There is generalized loss of subcutaneous tissue and sebaceous, sweat glands and hair follicles.
Collagen and elastin degenerate, blood vessels thicken and superficial vessels become prominent.
Loss of estrogen in women leads to the development of some male characteristics.
There is extrapyramidal tract impairment which affects facial reaction as well as producing slowing of movements.
1. Subjective complaints
loss and thinning of hair
wrinkling of face and neck
c. chin whiskers (female)
d. decreased facial hair (male)
2. Objective findings
graying thin hair
wrinkled dry facial skin
facial hair growth (females)
prominent superficial face blood vessels
thinned and bristling eyebrows
impassive facial expression with decreased eye blinking
Skin becomes thickened in nasal area, and gravitational pull makes organs appear longer.
CNS changes contribute to decreased smell (parietal lobe).
There is thinning and drying of nasal mucous membrane.
1. Subjective complaints
nose is larger
loss of smell
large elongated ‘thick skinned’ vascular nose
inability to recognize scents or discriminate between smells
shiny, vascular nasal membrane turbinates
IV. MOUTH, THROAT, AND NECK
There are atrophic changes which occur in the mouth. Salivary glands and lateral papilla on sides of the tongue atrophy and mucous membranes thin.
Facial muscles become lax, and mandible loses normal contours due to bony changes, gravitational pull and muscle weakening.
There is inward bulging of the buccal mucosa because of loss of elasticity of the fibers that attach the buccinator muscle and the mucous membrane.
Gingival tissue atrophy and recede, and there is a diminished cough and swallowing reflex.
Neuronal degeneration results in a diminished sense of taste, especially sweets.
The surface pattern of and color of teeth change, roots are resorbed and pulp fibroses and calcifies.
Dentine loses permeability and becomes dehydrated.
Loss of skin elasticity and gravitational pull result in accentuated wrinkling in the neck area, and the musculoskeletal changes of the spine produce a forward tilting of the head.
The neck is shortened as a result of these changes and the thyroid may descend below the clavicles.
Elongation of the aorta and elevation of the aortic arch may cause malposition or distention of the innominate artery or jugular vein.
Tonsillar lymph nodes may be calcified as a result of old infections such as tuberculosis.
There is a loss of elasticity in laryngeal muscles and cartilage.
V. HEARING LOSS AND HEARING AIDS
Consider hearing loss in three ways (all 3 benefit from hearing aid):
degree--volume above normal level needed to hear
configuration--rage of frequencies at which loss occurs
type--part of the auditory system affected.
B. Type influences treatment
conductive--basically mechanical; often treated surgically or manually
sensorineural--abnormality of cochlea, auditory nerve or brain
infections--in utero or infancy/childhood
congenital (Down’s syndrome, cystic fibrosis, etc.
3. Mixed--combination of 1 & 2
4. Central--centers responsible for decoding nerve signals that represent could can be damaged by trauma, strokes, tumors, and genetic defects. Peripheral hearing is good but patient cannot process the information.
C. How Does A Hearing Aid Help?
1. By setting or programming the amount of amplification the instrument provides at various frequencies,
the hearing aid attempts to make speech easier to hear and understand.
2. Although the aid amplifies sound it does not automatically improve the clarity of speech for all wearers.
3. Recent improvements in hearing aids:
a. filter background noise
b. change tonal qualities
c. modify (suppress) amount of power delivered to ear to control environmental loudness
e. digital--able to program to various listening situations