Health & Disease (Test 1) 2-7

Changes in cardiovascular system

Heart valves and arterial walls thicken, oxygen supply decreases, cholesterol/lipids accumulate in arteries

asphyxial injury:

drowning

Changes in endocrine system

Reduced response to hormones

Changes in gastrointestinal system

Saliva decreases, periodontal disease increases, obesity is common, essential nutrients inadequately absorbed.

Changes in integumentary system

Skin/mucous membranes become fragile, wounds heal slower, fibers reduce in amount and flexibility, hair is gray and thinner

Changes in musculoskeletal system

Bone mass is lost, fractures are more common, cartilage degenerates

Changes in neurological system

Brain mass reduced, less response to neurotransmitters, sensory function is reduced

Changes in reproductive system: Women

Menopause, breast tissue decreases, hot flashes

Changes in reproductive system: Men

Reduced sperm production

Changes in respiratory system

Lung tissue elasticity decreases, skeletal muscle weakens, vascular degeneration occurs

Changes in urinary system

Kidneys degenerate, bladder function reduces, muscles weaken

Sarcopenia and how to help combat it:

Loss of skeletal muscle mass (begins in someone's 30s & accelerates around 65-80). Progressive weight training is the most effective treatment.

Most common diseases found in women:

Heart disease, cancer, stroke, COPD, Alzheimer's, diabetes, influenza

Most common diseases found in men:

Heart disease, cancer, stroke, COPD, diabetes, influenza, kidney disease

COPD means:

Chronic Obstructive Pulmonary Disease

Osteoarthritis:

Most common type of arthritis in elderly, pain & impairs mobility.

PT can help by hypertrophy & strengthening of muscles to absorb shock and weight bearing joints. Strengthening quadriceps & gastrocnemius muscles help.

Environmental Risk Factors for Disease:

Air/Water pollution

Noise

Poor living conditions

Poor sanitation

Harsh locations

Chronic Stress

Common air pollutants include:

Ozone

Particulate matter

Carbon monoxide

Nitrogen Oxides

Sulfur Dioxide

Lead

Family history of many diseases can:

make family members more likely to develop them.

Family history of certain disease can increase by:

Smoking

High-fat diets

Lack of exercise

Lifestyle Components Increasing Disease Risks:

Dangerous jobs, habits, behaviors

Smoking

Excessive alcohol use

Risky sexual behavior

Use of illegal drugs

Lack of exercise

Poor nutrition

Psychological stressors

Stress

Regular Exercise Importance in Preventing Conditions:

Heart Disease

Stroke

Type 2 diabetes

Obesity

Back Pain

Osteoporosis

What is the percent of men and women that DON’T exercise:

60%

Low Socioeconomic Classes:

Have a higher likelihood for developing some diseases than other groups of people. Has 3x reported chronic diseases vs high income class, and treatment may be delayed due to no healthcare insurance or ability to pay.

Cancer:

Uncontrolled cell proliferation, causes development of tumors or neoplasms.

Malignant Tumors usually develop:

More quickly than benign tumors, often invade surrounding tissue (bloodstream & lymphatic vessels).

Family history is vital in regard to genetic diseases:

Involved abnormalities in genes or chromosomes.

Common Genetic Diseases:

Cancer

Coronary disease

Various arthritic conditions

Kidney disease

Immune Disorders:

Result from the body’s natural defense system breaking down.

Three types of Immune Disorders:

Hypersensitivity (allergy)

Autoimmune diseases

Immunodeficiency disorders

What causes Infections and their symptoms?

Pathogens

Symptoms of infections

Redness, heat, pain, swelling, fever, pus, enlarged lymph glands. red streaking of the skin

Source of infection include:

Endogenous & Exogenous

Endogenous:

From within the body.

Exogenous:

From outside the body.

Acute Inflammation:

A normal protective physiologic response to disease tissue injury.

RPTA: Obesity

Hypertrophy of muscle mass increases the body's lean body mass. For obese patients, exercise might include aquatics, recumbert bike, or NuStep machines

What has positive & negative effects upon health?

Diets

Diets high in fruits & vegs, low in saturated fats & unprocessed carbs:

Associated with lower health risk.

Most Significant diseases related to diet include:

Diabetes

Cardiovascular disease

Cancer

Obesity

Osteoporosis

Obesity:

Excessive fat accumulation; body mass index greater than or equal to 30 kg per square meter. (65% of adults are overweight or obese)

CPTA: Obesity

BMI - mass and height of a person

Obesity places excessive load on joints, 1 of 5 children are obese, 1 of 3 adults is obese

Three overall causes of death:

Cardiovascular disease, cancer, and diabetes mellitus

Complications of obesity

Liver Disease

Asthma, Stroke, Liver Disease, Sleep Apnea, Hypertension, & Infertility

Leading cause of death in children & young adults:

Physical Trauma (Falls, Motor Vehicle Accidents & Burns)

Potentially Dangerous Chemical Agents:

Poisons

Pollutants

Drugs

Preservatives

Cosmetics

Dyes

Domestic Violence: DV

Occurs in all socioeconomic & racial-ethnic groups.

Examples of DV:

Physical abuse

Emotional/Psychological abuse

Sexual Abuse

Neglect

Stalking

PTA responsibilities to report abuse (DV):

mandatory reporters; required to "report suspected cases of abuse involving children or vulnerable adults to the supervising PT and appropriate authority subject to law"

Child Abuse:

May be physical or emotional which includes neglect & sexual abuse; frequent illness related to the ears, throat, lungs, chest, and/or GI tract.

Shaken Baby Syndrome:

Retinal hemorrhage & signs of traumatic brain injury

Elder Abuse:

Intentional & negligent acts by caretakers or others than cause harm or serious risk of harm to older patients. Older than 60 years!

Examples of Elder Abuse:

Soiled clothing or bedding

Dehydration

Malnourishment

Weigh loss without illness

Skin conditions

Poor Hygiene

Cultural Diversity Differences in:

Language

How health issues are views

Religious beliefs

Life experiences

Dietary preferences

Traditions concerning life/death

Mental Disorders include:

Dementia

Grief Response

Mood Disorders

Somatoform Disorders

Linked to premature aging & death:

Social, Psychologic, & Physiologic factors

Severe prolonged stress or multiple stressors may result in:

Peptic Ulcer or Acute Renal Failure.

Stress and how a PTA can reduce it

Allow pt to have as much choice in tx and goals as possible, assess pts readiness to change, provide pt with achievable goals and outcomes, provide stress-relieving strategies, give constructive feedback

Psychological Factors:

Affect health; physical evaluation also includes assessment of the patient’s mental status.

Cellular Changes:

A body cell undergoes changes that allow it to survive and maintain its functions under harmful conditions.

If cell adaptation is inadequate, what occurs?

Cell injury & death

Adaptive Cellular Changes include:

Differentiation & Growth

Integumentary System:

Aging causes skin/mucous membrane to become thin/fragile. Wrinkling of skin occurs due to reduced amounts of elastic fibers & toughening of collagen fibers.

Skin Turgor:

Inability of the skin to change shape and return to normal, determined by hydration and age.

Musculoskeletal System:

Common changes due to aging include Osteoporosis, Osteoarthritis, & Herniated Intervertebral Discs as well as sarcopenia.

Musculoskeletal System Changes Beginning @ age 30:

Decline in skeletal muscle mass from atrophy; reduced strength of muscle contractions & flexibility; slow or stiffened movements.

Sarcopenia:

Decrease in strength & mass

What is of vital importance to decrease the effects of aging:

Regular Exercise

Osteoporosis:

Loss of calcium & bone mass, as a result of aging.

Some risk factors of Osteoporosis:

Decreased calcium, vitamin C, and vitamin D intake.

Decreased osteoblastic (cells that build bone) activity.

Decreased estrogen levels due to aging.

Decreased Bone Mass & Density:

Caused by reduced new bone deposition; which causes the bone to become porous and brittle, leading to fractures.

Decreased Bone Mass & Density in Spine:

Spontaneous fractures of the vertebrae result in decreased height & kyphosis.

Recommendation to reduce risk/progression of Osteoporosis:

Weight-bearing exercise, walking, physiotherapy, rehabilitation programs.

Osteoarthritis:

Degeneration of joint cartilage which causes articular to become thin and eroded. This causes pain in large weight bearing joints and impaired joint movement.

Herniated Intervertebral Discs:

Discs of the spine degenerate, sudden stress, and may cause the herniation of a disc; causes pressure on spinal nerves and severe back pain.

Neurological & Sensory Systems: Affects of Aging

Neurons in brain not replaced after birth; natural reduction in brain mass as we age.

Common manifestations due to aging in the Neurological & Sensory Systems:

Increased neurological lipids

Myelin sheath loss

Development of abnormal plaques & neurofibrils

Decreased cellular response to neurotransmitter chemicals (norepinephrine) lead to delays in what?

Synaptic Transmission in the brain.

Glaucoma:

Eye muscles degenerate which can result in decreased adaptation to light, intraocular pressure.

Hearing Conditions that are more common in older adults:

Meniere’s Disease

Otosclerosis

Tinnitus

Meniere’s Disease:

Vertigo, ear ringing, ear pressure

Otosclerosis:

Excessive bone growth in inner ear, decreased vibration of inner ear bones)

Tinnitus:

Ringing of ears

Affects of age: Endocrine system

System and hormones change little

As the number of tissue receptors decreases, the body's response to hormonal effects decreases

Affects of age: Cardiovascular system

Causing the heart's fibers and connective tissues to change

Affects of age: Respiratory system

Becomes reduced in older individuals due to skeletal, cartilage, lung, and muscular changes

Affects of age: Musculoskeletal system

Causes osteoporosis, osteoarthritis, herniated intervertebral disks

Sarcopenia causes muscles to decrease in strength and mass

Affects of age: Digestive system

Good nutrition in the elderly is vital to support body function; teeth are lost, reduce saliva, lack of mobility, peptic ulcers

Affects of age: Urinary system

Aging causes reduced kidney function because of degeneration of tubules and blood vessels, loss of bladder function, incontinence

Affects of age: Reproductive system (Females)

Ovaries stop responding to FSH and LH, ovulation cesases, estrogen and progesterone levels decline

Affects of age: Reproductive system (Males)

Experience far fewer reproductive changes, benign prostatic hypertrophy may be a significant problem

Disease Processes Associated with Aging:

Cancer is more prevalent because the immune system is less effective; increased medication use increases undesirable interactions; Elderly infections are more common because normal defense mech and tissue healing impacted.

Majority of components of the inflammatory process are found in:

Circulatory System

1st line of defense: Nonspecific

Skin

Mucous Membrane

Body Secretions

2nd line of defense: Nonspecific Phagocytosis & Inflammation

Neutrophils

Macrophages

Interferons

Neutrophils:

One the leukocytes (WBC)

Macrophages:

Both use phagocytosis to engulf & destroy BACTERIA, cell, debris, & foreign matter.

Interferons:

Non-specific agents that protect uninfected cells against VIRUSES.

3rd line of defense: Immune System & Specific

Stimulates production of unique antibodies or sensitized lymphocytes, after exposure to specific foreign substances.

Inflammation is the reaction of:

Vascularized tissue to local injury. Should not be confused with infection. Normal body defense mech that localizes & removes agents harmful to the body.