Unit 6-8: Ageing, Haemodynamic disorders, and Immobility

Flashcards covering ageing, haemodynamic disorders, and immobility concepts from the notes.

What is ageing?

The time-related deterioration of physiological functions necessary for survival and fertility, with progressive degeneration of tissues due to accumulation of molecular and cellular damage over time.

Name some risk factors associated with ageing.

Chronic diseases, neurodegeneration, cardiovascular issues; changes in the musculoskeletal and immune systems.

What are the cardiovascular risk factors mentioned in ageing notes?

Atherosclerosis/arteriosclerosis (hardened and narrowed vessels due to plaque), Decreased cardiac output (diminished pumping), Increased blood pressure (hypertension).

What is atherosclerosis/arteriosclerosis?

Hardening and narrowing of blood vessels due to plaque buildup, reducing blood flow and increasing risk of heart attack and stroke.

What does decreased cardiac output mean?

Diminished heart's ability to pump blood effectively, potentially leading to fatigue and shortness of breath.

What is hypertension?

Increased blood pressure, putting extra strain on the heart and blood vessels.

What is neurodegeneration?

Loss of neurons and impaired cognitive function; associated with conditions like Alzheimer's and Parkinson's disease.

What is cognitive decline?

Decline in memory, processing speed, and executive functions; the extent varies between individuals.

What is brain atrophy?

Brain shrinkage and loss of neurons and synapses; contributes to cognitive changes.

Define osteoporosis.

Decrease in bone density; bones become more fragile and susceptible to fractures.

Define sarcopenia.

Loss of muscle mass and strength; leading to reduced mobility and increased risk of falls.

Define osteoarthritis.

Degenerative joint disease due to wear and tear of cartilage tissue; leading to joint pain and stiffness and affecting mobility and quality of life.

What is immunosenescence?

Immune system becomes less effective at fighting off infections and diseases, increasing susceptibility to illnesses like pneumonia and influenza.

What is inflammaging?

Chronic low-grade inflammation that contributes to age-related diseases.

Name the hallmarks of ageing.

Genomic instability, telomere degradation, epigenetic changes, loss of proteostasis, impaired perception of nutrients, mitochondrial dysfunction, cellular senescence, exhaustion of stem cells, altered intercellular communication, deteriorated autophagy, chronic inflammation, and dysbiosis.

What is telomere degradation?

Telomeres protect chromosome ends; during cell division they shorten; as telomeres become too short, cells halt division and inflammation may occur.

What are telomeres?

Protective caps at the ends of chromosomes that shorten with each cell division.

What are epigenetic changes?

Heritable modifications to DNA that alter gene expression without changing the DNA sequence, caused by factors like diet, drugs, or stress.

What is loss of proteostasis?

Loss of protein homeostasis leading to accumulation of damaged and non-functional proteins, linked to neurodegenerative diseases.

What is impaired perception of nutrients?

Cells link growth and metabolism to nutrient availability; loss of nutrient-sensing pathways; examples include hormonal changes (e.g., menopause-related loss of libido).

What is mitochondrial dysfunction?

Loss of mitochondrial respiration/dysfunction often due to mtDNA damage or other mitochondrial defects.

What is cellular senescence?

Cells stop dividing in response to stress and may secrete inflammatory molecules, contributing to aging phenotypes.

What is exhaustion of stem cells?

Loss of tissue repair or renewal capacity due to depletion of stem cell reserves.

What is altered intercellular communication?

Loss of signaling between cells through hormones, cytokines, and metabolic products.

What is deteriorated autophagy?

Reduced breakdown and recycling of unwanted or damaged cellular components.

What is chronic inflammation in ageing?

Increased inflammatory processes that contribute to tissue damage and age-related diseases like obesity and type 2 diabetes.

What is dysbiosis?

Imbalance of the intestinal flora, leading to opportunistic infections.

What is hyperemia?

Increased blood flow to tissues or organs.

Name the types of hyperemia.

Reactive hyperemia, Active hyperemia, Functional hyperemia, Conjunctival hyperemia.

What is passive hyperemia?

Decreased outflow from blood vessels (congestion); can be acute or chronic.

What is edema?

Retention of fluid in body tissues causing swelling, which can be localized or generalized.

What are common causes of edema?

Circulatory problems, infection, tissue death, malnutrition, total body fluid overload, electrolyte imbalance; heart failure, kidney disease, liver disease; pregnancy; certain medications.

Name some edema locations.

Peripheral edema (legs/feet), pulmonary edema (lungs), cerebral edema (brain), macular edema (eye), periorbital edema.

What is thrombosis?

Blockage of a blood vessel caused by a blood clot; venous thrombosis (e.g., DVT) and arterial thrombosis.

What are D-dimers?

Proteins produced during breakdown of blood clots by plasmin; elevated levels indicate recent clot formation and breakdown.

What is the coagulation cascade?

Hemostasis process with primary (platelet) and secondary (coagulation cascade) hemostasis and fibrin clot remodeling; vessel constriction also occurs.

What are basic coagulation tests?

PT, aPTT, TT, D-dimers, bleeding time, FDP, INR (optional).

What is disseminated intravascular coagulation (DIC)?

A rare clotting disorder that can cause organ damage and uncontrollable bleeding; progresses from microthrombi formation to consumption of platelets and clotting factors.

What is an embolism?

Blockage in a blood vessel caused by a detached piece of material such as a clot; types include pulmonary thromboembolism, systemic thromboembolism, fat embolism, amniotic fluid embolism.

What is ischaemia?

Decreased blood flow to a tissue resulting in hypoxia.

What is infarction?

Complete cut-off of blood flow resulting in necrosis (cellular death).

What are myocardial ischaemia and myocardial infarction?

Myocardial ischaemia is partial obstruction of a coronary artery; myocardial infarction is complete blockage of a coronary artery. Both affect heart muscle.

What are the main types of shock?

Obstructive shock, Cardiogenic shock, Distributive (vasodilatory) shock.

Give examples of distributive (vasodilatory) shock.

Anaphylactic shock, septic shock, neurogenic shock.

What is immobility?

State of being unable to move or having limited movement; prolonged non-motion can have detrimental health effects.

What does hemiplegia mean?

Paralysis on one side of the body.

What does paraplegia mean?

Paralysis of the lower half of the body, affecting both legs.

What does quadriplegia mean?

Paralysis of the trunk and all four limbs.

What does diplegia mean?

Symmetrical paralysis in the same area on both sides (commonly legs or arms).

What does monoplegia mean?

Paralysis that affects a single limb.

What are the musculoskeletal effects of immobility?

Loss of strength, endurance, and mass; muscle atrophy; potential loss of half of muscle strength after prolonged bed rest.

How does immobility affect bone?

Loss of bone mass due to reduced weight-bearing activity; decreased osteoblastic activity with continued osteoclastic activity.

How are tendons and ligaments affected by immobility?

They require movement to maintain structure; immobility shortens connective tissue and increases density, reducing flexibility and range of motion.

What are cutaneous effects of immobility?

Poor circulation or anemia, edema, inadequate subcutaneous tissue, loss of sensation, friction, excessive moisture, poor hygiene, inadequate nutrition/hydration, trauma to skin.

What cardiovascular changes occur with full immobilization?

Blood pools in the trunk; venous return and cardiac output may be reduced; orthostatic hypotension on position change; dizziness, fainting, sweating, rapid pulse.

What happens to cardiovascular reflexes after prolonged bed rest?

May take weeks for reflexes to return to normal; risk of blood pooling and thrombosis.

What are respiratory effects of immobility?

Decreased metabolism, slower/shallow respiration, difficulty deep breathing and coughing, increased lung secretions, risk of pneumonia.

What are gastrointestinal effects of immobility?

Decreased dietary intake, negative nitrogen balance, protein deficit, constipation, obesity if caloric intake exceeds needs.

What are urinary effects of immobility?

Urinary stasis, infection, renal calculi risk (especially with dehydration or catheter use).

What are neural and psychological effects of immobility?

Continuous pressure on skin can stimulate pain receptors; muscle spasms; potential nerve damage leading to impaired innervation; risks include depression.

How can immobility affect children?

Extended immobility can delay normal growth and development; contractures and loss of muscle tone may occur in hips, spine, hands, and feet; catch-up growth is possible.