effect of aging on cardio-pulmonary system
DESCRIPTION
The PPT presents in brief the importance and effect of age on cardio-pulmonary systemTRANSCRIPT
![Page 1: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/1.jpg)
Effect of aging in CARDIO-PULMONARY
SYSTEMKrishna priya
![Page 2: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/2.jpg)
?
PHYSIOTHERAPY - AGING
![Page 3: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/3.jpg)
Physiological changes Exercise prescription Exercise response Factors affecting aging – biological and
psychological factors, disuse, disease etc…….
SAFETY OF THE CLIENT DURING REHABILITATION
![Page 4: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/4.jpg)
ANATOMICAL - Increase in heart weight Decrease in myocardial cells and
enlargement of remaining cells
Cardio-vascular system
![Page 5: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/5.jpg)
Increased left ventricular thickness Increase in left atrial size Reduced elastin and increased collagen in
the intimal layer of the heart and blood vessel walls and calcification stiffness
Decreased aortic distensibility
![Page 6: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/6.jpg)
Stiffness increase in systolic blood pressure
Decreased distensibility increased load on LV
AT RESTDiastolic propertiesEDV in cardiac cycle - Sufficient venous return Relaxation of ventricles Duration of atrial contraction Inspite of the stiffness if the walls, LA increase
in size maintains EDV
Relation between anatomical and physiological changes
![Page 7: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/7.jpg)
Increase in iso-volumic myocardial relaxation Decrease in ventricular filling rate in early
diastole Over all increased diastole of
ventricles DURING ACTIVITY OR MINIMAL EXERCISE EDV index increases Ventricular filling rate decreases due to
prolonged relaxation time and ventricular stiffness
![Page 8: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/8.jpg)
AT RESTSystolic properties End systolic volume Stroke volume same Ejection fractionDURING ACTIVITY OR MINIMAL EXERCISE End systolic volume Ejection fraction Myo-cardial contractility
![Page 9: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/9.jpg)
Causes – Decreased response to B-adrenergics Systolic BP Ventricular wall changesAEROBIC CAPACITY VO2 max As age VO2 max 0.4-0.5 ml/kg/min/yr – male 0.2-0.35 ml/kg/min/yr – female 10% per decade
![Page 10: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/10.jpg)
VO2 max inversely proportional to body weight and physical inactivity
Causes – Maximum HR CO and SV A-V O2 difference OTHER CHANGES Reduced baro receptor and cardio pulmonary
reflexes Reduced A-V dilatation Postural hypotension
![Page 11: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/11.jpg)
Diastole – Left ventricular wall thickness Left ventricular filling rate End diastolic volume Systole – Myocardial contractility End diastolic volume Ejection fraction
Effect of aging
![Page 12: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/12.jpg)
Arterial wall thickness Systolic blood pressure Diastolic blood pressure Orthostatic tolerance Arterial and venous dilation Vasoconstriction
same
![Page 13: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/13.jpg)
Cause peripheral effects not central HR max cannot be changed so SV, CO, VO2
max cannot be altered significantly Extraction of O2 by peripheral skeletal
musculature A-V O2 difference
VO2 max increases
EDV at rest and exercise Peak rate of ventricular filling
Effect of exercise training on CVS
![Page 14: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/14.jpg)
6 months – avg- 30 min, 3 times/week, 4-6 months – increased VO2 max by 14%
Active / sedentary – VO2 max reduces (5%) (10%)Poor improvements in Less initial VO2 max Increased age Short sessions of exercises Short over all duration of the study period
![Page 15: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/15.jpg)
Study –60-82 yrs, intensive endurance training,
Increase in EDV and peak ventricular filling rates
Causes Increased uptake of Ca Reduced relaxation time Increased fatty acid oxidation and
cytochrome C oxidase levels
![Page 16: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/16.jpg)
Systolic performance Increased exercise stroke volume, Increased ejection fraction, on
exercise End systolic volume decrease
Very old age, estrogen deficient women – no changes on exercise training
![Page 17: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/17.jpg)
Improvement in postural hypotension – blood flow to peripherally active muscles from inactive limbs and viscera
Reduce systolic and diastolic BP Reduce age related baro-reflex sensitivity Alters ANS and its control on resting HR Increase para-sympathetic activity and
attenuates sympathetic activity
![Page 18: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/18.jpg)
Long term aerobic training - Decrease symp + at given work rate Decrease exe HR Decrease BP
![Page 19: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/19.jpg)
Diastole – on exercise Left ventricular wall thickness
Left ventricular filling rate End diastolic volume Systole – Myocardial contractility End diastolic volume Ejection fraction
Effect of exercise training
![Page 20: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/20.jpg)
Arterial wall thickness ? Systolic blood pressure Diastolic blood pressure / Orthostatic tolerance ? Arterial and venous dilation ? Vasoconstriction Central venous pressure
?
![Page 21: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/21.jpg)
PULMONARY SYSTEM
![Page 22: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/22.jpg)
Anatomical changes – (thoracic cage, lungs, diaphragm) decreased – Calcification of costal cartilage with sternum Degenerative changes in thoracic spine and rib
articulations Kyphosis Reduced intervertebral spaces, Wedge shaped Increases AP diameter
Resp muscles in mechanically disadvantageous position
Decreased force generation
![Page 23: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/23.jpg)
Loss of elastic fibres in alveolar ducts Loss and destruction of supporting structures
of lung parenchyma Pre-mature closure of airways
Hyper-inflation Elastic recoil chest wall compliance Progressive decrease in respiratory muscle
strength (mild)
![Page 24: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/24.jpg)
Compliance – lung and chest wall Decrease in chest wall complian-ce is more than lung compliance
![Page 25: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/25.jpg)
Decrease in Alveolar – capillary surface area Alveolar surface area Total surface area of lung parenchyma Pulmonary blood flow volume
Reduced diffusion Increased dead space ventilation V/Q mis-match
![Page 26: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/26.jpg)
![Page 27: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/27.jpg)
Reduced elastic recoil – reduced exp flow + narrowing of airways
Reduced FEV1 Reduced closing volumes, increased FRC and
RV
Reduced FVC and flow rates Increased FRC TV decreases
![Page 28: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/28.jpg)
![Page 29: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/29.jpg)
Minute ventilation –RR*vol of air inhaled in 1 breath
Increase in RR, inspite of TV inspiration Diaphragm – change in muscle type –
reduced type 1 muscle fibres
Easy fatigue during increased load on RSIncreased WOB
![Page 30: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/30.jpg)
Immunological changes – BAL – broncho alveolar lavage Increased neutrophils; IgA, IgM, Reduced macrophages Antigens toxin production
Increased T lymphocytesIncreased neutrophilsRelease of super-oxide
![Page 31: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/31.jpg)
Persistent low grade inflammation
Damage to lung matrix
Impaired gaseous exchange ELF- epithelial lining fluid – rich in anti-
oxidantsAging – reduced ELF
Increased susceptibility to env toxins
![Page 32: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/32.jpg)
25-35/40 yrs (plateau)
Growth and maturation declines
0-20 yrs
Pulmonary changes also depend on -nutrition / dietlife style – sedentary/active, smokinginfections, environmentimmune system
![Page 33: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/33.jpg)
Chest wall stiffness Elastic recoil Alveolar capillary surface area Forced expiratory flow Total residual volume Forced vital capacity P I max and P E max V/Q matching Pa O2 Oxygen saturation Pulmonary vascular resistance
Effect of aging
![Page 34: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/34.jpg)
Expiratory flow limitation Minute ventilation Work of breathing Resp muscle O2 consumption Pulmonary artery pressure
![Page 35: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/35.jpg)
DURING ACTIVITY OR MINIMAL EXERCISE Expiratory flow limitation due to narrow air
ways Increase in minute volume, minimal increase
in TV, more in RR, shortness of breath Increased WOB to meet O2 demands via
alveolar ventilation, diffusion Exe – stiff alveolar walls – reduced elastic
recoil- increase pressure development by insp and exp muscles – increased WOB – increased O2 consumption by resp muscles (10-12% of total body O2 consumption)
![Page 36: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/36.jpg)
Sub-maximal exe – aerobic training – MV Walking, 70 yr, 12 week sub-maximal aerobic
exe, 7.7% in MV Reduced breathlessness Low exertion Use of low % of max ventilatory capacity
during exercise (reduced WOB)
Effect of exercise training
![Page 37: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/37.jpg)
Maximal exercise – 5 days/ week, 78% HR max Same case 14% in max MV Improved MV in terms of TV not RR
![Page 38: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/38.jpg)
aging on exercise
Expiratory flow limitation Minute ventilation
S M Work of breathing Resp muscle O2 consumption Arterial hypoxemia Pulmonary artery pressure Pulmonary wedge pressure
Effect of exercise training
![Page 39: EFFECT OF AGING ON CARDIO-PULMONARY SYSTEM](https://reader033.vdocuments.site/reader033/viewer/2022051323/54929ddeb47959676b8b45b1/html5/thumbnails/39.jpg)
Thank You