndrome

8.3.1. related to iron deficiency anemia, uremia, Parkinson’s, rheumatoid arthritis, diabetes, neuro lesions

8.4. Sleep Apnea

8.4.1. can be caused by COPD

9. Sexuality

9.1. Adropause

9.1.1. Decline in testosterone Can lead to erectile dysfunction, decrease in muscle mass, osteoporosis

9.2. Menopause

9.2.1. Cessation of menses

9.3. Erectile dysfunction

9.3.1. can be caused by diabetes, hypertension, MS, thyroid dysfunction, alcoholism, renal failure

10. Respiratory

10.1. Decrease in lung size

10.2. Decreased elastic recoil

10.3. Decrease in vital capacity

10.4. COPD

10.4.1. Asthma overuse of bronchodilator nebulizers increase risk for arrhythmias

10.4.2. Chronic bronchitis Scarring that restricts air flow Recurrent inflammation and mucus production Emphysema may develop

10.4.3. Emphysema Long term exposure to smoke, chronic bronchitis, chronic irritation, dissension of alveolar sacs

10.4.4. Lung cancer related to smoking Chronic exposure to coal gas, radioactive dusts, and chromates

10.4.5. Lung abscess Can be caused by pneumonia, TB, malignancy,, trauma and aspiration

10.5. reduced submucosal gland secretion

10.5.1. mucus is thicker and harder to expel

10.6. Trachea calcifies

10.7. Coughing reduced

10.8. Gag reflex becomes weaker

10.8.1. At risk for aspiration

10.9. Loss of skeletal muscle strength in thorax

10.9.1. Kyphosis

10.9.2. Barrel chest

10.10. Pneumonia

10.10.1. poor chest expansion

10.10.2. decreased immune function

10.10.3. reduced sensitivity of pharyngeal reflexes

10.10.4. Important to get pneumococcal vaccine recommended every 5 years

10.11. Influenza

10.11.1. recommended to go the flu shot, annually

11. Digestion and Bowel Elimination

11.1. Tongue atrophy

11.1.1. affects taste sensation dry mouth

11.2. Saliva production decreases

11.3. Presbyesophagus

11.3.1. Increased aspiration risk

11.4. Increased stomach pH

11.4.1. increase in gastric irritation

11.4.2. decrease in hydrochloride acid and pepsin decrease absorption in Ca, Iron, folic acid, B12

11.5. Increased constipation

11.5.1. decreased peristalsis, inactivity, decreased intake, drugs, low fiber diet

11.6. pancreases atrophies

11.6.1. Affects fat digestion

11.7. Hiatal hernia

11.7.1. Low fiber diet

11.8. Esophageal Cancer

11.8.1. Exposure to smoke, alcohol, poor oral hygiene contribute

11.9. Peptic Ulcers

11.9.1. Risk factors: smoking, alcohol, stress, H. Pylori infection

11.10. Diverticular disease

11.10.1. Diverticulitis overeating, straining with a BM, alcohol and irritating food

11.10.2. Chronic constipation, obesity, hernia, atrophy of intestinal walls, and low fiber diet

11.11. Colorectal Cancer

11.11.1. annual stool occult blood and digital rectal exams

11.12. Chronic constipation

11.12.1. Inactive, low fiber, low fluid, depression, laxative use, dulled sensations, incomplete bowel emptying

11.13. Intestinal obstruction

11.13.1. caused by diverticulitis, ulcerative colitis, hypokalemia, vascular problems, and paralytic ileus

12. Endocrine

12.1. thyroid gland atrophy

12.1.1. Decreased basal metabolic rate less secretion and release of thyrotropin

12.2. Adrenocorticotropic hormone decreases

12.2.1. Decreases activity of adrenal gland Decreases secretion of estrogen, progesterone, androgen, ketosteroids, and glucocorticoids

12.3. Pituitary gland decreases

12.4. Insufficient insulin release

12.4.1. Reduced tissue sensitivity to insulin Reduced ability to metabolize glucose

12.5. Diabetes

12.5.1. increased incidence between 65-74

12.5.2. Glucose intolerance

12.5.3. RF: obesity, inactivity, family hx

12.5.4. Fasting blood sugar screenings every 3 years over 45

12.5.5. Thyroid gland atrophies, fibrosis, increased colloid nodules, and lymphocytic infiltration

12.5.6. Renal threshold for glucose increases older adults hyperglycemia without symptoms

12.5.7. Risk for metabolic syndrome with diabetes

12.5.8. Hypoglycemia risk to older adults Uncorrected can cause tachycardia, arrhythmias, MIs, cerebrovascular accident, death

12.5.9. PVD common complication Retinopathy Cognitive impairment

12.6. Hypothyroid

12.6.1. production of T4 declines

12.6.2. More common in women

12.6.3. Primary Disease process that destroys gland Low T4, elevated TSH

12.6.4. Secondary Insufficient secretion of TSH low T4

12.7. Hyperthyroid

12.7.1. thyroid gland secretes excessive thyroid hormone

12.7.2. affects women more

12.7.3. Use of amiodarone potential cause

12.7.4. Goiter

12.7.5. Graves’ disease autoimmune

12.7.6. Risk for thyroid storm

13. Immunity

13.1. Decreased immune response

13.2. Thymus gland decreases

13.2.1. T cell function declines Less able to fight infection and illness

13.3. Decreased antibody response

13.4. More susceptible to influenza and pneumonia