Thursday, December 12, 2019
Explaining The Pathophysiology Of Asthma â⬠MyAssignmenthelp.com
Question: Discuss about the Explaining The Pathophysiology Of Asthma. Answer: Introduction Asthmarefers to a chronic inflammatory disease that occurs in the airways and is a commoninflammatory disease that affects the airwaysof the lungs.This condition is primarily characterized by recurring and variable symptoms such as, bronchospasm, reversibleairflow obstruction, chest tightness, coughing, andshortness of breath. These episodes are found to occur several times per day or week. Depending on the physiological condition of the individual suffering from it, these symptoms often worsen at specific time of the day (Bonini and Usmani 2015). Although, childhood asthma and wheezing are non-synonymous terms, they most often create similar outcomes among children. This report will discuss a case study on the occurrence of paediatric asthma in a child, Jessica, aged 5 years old. It will also elaborate on the pathophysiology of the disease and illustrate the common signs and symptoms, thereby relating them to the case study. Pathophysiology of the illness/disease Asthma is a direct manifestation of chronic inflammation that occurs in the conducting region of the airways. This inflammation commonly occurs in the bronchi and the bronchioles. This subsequently leads to an elevation in contractibility of the smooth muscles that are present near and around the airways. The aforementioned factors often contribute to bouts of airway narrowing, which in turn contributes to symptoms related to wheezing (Mahr, Malka and Spahn 2013). Airway hyperresponsiveness state is a characteristic functional abnormality of paediatric asthma and leads to narrowing of the airways due to a stimulus. Hyperresponsiveness most often occurs due to a viral infection and consists of an elevated sensitivity of the airways, to an external agent (Price et al. 2013). In this case scenario, it is evident Jessicas family have three pets, two long-haired dogs and one short-haired cat. Pet dander and hair are composed of even microscopic particles and flecks of dead skin, shed by the dogs, cats or other animals with feathers and furs. These skin and hair bits act as triggers and lead to hypersensitivity in the airways. According to research evidences, higher rates of allergies to cats are reported by individuals (Huang et al. 2013). The breathing allergens often decline the ability of the lungs to function in an appropriate manner, which in turn worsens the respiratory symptoms (Konradsen et al. 2014).Exposure to endogenous and exogenous factors such as, allergens and the increased viscosity of the mucus that lines the epithelium is found to modulate function of the cilia. Thus, the fact that Jessica has three pets can be attributed to onset of mechanisms that influenced the airway hyperresponsiveness and caused inflammation of her airways. Bronchoconstriction can be defined as the dominant physiological event that leads to subsequent interfering with the airways. In cases of acute exacerbation of paediatric asthma, the smooth muscles of the bronchi contracts rapidly to narrow the airways, thereby responding to exposure to a range of stimuli (Carraro et al. 2013). Jessicas diagnosis to seasonal asthma can be attributed to her shift to the suburbs. This made her more susceptible to exposure to a range of external agents such as, pollen, dust or fumes that might have resulted in an increase in the population of T helper 1 and 2 cells. In addition, generation of Th2 cytokines were also triggered by the allergens that lead to IgE overproduction, increase in eosinophil and bronchoconstriction. Furthermore, exposure to a range of allergens in the household and the new locality to which the patient Jessica shifted to, might have contributed to mast cell activation that releases bronchoconstrictor mediators, such as, histamine, prostaglandin D2, and cytokines (Boulet and OByrne 2015). Inflammatory cell infiltration has a probability of intraepithelial and subepithelial cell inflammatory cell accumulation (Manuyakorn, Howarth and Holgate 2013). The innate and adaptive immune systems play a considerable role in the onset and regulation of inflammation in the airways. In particular, research studies have found strong relation between inflammation and an imbalance between the Th1 and Th2 cytokines (Yuan et al. 2013). Furthermore, onset of paediatric asthma can be related to an increase or shift towards Th2 cytokine-like disease. This occur either in the form of an underexpression of Th1 or overexpression of Th2. In addition, the airway inflammation in the patient Jessica might also represent a loss of balance between the two opposite populations, composed of Th lymphocytes (Th 1 and Th2) (Farahani et al. 2014). Furthermore, the allergic inflammation that resulted in the onset of paediatric asthma might have been mediated by the family of cytokines by Th2 cells. This statement can be further validated by the fact that the immune system of infants and children are skewed towards generation of Th2 cytokines (Cho and Norman 2013). Two signs/symptoms Wheezing sounds during auscultation- Upon conducting an auscultation of the patient Jessica, with the help of a stethoscope, wheezing sounds were heard from her heart and lungs. This procedure was performed with the aim of examining the respiratory and circulatory system of the patient. Hence, the major symptom can was presented by Jessica in the form of whistled, or high-pitched sounds that were produced, during breathing. The sounds were most commonly heard when she exhaled. This continuous, coarse sound was produced due to narrowing of the respiratory airways (Bener et al. 2014). Obstruction of certain parts of the respiratory system might have contributed to such sounds in the patient. This symptom can be correlated to the manifestation of asthmatic conditions due to the fact that mucus accumulation, airway inflammation and tightening of the muscles can lead to a narrowing of the airways, thereby leading to the production of wheezing sounds. Upon getting exposed to a range of asthmatic triggers, such as pollutants, allergen, and pet dander, hypersensitive reactions are seen in the sensitive airways. These in turn get red and inflamed, thereby contributing to tightening of the air muscles (Esposito et al. 2014). This is often manifested in the form of excess mucus or phlegm production that narrows the bronchi and makes it difficult for an asthmatic individual to breathe. Wheezing has been associated with asthma in children who have been suffering from the health abnormality for a prolonged period of time (Tapiainen et al. 2016). Thus, the audible wheezes in the upper zone can be attributed to blockage of the upper part of the respiratory system. The audible wheezes that are heard can also be accompanied due to chest tightness and shortness of breath, the most common symptoms of asthma. Hence, the turbulent flow of air through the narrowed segments of the extrathoracic airways is responsible for producing a whistling noise . Airflow through the compressed or narrowed regions of the bronchi and bronchioles become turbulent, which in turn leads to vibrations in the walls of the airways (Silvestri et al. 2015). This vibration leads to the production of wheezing sounds, the primary symptom presented by Jessica. Increased respiratory rate- The typical respiratory rate for a healthy individual, aged 6 years is approximately in the range of 18-25 breathes per minute. However, upon admission, the patient Jessica showed elevated respiratory rate, 36 bpm. This condition suggests presence of symptoms that pertain to tachypnea. This symptom was presented in the form of abnormal breathing. This breathing condition refers to a physiological state where the breathing is fast and often shallow, due to accumulation of excess carbon dioxide in the body (Ozkiraz et al. 2013). Bronchial asthma, the disorder presented by Jessica occurred due to obstruction of the breathing pathways. This in turn was mediated by several allergens (Nievas and Anand 2013). The fact that the patient was susceptible to exposure to a range of pollutants, allergens and animal hair, she was at an increased likelihood of suffering from tachypnea, which increased the breathing rate. Presence of prolonged asthma can be associated with loss of adventitious breath sounds, thereby contributing to rapid breathing, in addition to high-pitched wheezing sounds (Kim et al. 2014). Hence, an inflammation of the respiratory tract, in association with release of inflammatory cytokines might have resulted in rapid breathing in the patient. This symptom is indicative of respiratory problem, persistent in the patient. Hence, it can be stated that the respiratory distress caused due to inflammation and narrowing of the airways are primarily responsible for tachypnea/rapid breathing symptoms in Jessica. Conclusion To conclude, the discussions presented above help in confirming the occurrence of asthma in the patient Jessica. The patient reported several signs and symptoms that are directly related to the inflammation of the airways. A reduction in the diameter of the bronchial tubes caused adventitious lung sounds that occur due to airflow through compressed airways. The immune system of the patient played a major role in the pathogenesis of the condition, by controlling the release of Th1, Th2 and other cytokines. Furthermore, hyperresponsiveness to pet dander, and other external agents in the suburbs, such as, pollen and pollutants, increased the susceptibility of the patient to suffer from asthma. These factors acted as major triggers that led to the development of paediatric asthma symptoms. Furthermore, inflammation of the skin, and development of learning and cognitive disabilities were also related to the asthmatic symptoms in the patient Jessica. References Bener, A., Ehlayel, M.S., Bener, H.Z. and Hamid, Q., 2014. The impact of Vitamin D deficiency on asthma, allergic rhinitis and wheezing in children: An emerging public health problem.Journal of family community medicine,21(3), p.154. Bonini, M. and Usmani, O.S., 2015. 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