Smooth Muscle In The Airway: A Case Study

Contractility of ASM requires an increased levels of intracellular Ca2+. When surface receptors are not activated, Ca2+ levels are low. Upon activation of these cell surface receptors by contractile agonists e.g. acetylcholine, serotonin and histamine, intracellular Ca2+ increases causing a contraction (9). Smooth muscle cell contraction is controlled by both receptor and mechanical activation of proteins actin and myosin and also changes to membrane potential.

Asthma is a chronic inflammatory disease of the airway that impacts a person’s and their family’s quality of life. In people with asthma, their airway becomes constricted with swelling and excessive mucous. This constriction or narrowing of the airway makes it difficult for the person with asthma to breath (Massachusetts Department of Public Health, 2009). If asthma is left uncontrolled, it leads to further wheezing, coughing, shortness of breath, tiredness, and stress. (Massachusetts Department of Public Health, 2009).

Pig Trachealis Smooth Muscle Pharmomechanical coupling uses Internal Calcium stores whilst Electromechanical coupling uses Extracellular Calcium

To better understand the impact of asthma, a brief overview of the causes (aetiology) and disease progression (pathophysiology) must be shown. As common as asthma is, not much is known about its aetiology, according to findings presented by Subbaroa, Mandhane and Sears (2009, pg. 181-187) in a review from the Canadian

Emphysema is the most common cause of death from respiratory disease in the United States and is generally caused by several years of heavy cigarette smoking (Olendorf, 2000). When a person smokes, the body’s immune system tries to fight off the invading smoke by using certain substances. These substances can also attack the cells of the lungs, but normally the body is able to release other substances to prevent this. In the case of people who are smokers, this doesn’t happen and the original substances that were released to fight off the smoke also end up injuring the cells of the lungs as well. Eventually, the lungs will not be able to supply enough oxygen to the blood and a host of problems can occur with this. Risk factors that have been identified for emphysema include exposure to tobacco smoke either through active or passive smoking (2nd hand smoke), occupational exposure such as dust or chemicals, ambient air pollution, or genetic abnormalities, including a deficiency of alpha-antitrypsin, an enzyme inhibitor that normally counteracts the destruction of lung tissue by certain other enzymes (Smeltzer, 2010). The symptoms of emphysema develop gradually over many years. It is generally characterized by three primary symptoms: chronic cough, sputum production, and dyspnea on exertion. Other signs and symptoms include weight loss and the development of a

There are numerous different challenges that the paramedic will face in attempting to keep an airway patent. These challenges vary from patient to patient depending on their condition. One challenge in keeping a patent airway the paramedic will face is trying to maintain the airway of a trauma patient. Trauma patients make it difficult to maintain an airway due to the traumatic damage, especially if it has affected the face and neck regions.

Discuss the roles of medications, ICS for long term anti-inflammatory effect and Beta adrenergic for immediate bronchial dilation.

Chronic inflammation leads to structural changes, narrowing of the small airways, and destruction of lung tissue, which diminishes the ability of the airways to remain open during expiration

. It is genetically passed down and it causes mucus to become to thick. It is a fake gene, or mutated gene, that can’t keep the respiratory airways clear. The thick mucus can build up in airways, and that is what is causing her to have shortness of breath and wheezing. It targets the respiratory system which causes problems with getting air, and it also targets the digestive system.

When this drug is inhaled or taken, it binds to the B2 adrenergic receptor which are “coupled to stimulatory G protein Gs” 3, 15, 16. The Gs protein is comprised of an alpha, beta and omega subunit 17. The activation of adenyl cyclase is caused by the alpha Gs, which catalyses the synthesis of cyclic AMP. As a result there is an increase in the intracellular concentration of cyclic AMP and protein Kinase A is activated 3,10. The protein Kinase A regulates the activity of an enzyme called myosin light chain phosphorylase. Decreased activation of myosin light chain phosporylase leads to relaxation of smooth muscles. The B2 adrenergic agonist also decreases Ca2+ intracellular concentration and it contributes to muscle relaxation3,16. Ultimately it leads to bronchodilation and allows enough oxygen to flow to the alveolar

According to the National Heart, Lung, and Blood Institute, Asthma is a chronic lung disease that affects the airways, which is comprised of tubes that carry air in and out of the lungs. People who experience difficulties breathing have inflamed airways. The inflammation causes the tubes to swell and become sensitive, especially when inhaling strong substances. As a result, the airways tighten and the muscles around the tubes become swollen and narrower. In addition, cells in the airways might produce more mucus. This sticky and thick mucus makes it even more difficult for air to pass into the lungs.

The bronchi and bronchiole tubes are loosely wrapped with muscle. During regular breathing, the muscles around these airways are relaxed (5). This allows air to flow freely through these passageways to the alveoli. However, during an asthma attack, air has trouble reaching the alveoli, which prevents the body from receiving oxygen. This is because the airways become smaller. Firstly, the muscles around the airways spasm and contract. This then causes inflammation of the bronchioles and bronchi themselves, which causes a mucus to be produced.

Stevens, the dose should not be more than 2mg up to 4 times a day. This dose may be slowly increased, up to 32mg per day. The purpose of Albuterol is to dilate the bronchioles and prevent airway obstruction caused by the COPD. Due to its adrenergic properties, common side effects include nervousness, restlessness, tremor, headache, chest pain, and palpitations. Excessive use of inhalers could result in paradoxical bronchospasm. Albuterol binds to adrenergic receptors which lead to increased levels of cAMP. Kinases are activated by cAMP, inhibit the phosphorylation of myosin, and decrease intracellular calcium; intracellular calcium relaxes the smooth muscle airways. The nurse should assess the lung sounds, pulse and blood pressure before administering albuterol, and should be aware that nebulized forms of the medication may result in temporary low levels of potassium. Pulmonary function tests should be monitored prior to and during treatment. Mr. Stevens should prime the unit with four sprays before using, and should contact his primary care physician if shortness of breath is not relieved, or it is joined by diaphoresis, palpitations, dizziness, or chest pain. Mr. Stevens should also discard his canister after 200 sprays (Vallerand, 116).

In conclusion, the airway hyperresponsiveness, odema of bronchial mucosa, increase mucus secretion, bronchospam will lead to airway obstruction hence it will result in patient having wheezes and dyspnoea.

The pathophysiology of Asthma includes inflammation of the airway. The way in which this works is from an irritant which can include dust, pollen, cedar, or cat hair. When a reaction occurs, the airways become inflamed and narrow. The narrowing occurs because once the inflammatory response is triggered by an irritant, histamines, immunoglobulin E antibodies, and leukotrienes are released. Because of this, mucous production occurs. Since the bronchioles are inflamed and narrow, breathing becomes difficult. Wheezing sounds can be heard due to the lack of air being able to easily move in and out of the narrowed bronchioles.