Rodgers and colleagues found a difference in the composition of mucus between normal patients and those with asthma. The mucus in asthma patients was noted to have different cross-linking, size, acidity and appearance as seen by electron microscopy (Rodgers,2007). It was concluded that the asthmatic mucus was formed by extremely large mucins assembled by the ‘normal’ sized subunits found in normal patients (Rodgers, 2007). More research needs to be done in the actual abnormality that seems to be present in the asthmatic mucus.
Airway obstruction is the result of this hypersecretion of asthmatic mucus along with a combination of ciliary dysfunction. The mucus causes small diameter airways and a larger surface tension in parts of the
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It also appears that mast cells and macrophages have key roles in allergen-induced tissue remodeling (Maltby, 2017., 2017).
An increase in mass of muscle, mucous glands, and tissue edema all lead to a thickened airway and decreased airflow throughout the lungs (Figure 4). These structural changes also are known as remodeling since they a complex morphological changes involving all of the structures in the bronchial walls (Bousquet et al., 2000) Remodeling occurs after inflammation and mucus cell hyperplasia have resolved (Maltby, 2017 et al., 2017). Some anatomic changes which young children and preadolescents are especially prone to include an increase in the anterior to posterior diameter of the chest, elevated clavicles, and a depressed diaphragm (Fireman, 2003).
CLINICAL MANIFESTATION AND TREATMENT
The symptom severity of asthma can be manifested as mild, moderate, or severe (Maltby, 2017 et al.) There are many symptoms and physical effects of asthma that can be seen in patients as well as through autopsies. Respiratory symptoms in those with asthma include: wheezing, breathlessness, chest tightness, and coughing (Valenta, 2017). A simple test to check if a person has asthma is a auscultation of breath sounds since normal breath sounds are distributed evenly over the lungs (Silverthorn,
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).
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
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.
In addition, asthma affects the smooth muscle walls and glands of the bronchioles, due to narrowing of the bronchial passageway, this results in a build-up of mucus in the bronchial tubes leading to difficulty breathing (Rizzo 2016, p.423). Airflow in the alveoli becomes limited due to inflammation causing bronchoconstriction, as the inflammatory process begins mast cells degranulate and release inflammatory mediators (Kaufman 2012, pp.589-590). ‘The inflammatory process results in vascular congestion, production of thick mucus, bronchial muscle spasm and thickening of the airway walls’ resulting in Jessica becoming short of breath and coughing (Kaufman 2012, pp.589-590). Typically, this reaction occurs 30 to 60 minutes after being exposed to the triggering allergen or irritant (Kaufman 2012, pp.589-590). Asthma can be triggered by a range of different factors including exercise, infection, exposure to allergens or airborne substances such as dust, fumes or pollen (Rizzo 2016, p.843). However, some asthma attacks may be worse than others, this is because a severe asthma attack can completely narrow and close the airway (Lew 2011, pp.43-45). This can result in oxygen not getting to vital organs such as the heart or brain and can result in
Asthma is an inflammatory condition of the airways causing attacks of wheezing and breathlessness. It affects a person’s
Your airway has smooth muscles around the outside of the airway tubes also known as bronchial tubes. The tubes are open allowing air to flow freely; during an asthma attack those muscles begin to tighten that is called a bronchospasm restricting the airflow. During an asthma attack the lungs also become inflamed and the mucus in the tubes begins to become thicker and builds up, this makes it even more difficult for air to pass through the opening of the tubes. With the airway being restricted and the mucus build up causes a wheezing sound and shortness of breath and difficulty in inhaling and exhaling air (WebMD).
The bronchial epithelium plays an important role in the respiratory system. It is an important part of host defense; it acts as a barrier against foreign particles, and it warms and humidifies incoming air. The airway is lined with ciliated cells that act as a sort of escalatory system, pushing foreign particles embedded in mucus out of the central pathways, towards the peripheral, and finally out of the respiratory system. In asthmatic children, these ciliated cells become damaged and slough off; this is proven by looking at the sputum of patients which, when checked, contains ciliated epithelial cells (Tulic 73). Simple squamous, or flat, epithelial cells that cannot move the mucus out replace the ciliated cells, creating a plug. Also contributing to the mucus plug formation is the hyperplasia of goblet cells, which are the sites of mucus production in the epithelium (Tulic 74).
This paper discusses bronchial asthma, a chronic inflammatory disorder of the airways that involves a complex interaction of airflow obstruction, bronchial hyperresponsiveness and an underlying inflammation. The paper begins with background information on the condition, followed by describing its mechanisms and breaking down its major components. It will also discuss the signs, symptoms, and diagnosis and treatment options for asthma. Throughout the paper, key concepts and terms associated with the disease are defined.
change in air temperature). In short your lungs are used more like a balloon filling up
The pathology of asthmatic symptoms is quite complex, and includes the effects of mast cells, eusinophils, T cell lymphocytes, mactrophages, neutrophila, and epithelial cells, which collectively lead to inflammation. Pathologic qualities of asthma include goblet cell hyperplasia leading to mucus overproduction, basement membrane thickening with subepithelial fibrosis, desquamation of the airway epithelium, bronchial smooth muscle hyperplasia, and cellular infiltration with lymphocytes, neutrophils, and eosinophils. Airflow obstruction is caused by the smooth muscle constriction around airways, leading to wheezing, coughing, and chest tightness. Exposure to allergens, irritants (eg smoke), and viral infections can also
Airway inflammation and tissue injury with subsequent abnormal repair may lead to structural changes in the airway of asthmatic subjects that defined as airway remodeling. Airway remodeling contributes to irreversible airflow obstruction and airway hyperresponsiveness, and it has been associated with increased disease severity and impaired pulmonary function. [5] Reversal of remodeling gain therapeutic importance, and mechanisms responsible for airway remodeling has become an important target for asthma treatment (Shifren,
In addition, mucus production occurs at the airways and muscles surrounding the airway spasm. These cause a reduction in air flow. (2) Asthma is a chronic inflammatory disorder of the airways. It is defined by history of respiratory symptoms such as wheezing, shortness of breath, chest tightness, and cough that varies over time and intensity, together with the variable expiratory airflow
It then travels down the trachea to the bronchi into the bronchioles then to the alveoli where oxygen is transferred to the blood and carbon dioxide is expelled from the blood to the air. Pathophysiology of the lungs with Asthma has multiple aspects. Some of those are Bronchoconstriction, Airway edema, Airway hyper responsiveness and airway remodeling not to mention the immunohistopathologic features. The immunohistopathologic features include inflammatory cell infiltration of Neutrophils, Eosinophils, Lymphocytes, Mast cell activation and Epithelial cell injury. With asthma, bronchoconstriction is one of the main physical events leading up to an asthma attack. The narrowing and constriction of airflow into the lungs can happen quickly and sometime without warning. With an acute attack the smooth muscles contract and it causes narrowing in the airway tract causing a patient to have difficulty breathing. This attacks can stem from a variety of irritants or allergens. When they body is introduced to an irritant or allergen it can cause Lymphocytes, specifically T helper 2 cells and Mast cells to release inflammation mediators which include tryptase, prostaglandins, leukotrienes, and histamine, some of them are also bronchoconstrictor mediators. A variety of stimuli can cause the smooth muscles of the bronchials to contract thus narrowing the airway, which causes an interference in airflow. Aspirin and
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.
Is characterized by inflammation and spasm of the airways. The inflammation makes the airways smaller and it becomes difficult for the air to move in and out of the lung. The inside walls of airways become swollen, making it very sensitive and they may react strongly to things that you are allergic to or find irritating. [3]