Pathophysiology of Asthma
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Jessica has been feeling unwell for the last 2 days with cold like symptoms, clear discharge from her nose, low grade fever and occassional coughing at night. The following nigh Jessica woke short of breath. Jessica’s mother, Anne , also noticed that Jessica’s breathing was quite noisy.
Anne, Jessica’s mother sat Jessica upright, found her salbutamol puffer and spacer which was on her bedside table and administered six puffs via her spacer as instructed by the asthma nurse at her local GP practice. Jessica’s breathing appeared to settle not long after the puffer and she then went back to sleep.
Anne woke with a start 2 hrs later and rushed to Jessica’s room and found her becoming increasingly short of breath and coughing continuously. Anne gave Jessica a further 6 puffs of salbutamol through her spacer. Jessica’s breathing did not appear to be improving, so Anne decided that they should go to the hospital.
One of Jessica’s cousin is a second year student nurse. He tells you he doesn’t understand the pathophysiology of asthma and how it affects the respiratory system. Jessica’s mother Anne asks you to explain to him the pathophysiology of asthma and how it affects the respiratory system using the correct medical and nursing terminology. You are also to explain two signs and symptoms that the patient Jessica has presented, therefore, shortness of breath and wheezing/coughing and explain why they manifested as part of the illness/disease.
SAMPLE ANSWER
Pathophysiology of Asthma
Asthma is a long-lasting inflammatory ailment of the breathing systems. It can be classified in different ways; physiologically, pathologically and bronchoconstriction. Physiologically it can be observed as an adjustable. It can also be partly reversible by blocking of airflow just as in the case of Jessica. Your aunt Anne, following doctor’s instructions used salbutamol puffer and as pacer to reverse the blocked air.
Pathologically it comes with overdeveloped mucus glands and airway thickens due to scarring inflammation and bronchoconstriction and thinning of the respiratory system in the lungs due to the tightening of adjoining soft muscles.It has many symptoms and among them is feeling extreme cold, clear discharge from the nose, low-grade fever and frequently coughing at night. These symptoms of asthma have implications for the diagnosis, management, and potential prevention of the disease (Murphy, 2011, Pg. 78).
Pathophysiology or physiopathology is a word that is formed by the combination of two words;pathology and physiology. Pathology is a medical discipline that is used to explain conditions that are initially seen during a disease and in this case, Jessica’s ailment, On the other hand, physiology is the biological word for defining procedures or methods which operate within a person. Pathology has always been used to describe the irregular or undesired disorder. On the other hand, pathophysiology tries to explain the physiological processes or mechanisms in which such a condition grows and advances. (Marthan., R, et al. 2014, pg. 153)
Pathophysiology is also used to mean the functional variations related with or resulting from illness or injury. Lastly, it can also be defined as the practical changes that accompany a specific disease.
How it affects the respiratory system
During an asthma incident, swollen breathing system react to environmental activates such as smoke, dust, or pollen. The airways become narrow due to excess mucus, these makes breathing difficult. In essence, asthma is the result of a resilient response in the bronchial airways (Loo, 2009, Pg. 67). The airways of asthma patients are oversensitive to certain activates, also known as stimuli. In response to exposure to these triggers, the bronchi having large airways contract into spasm that is an attack by asthma. Further Inflammation leads to further narrowing of the breathing system due to excessive mucus that is produced. This causes coughing and other breathing difficulties. Bronchospasm may resolve impulsively in a period of two hours, or in about half of the subjects, may become part of a delayed response.
This initial insult is followed three to twelve hours later with further bronchoconstriction and inflammation.The normal ability of the bronchus is usually maintained by a stable operative found in the autonomic anxious system. Both of them function involuntarily. The parasympathetic impulse circle having afferent nerve finales that originates underneath the inner linings of the bronchus. Whenever these afferent nerve endings are stimulated by different things such as dust, cold air or fumes, impulses travel to the brain-stem called the vagal center, and then it moves down the vagal efferent pathway up to the bronchial small breathing system (Harver & Kotses, 2010, pg. 585). When it reaches here acetylcholine is released from the afferent nerve endings which results in the extreme creation of inositol one, four and 5-trisphosphate (IP3) in the bronchial smooth muscle cells which lead to muscle shortening and this initiates bronchoconstriction that brings the chest problems of difficulty in breathing that is called asthma (Murphy, 2011, pg. 46).
Shortness of breath in asthma and its manifestation
Asthma is a lifetime ailment that makes someone’s lungs hypersensitive and hard to breathe. It is an incurable disease, but with right treatment, people with asthma can lead healthy, active lives. Shortness of breath is a feeling whereby you get a dyspnea. Dyspnea is having a difficulty in breathing. If one has asthma, their breathing passages are highly sensitive. Some things can thereby make their respiratory system encounter some problems. One of the problems faced is swollen and blocked airways. This is as a result of excessive mucus. The swelling and mucus make the respiratory system narrow. This causes difficulty in breathing. This is one of the primary signs of an asthma patient even before diagnosis is carried out (Wolfson & Montgomery-Downs, 2013, Pg. 751). Other symptoms of asthma include wheezing, chest tightness and chronic cough as in the case of Jessica.There is no medical terminology for shortness of breath. Asthma patients will frequently describe this trouble of breathing in different ways. While others call it unable to catch my breath, others call it gasping for breath. (WebMD. 2015)
Wheezing and in asthma and its manifestation
These are some of the most common asthma symptoms and are often the purpose why many people look out for care. Wheezing makes a patient produce a high-pitched sound during respiration. Mostly, it occurs when he patient breaths out but can also be heard when they breath in. The narrowing of the respiratory passages due to inflammation is the primary cause of wheezing.
References
Marthan., R, et al. 2014. Pathophysiology of asthma. Europe Pub Med CenteMorris., J, et al.2015. Asthma. Medscape
WebMD. 2015. Symptoms of Asthma. Medical Health Center.Viewed at www.webmd.com 25/05/2015
Murphy, W. B. (2011). Asthma. Minneapolis, MN: Twenty-First Century Books.
Wolfson, A. R., & Montgomery-Downs, H. (2013). The Oxford handbook of infant, child, and adolescent sleep and behavior.
Loo, M. (2009). Integrative medicine for children. St. Louis, Mo: Saunders/Elsevier.
Harver, A., & Kotses, H. (2010). Asthma, health, and society: A public health perspective. New York: Springer.
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