- Disability in geriatrics.

-Morbidities and injures in old age interfere with physical activities , mental and psychologic behavior.

- And associated with variable degrees of disabilities from so mild and hardly noticed to sever and complete disabilities.

- Causes of (disabilities) handicapping in old age = 10 I :-

• Intellectual Impairment (dementia,...etc)
• Impairment of vision & hearing.
• Immobility.
• Instability causing repeated falling.
• Inanition(loss of teeth)causing malnutrition.
• Infection.
• Incontinence.
• Impotence.
• Iatrogensis.
• Isolation causing psychological disorders.

-Sudden Infant Death Syndrome.

Sudden Infant Death Syndrome.
(SIDS) Or COT death

Def:- Sudden unexpectrd death in infant of appearant good health,without giving a commonly accepted cause at autopsy.

The cause:- undefinite but may be:-

1. Suffocation.
2. Infections:fulminant viral infections.
3. Impaired respiratory reflexes.
4. Diet : Improper diet causing nutritional deficiences or hypernatremia.
5. Sensetivity to milk proteins.
6. Cardiac conduction disorders.
7. Co or Co2 poisoning.
8. Overlying in the early life.
9. Thermal: Hyper or hypothermia.

*Features of the syndrome:

- Age: () 2weeks and 2 years with a peak 2-3 months of life.

- Sex : males more than  females.

- Social level: low socioeconomic level more than high socioeconomic level.

- Whether: cold winter more than hot summer.

- Twins more than single babies due to:

•   increase icidence prematurity.
•   low birth weight.

- Important Points in Nutrition.

- Animal milk is poor in:-

*Vitamins:-

Vit D

Vit C

Thiamine (Vit B1).

*Minerals:-

Zinc

Iron


*Essential fatty acids

--------------------------------

- Vitamins syenthesized by Intestinal flora:-

Vit K2

Vit B6

Folic acid

Niacin

--------------------------------

- Nutritional Bone diseases:-

Rickets (Vit D deficiency)

Osteomalacia (Ca deficiency)

Osteoprosis

Dental Caries (Ca,fluorine deficiency)

--------------------------------

- Nutritional Anaemia:-

Iron ( hypochromic microcytic anaemia)

Vit B12 (megaloblastic anaemia)

Folic acid (megaloblastic anaemia)

Enjoy...

Dr Ibrahim Samaha

- Muscles.

-Types :-
There are 3 types of muscles each type of muscles has its specific structural and functional unit which is called muscle fiber ( cell):-
1- skeletal muscle has skeletal muscle fiber.
2- cardiac muscle has cardiac muscle fiber.
3- smooth muscle has smooth muscle fiber.

- Innervation of the muscles:-
*skeletal muscle fiber has somatic innervation.
* both cardiac muscle fiber and  smooth muscle fibers have autonomic innervation.
so
-skeletal muscle fiber is under voluntary control
- both cardiac muscle fiber and smooth muscle fibers are under involuntary control.

- Excitability.

-Def:- is the ability of cells to respond to stimuli.

-Excitability of cells and tissues is a basic function of life,as it is necessary for the functioning of nerves, muscles, and hormones,etc...

-The basis for the excitability of cells is their ion distribution, and the distribution of ions and molecules is determined by transport mechanisms associated with their plasma membrane structure.
-This structure permits and regulates various forms of ionic and molecular transport.

-Stimuli which induce Excitability are classified into two types:-
1-electrical. (galvanic ,faradric)
2-chemical.( ions , chemical transmitters, gases,……etc)

-you must know that:-
Excitable cells are those that can be stimulated to create a tiny electric current which in turn is transformed into physiological function and excitable cells are of three types:-

• Muscle cells.
• Nerve cells (neurons).
• Glandular cells.