The 7 Signs of Respiratory Aging: 1. Sign: Muscle Decline (Nursing)

by Rhonda Lawes, PhD, RN

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    00:01 Okay, we're talking about the 7 signs of respiratory aging.

    00:04 These are the 7 that we're going to look at.

    00:07 We'll look at them in this order.

    00:09 So you can follow right along with us.

    00:11 We'll just use this as a framework for our outline in the slides.

    00:14 Okay, so the respiratory muscles decline.

    00:17 It shouldn't be a surprise, right? That makes sense.

    00:20 But first I want you to think about, what are the muscles of respiratory? So take a minute.

    00:26 See if you can predict or if you can jot in the column.

    00:30 What are the respiratory muscles? Okay, let's walk through it.

    00:34 Now, you might be wondering what this is up here? Well, first of all, we're going to start with young Jose, because we always start with normal before we can talk more about the changes or abnormal.

    00:43 Now I do this with my students in a class and I usually take a 2.0 L pop bottle, and I put a balloon inside it.

    00:51 So you see down there that's supposed to represent a balloon.

    00:53 And then across the bottom, I have a flexible membrane that they can pull down.

    00:58 Now, if you were thinking about this as your respiratory system, does it make sense to you that the top if is the lungs, what is that membrane at the bottom? Well think about my body, if these are my lungs, what is the muscle that goes across my body this way? Right, it's the diaphragm.

    01:19 So we use this to help you understand the negative pressure that's needed to help your lungs expand.

    01:26 So your lungs are the balloon and the muscles along the bottom, your diaphragm are those that help pull down and cause negative pressure in your chest.

    01:36 Well, that's what allows me to take a big breath in.

    01:40 So as the air comes in, what caused that? Right, the diaphragm is domed.

    01:47 And when it flattens like that or when it pulls down as our membrane, that's when there's negative pressure created and air fills the lungs.

    01:56 So it's just another way to think about it.

    01:58 We build these models, we can put directions for you in the handout, but it helps you see that it takes that diaphragm being able to flatten to cause the air to rush into the lungs or to be able to inhale.

    02:12 That's why patients whose diaphragms are paralyzed, can't breathe on their own.

    02:17 So one big muscle of the respiratory muscles is clearly your diaphragm.

    02:22 Look at young Jose, right? Look at the difference in his diaphragm and old Jose, his diaphragm muscles are weaker than than they were when he was 20 years old.

    02:33 So you can tell that the work of breathing is going to be a little bit harder for him.

    02:40 So before we move on, I just want to go over this slide one more time.

    02:44 Remember, this is an analogy for you.

    02:47 This isn't exactly what your lungs look like, this is the analogy of using it in a bottle with a balloon and a piece of membrane along the bottom.

    02:55 So we'll show you more exactly what happens to the diaphragm.

    02:58 But the takeaway point here is it's that diaphragm muscle that when it flattens it pulls that air in by creating negative inspiratory force.

    03:09 So on the left, you have young Jose, on the right, you have older Jose, and you can see the difference in their diaphragm muscles there.

    03:19 So let's take a look at the specific muscles of respiratory like we just said we're wrapping it up.

    03:25 Your lungs were the balloon in that analogy.

    03:28 And that elastic membrane represents by your diaphragm.

    03:32 So take a look at that diaphragm you'll see that it's the MVPs.

    03:35 We told you it is the most important player there.

    03:38 Your diaphragm is dome-shaped and it's what divides my upper from my lower, right? This is why my lungs do not touch my intestines.

    03:46 So I have a diaphragm here.

    03:49 This is a main driver of respiratory rate.

    03:52 Now the ribcage muscles also play a role.

    03:56 Why would you need ribcage muscles so you can breathe? What I want you to do is take a big breath.

    04:03 What happens to your ribcage? Right, it lifts up and out.

    04:08 Fill up.

    04:11 Yeah, so they're muscles in between your ribcage that is what makes that movement.

    04:16 So the diaphragm causes negative pressure.

    04:20 The ribcage muscles help expand your chest, move it up and out.

    04:25 Now you also use abdominal muscles.

    04:27 We all want more of those and who doesn't want a six pack.

    04:30 Actually we all have one, some of us just keep ours hidden.

    04:34 But when we're talking about the muscles that allow us to breathe, you need an intact diaphragm, you need ribcage muscles and you need good abdominal muscles.

    04:46 Now when a young fit, healthy person.

    04:49 It's easy to see how these could be very strong.

    04:51 Let's take a look at what happens as you age.

    04:54 Because when your diaphragm relaxes, air leaves the body.

    05:00 So let's take a look at this in action.

    05:03 When the diaphragm muscle contracts, that's when it flattens.

    05:07 Now remember, that's going to cause negative pressure and you'll see that air rushes in to the lungs into the chest cavity.

    05:15 Now when those muscles relax, then air will leave the body.

    05:19 So those three groups of muscles, the ribcage muscles, the abdominal muscles and the diaphragm.

    05:25 Let's go over that when they contract, then you take air in and your chest wall expands when they relax.

    05:33 You breathe back out again.

    05:35 Now let's take a look at Jose at age 85.

    05:39 See this respiratory muscle strength.

    05:41 Remember and his endurance has deteriorated.

    05:44 Now, since these muscles, these three groups of muscles are not going to be as strong as he was when he was in his 20s, then we're going to have the maximal ventilator capacity is going to be decreased.

    05:55 So the major change we're going to see is that maximal ventilatory capacity is going to be less than when he was 20 years of age.

    06:03 So point 1, respiratory muscles decline.

    06:08 And when we say muscles, that's when we put pictures up here of someone exercising.

    06:12 Because the more we exercise the muscles, the better they will remain.

    06:17 So if you want to maintain health over your lifetime, exercising those muscles is the best way to do it.

    06:23 So it works with our cardiovascular system and it also works with our respiratory muscles.

    06:28 So you want to keep those in shape.

    06:29 The more we use a diaphragm, force yourself to do exercise that cause you to breathe faster and harder.

    06:35 That's going to keep your respiratory system in much better shape.

    06:40 And that's really what the difference is between a very active Jose, who can still jog and Enrique who stopped exercising years ago.

    About the Lecture

    The lecture The 7 Signs of Respiratory Aging: 1. Sign: Muscle Decline (Nursing) by Rhonda Lawes, PhD, RN is from the course Assessment of the Geriatric Patient: Respiratory System (Nursing).

    Included Quiz Questions

    1. To facilitate lung inflation by creating a negative-pressure environment when the diaphragm flattens.
    2. To facilitate lung inflation by creating a positive-pressure environment when the diaphragm flattens.
    3. To facilitate lung inflation by creating a negative-pressure environment when the diaphragm pushes upwards.
    4. To facilitate lung inflation by creating a positive-pressure environment when the diaphragm pushes upwards.
    1. The diaphragm
    2. Intercostal muscles
    3. The heart
    4. Abdominal muscles
    1. The diaphragm is the only respiratory muscle unaffected by normal aging.
    2. Maximal ventilatory capacity is decreased.
    3. Endurance and strength of respiratory muscles deteriorate.
    4. Further deterioration can be prevented or lessened by regular exercise.

    Author of lecture The 7 Signs of Respiratory Aging: 1. Sign: Muscle Decline (Nursing)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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