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211 exam 1
Geriatric sensory and gait changes
| Question | Answer |
|---|---|
| Normal changes with Visual ____ with aging | Acuity |
| how does visual acuity change with age | Gradual decline through 60’s, then by 80’s - 80% loss |
| what causes changes in visual acuity with age | Smaller pupil Clouding/hardening of the lens |
| presbyopia | loss of ability to focus on objects up close, Natural part of aging |
| common early sx of presbyopia | need to hold reading materials farther away to focus. Reading glasses help. |
| treatments/adaptations for visual changes | Glasses – Bifocals can be dangerous, decrease in speed of eye adjustment = falls Magnifiers, large print 2-3x more light needed Use night lights to light the way to BR |
| how does aging affect tolerance to glare? | decrease tolerance due to opaqueness - Do not do well with white floors, white walls, etc |
| adaptations for reducing glare | Soft light, use lamp shades, sheers, tinted glass decrease reflective surfaces – matte finishes, visors Difficulty driving on rainy nights |
| with age, the ability of the eye to accommodate to darkness ____ (decrease/increase) due to smaller pupil | decrease |
| adaptations for better vision in the dark | carry a flashlight with keys, avoid night driving, auto timers on porch lights, night lights |
| how does aging affect color discrimination? | decrease perception in distinguishing color due to changes in cones and lens |
| what color perception is most impaired with aging? | Cool pastel colors are most impaired (blues, greens, violets) |
| what colors are easiest to see for older people? | Warm bright colors are easiest to see (reds, oranges, yellows) |
| adaptations for impaired color discrimination | use lots of contrast colors and warm colors |
| other changes with aging | decrease depth perception (need to feel chair and stairs) decrease visual field decrease spatial sensitivity decrease convergence (ability to focus) |
| how do cataracts manifest | decrease central vision 1st then peripheral Cloudy lens Bothered by glare, gradual darkening |
| treatment/adaptations for cataracts | Laser surgery Meds Cataract lenses (these make things appear closer than they actually are) |
| presbycusis | progressive loss of hearing due to normal aging most common cause of hearing loss |
| what causes presbycusis | Due to acoustic trauma – loud machinery, music Due to ototoxic meds |
| two types of presbycusis | 1. conductive loss 2. sensorineural loss |
| conductive loss | Change in peripheral sensory organs, thinning of tympanic membrane etc |
| what can help with conductive loss | Hearing aids - amplification can be helpful – need fine motor skill, clean hearing aid |
| sensorineural loss | Degeneration of nerve fibers in cochlea - decrease in speech discrimination *hearing aids do not help with either |
| treatment strategies for all types of hearing loss | Face at eye level Slow, clear verbalization Lower pitch of voice increase use of non-verbals Write in big print decrease background noise Use visual aids for emergencies – lights flash for doorbell, phone – a lot of stuff from blind society. |
| how does age affect somatosensation? | decrease concentration of touch/texture receptors (Meissner Corpuscle – light touch & Pacinian Corpuscle – pressure/play a role in proprioception) |
| how can you check somatosenation? | tuning fork for vibration, or hip and ankle strategies |
| how does aging affect taste? | decreased by age 60, increased gingivitis |
| how many taste buds have been lost by age 60? | about 1/2 |
| what taste buds are lost first? | sweet/salty (front buds) are lost first due to increased salt and hypertension |
| why should everyone exercise? | Use it or lose it Maximize independence Improve psych. Health Weakest have most to gain |
| how does age affect stride? | slower, shorter stride, increase number of steps and energy expended |
| how does age affect the pelvis, hip, knee and ankle during gait? | Decreased pelvic rotation Increased pelvic shift Decreased motion at the hip, knee, ankle and arms |
| how does age affect the stance phase of gait? | Longer stance, double limb support Increased sway |
| how does age affect COG? | more forward, decreased reaction time |
| muscle activity changes in glute max and med during gait in elderly | Glut. Max and Med fire during midswing on swing leg (normally should fire end of terminal swing/inititial contact/LR/midstance) Glut Max will fire also during Terminal stance/preswing glute med contract during initial swing |
| why does glute max contract during initial swing in elderly? | probably for balance control |
| muscle activity changes in the hip flexors during gait in elderly | fire early and longer at terminal swing and IC/LR. |
| why do hip flexors fire early in elderly during gait? | probably looking down |
| what causes gait changes? | decrease ROM Postural changes due to osteoporosis decrease sensation (proprioception) Slower muscle response time ( nerve conduction velocity) decrease vision Impaired hearing – echos, traffic noise may make community ambulation difficult |
Created by:
bdavis53102
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