• Like
Lecture26
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

Published

 

Published in Health & Medicine
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Be the first to comment
    Be the first to like this
No Downloads

Views

Total Views
283
On SlideShare
0
From Embeds
0
Number of Embeds
0

Actions

Shares
Downloads
2
Comments
0
Likes
0

Embeds 0

No embeds

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
    No notes for slide

Transcript

  • 1. Effects of Aging on Mobility and Independence Anthony Poggio, DPM,MS Cal ‘ 79
  • 2. Affects of Aging
    • Muscle
    • Tendon
    • Bone
    • Skin
    • Neurology
    • Vascular
    • Psych
  • 3. Muscle/Tendon
    • Support Skeletal system; Posture
    • Facilitate motion
    • Heat Production
    • Weakness
    • Contracture
    • Gait changes
    • decrease in energy supply (ATP, creatine phosphate and glycogen
    • decreased circulation to bring in O2 and clear lactic acid
    • Changes at the motor end plate, therefore decrease in stimulation potential
  • 4. Muscle/Tendon
    • Changes at the motor end plate, Sarcolemma are fewer, shorter, become smoother
    • decrease in surface area therefore decrease in stimulation potential
  • 5. Muscle/Tendon
    • reduction in size and number of mitochondria hence decrease in available energy
    • decrease in substances to supply energy (ATP, creatine phosphate and glycogen)
  • 6. Muscle/Tendon
    • Decreased circulation to bring in O2 and nutrients
    • breakdown of other substances creating build up of lactic acid
  • 7. Muscle/tendon
    • Increase in fat/fibrinous tissue within muscle
    • decreased ability or muscle repair
    • increased scar tissue
    • therefore there is slower, weaker, irregular contraction with longer recovery period
  • 8. Bone
    • skeletal structure
    • Attachment for muscle, tendons. ligaments, etc
    • Blood cell production
    • Osteoporosis
    • Osteopenia
    • fracture, hip
    • delayed healing
  • 9. Bone
    • Cortical bone:
      • Dense packed bone, very compact and hard
      • forms outer shell of bone
    • Trabecular bone:
      • loosely packed matrix, “spongy”
      • head and base of long bones
      • majority of irregular bones
  • 10. Joint
    • Arthritis
      • Joint Stiffness
      • loss of cartilage
      • loss of joint contour
      • angular deformities
    • Synovial membrane less elastic as are adjacent ligament structure
    • with less movement-joint (ligaments) contract to position
    • Hyaline vs fibrocartilage
  • 11. Joints
    • Loss of hyaline cartilage
    • decreased water content with increased calcium salts, crosslinking of fibers therefore more stiff and less elastic
    • can reform fibrocartilage
  • 12. Joints
    • Synovial fluid decreased in volume secondary to decreased blood flow,
    • Synovial membrane less elastic as are adjacent ligament structure
    • with less movement-joint (ligaments) contract to position
  • 13.  
  • 14.  
  • 15. Skin
    • Provides barrier
      • organisms,
      • chemicals,
      • water,
      • light,
      • trauma
  • 16. E Epidermis PIDERMIS With aging less able to keep out substances; chemicals, microorganisms athletes foot, fissures ROLE: Provides Protective Covering & Generates New Cell Growth
  • 17. D Dermis ERMIS
      • Major Structures : Blood Vessels, Nerve Endings, Hair Follicles, & Sebaceous Glands that secrete sebum to prevent skin from drying out
    • With aging less h20 more crosslinking of collagen therefore thinner and less elastic- fissures
    ROLE : Provide the Skin with Strength & Elasticity
  • 18.
    • With aging
      • decreased fat: decreased cushion, callous/corns
      • less skin support: increased sheer force
    • ***Typically the subcutaneous tissue is poorly vascularized.
    Subcutaneous tissue UTANEOUS TISSUE ROLE: Provides protection & insulation for the underlying tissue
  • 19. Skin
    • Decubitus ulcers-bed sore
      • weaker skin
      • thinner skin
      • decreased blood supply
      • skin hygiene
      • poor nutrition
      • decreased ability to repair
  • 20. COMMON LOCATIONS
    • Bony Prominences
    • Occiput
    • Scapulae
    • Elbows
    • Sacrum
    • Trochanter
    • Ischium
    • Knees
    • Ankles
    • Heels
  • 21.
    • Annual US healthcare costs are over $1.3 billion
    • Average cost per ulcer = $27,000
    • Quality of life issues
    • Increased length of stay
    • Tissue and bone infections
    COSTS OF PRESSURE ULCERS
  • 22.
    • Pressure ulcers occur in 11% of all hospital admissions
    • Pressure ulcers occur in over 25% of long term care residents
    • Certain patient groups have even higher groups have even higher incidences - 66% of femoral fracture patients, 60% of quadriplegic patients
    PRESSURE ULCERS
  • 23. DEFINITION OF A PRESSURE ULCER
    • Localized area of tissue breakdown resulting from compression of soft tissue between a bony prominence and an external surface
  • 24.  
  • 25.  
  • 26. SKIN BREAKDOWN: DIABETIC ULCERS Skin breakdown due to loss of sensation coupled with repetitive pressure and shear
  • 27. Vascular
    • Peripheral arterial disease
    • venous disease
    • diminished healing ability, defense
    • micro-circulation to muscle, nerves, etc
    • amputation
    Function: Transportation
  • 28.  
  • 29.  
  • 30. Venous disease
    • Return blood to heart
    • slower blood flow-clot formation
    • venous stasis dermatitis- skin damage
  • 31.
    • Capillaries have thin, single-cell thickness walls
    • Venous hypertension causes capillary walls to stretch, creating gaps between cells
    CAPILLARY HYPERTENSION
  • 32. Neurology
    • Function
      • monitoring,
      • communicating
      • stimulation
      • coordination
  • 33. Neurologic
    • Nerve Loss
      • sensory
      • motor
    • Coordination
    • reflexes
  • 34. Neurology
    • Sensory
      • requires more stimuli to elicit response
      • awareness of position
    • reflexes
    • Somatic
      • decreased transmission speed down axon resulting in slower and weaker contraction ability
      • prolonged refractory period before next contraction
      • less coordinated motion
  • 35.  
  • 36. Misc
    • Vision
      • obstacle
    • cardiac
    • pulmonary
      • stamina
  • 37. Putting it all together
  • 38. Psychological Factors
    • Loss of independence
      • fear of losing independence
      • rely on family/friends for simply tasks
      • must be done at their convenience
      • isolation
  • 39. Psychological Factors
    • Assistive devices
      • realization they are old
      • embarrassment in public
      • limitation in activities
  • 40. Psychological Factors
    • Self Care
      • inability to bend to reach items
      • open bottles, apply dressing
  • 41. Psychological Factors
    • Fear of Falling
    • Decreased stamina
    • Cycle of decreased activity
      • more stiffness
      • decreased vasc supply and overall health
      • less coordination
      • increased isolation
      • depression
  • 42. Prevention/Treatment
    • In home support vs nursing home
    • improvement in function
      • physical therapy, medication
    • Age related or not??
    • Social agencies
      • paratransit, special equipment (scooters)
  • 43. Prevention/Treatment
    • Put in perspective
    • Enlist family support
    • active participation-feel in control
    • speak to them, not down to them
    • patience
  • 44. THANK YOU! Good Luck in Your Future Careers G O B E A R S ! ! !