Respiratory Physiology Case Report

Asthma

In some living things, that is human and some animals, the lungs, airways, and the respiratory muscles define the anatomical features of their respiratory systems. This means that, there is a constant and passive switch of the molecules of oxygen and carbon dioxide gases between the gaseous surroundings and the blood in their veins, by inhalation and exhalation, via diffusion by the processes. Such processes are a characteristic of the cardiovascular lung region. Despite this vital role of the respiratory system, it is associated with so many diseases, disorders and/or conditions that range from mild to acute to chronic conditions that can even result to death.

The classifications of such into diseases, conditions and disorders brought about by the many symptoms that are associated with each class but of course subject to other conditions that are outstanding and only associated to a particular disorder, disease or condition. Classifications can also be based on the causes of the existing conditions in a given patient like in this case of the 17-year old girl. These causes may be hereditary or caused by factors external or internal to the body of the patients. With the cause and the symptoms established, it is therefore the work of the medical attendant to give the right diagnosis to the patient to either control, prevent or even cure these situations. This paper intends to discuss the case study of the 17-year old given the examined symptoms and then answering the questions that follow thereafter.

From the case study history, these 17-year old girls are suffering from Asthma. The reasons for associating her symptoms to Asthma and not any other respiratory condition, disorder, or disease are because, according to Landau (1), Asthma is an on-going condition that affects breathing, that is, the lungs. A more complex definition for Asthma would therefore be taken to be a constant, enduring lung disease manifested by acute burst attacks of dyspnea or difficulty in breathing unlike apnea which is cessation in breathing with the duration dependent upon the age of patient. The hallmark symptoms for Asthma condition are wheezing and shortness of breathe which are present in the case of the 17-year old girl.

From Rees, Kanabar and Pattani (1), clinical characteristics of Asthma is the airflow obstruction, which in young adults, like the 17-year old girl, are identifiable and reproducible and which can be reversed over a short period of time with or without treatment. In their argument, the obstruction of airflow in the lungs is associated with the symptoms of short of breathiness which due to the inflammation or swelling of the inner walls of the airways result to coughing. Since Asthma is a disease of the lung airways this inflammation of the airways tends to cause easy reaction to certain things, like viruses, smoke, or pollen.

The surrounding muscles of the lungs also tighten and further block the flow of oxygen into the lungs causing wheezing. When the airways are blocked, the it becomes difficult for the patient to breathe out than breath in. other associated symptoms of Asthma include chest tightness, anxiety, restlessness, and most importantly the retracting of the muscles around the rib cage. Such retractions mean that the patient’s ribcage seems to be overworking and the muscles in and above it to suck in at every breath (Porth and Matfin, 567). For this reason, breathing difficulties occur and the patient is only comfortable while sitting forward with arms placed on a support. It is therefore restricted for such patients to wear tight clothes around the abdomen (Porth and Matfin, 540). Finally, x-rays can be used on patient to detect other symptoms or conditions of the lungs like pneumonia or hypoxia. Such is the case of the 17-year old whose x-ray indicates the presence of over inflation of the chest. In general, the more severe the asthma attacks are, the greater the inflammation of the airways and the more they react to these challenges.

There are two major types of asthma attacks the restrictive and the obstructive respiratory disorders. In the obstructive disorders of the respiratory system, the expiratory airflow is limited by several conditions. There are two categories of the Obstructive airways disorder being the acute and the chronic disorders (Porth and Matfin, 567). In the acute respiratory disorders, like the bronchial asthma, this form of respiratory disease is reversible and is as a result of the swelling of the airways that makes them narrow up, as well as increases the airways secretions which leads to difficulty in breathing in rather than out. In the chronic obstructive disorder of the respiratory diseases, like the bronchial asthma, the swelling of the airways causing short breathiness is poorly irreversible (Rees, Kanabar and Pattani 1).

The other form of respiratory disease is the restrictive respiratory disease in which the characteristic associated are loss of lung compliance, that is, the change in the air volume in the lung either for a given pressure or at any given moment of authentic air movement. From the provided symptoms of the 17-year old girl, it is clear that she is suffering from the obstructive respiratory disease as her the major symptoms are shortness in breath and wheezing which are caused by the narrowing of the airways to the lung causing difficulties in breathing, decreased oxygen level in the blood among other symptoms.

The correct formula for determining the residual volume (RV) is given by RV = TLC – VC. Therefore the residual volume from the given results will be a) RV = 6.82 L - 2.9L = 3.92 L before the use of the Bronchodilator, while the Residual Value will be RV = 5.96 L - 4.15 = 1.81L after the use of the Bronchodilator; where TLC is the total Lung Capacity, VC is the Vital Capacity and L is volume in liters. According to the symptoms provided, the girl is experiencing difficulties in breathing in than in breathing out because of allergens or respiratory infections that cause the constriction and mucous membrane swelling in the lungs’ airways causing shortness of breath which attempts to be clearer by wheezing and coughing. Such swelling of the lung airways is associated with obstruction of normal airflow to and from the lungs and the increased tetchiness or hyperresponsiveness of the airways (Porth and Matfin, 567).

At this juncture, bronchospasm is induced and causes the difficulty in breathing out or exhalation of air from the lungs. Inhalation is not affected that much as the inhaled allergens are the cause of the inflamed air passages. From the case study, there is observed change in the pulmonary function as the bronchodilator therapy is used since this causes the reversal of the airways obstruction and hence controlling the attack. Such an attack is said to be acute respiratory disorder. Essentially, the Residual volume suggests that the hyperinflation seen on chest radiograph has been lessened by widening the bronchial passages. Most significantly, the patient is observed to have a 100 percent plus increase in the FEV1 value after the use of the bronchodilator because it responds to her condition devastatingly with a notable more than 20 percent clinical response.

For the suggested antiparasympathetic agent as a possible nebulizer agent, there are several reasons as to why this may be a help in the breathing pattern of the above patient. First, the Beta agonist causes an increase in the sympathetic activities of the heart. This functions effectively in increasing the heart rate and decreasing the vagal tone hence it pumps more air to the lungs and the lungs function in removing the used-up air through exhalation. As for the Hypoxemia, the asthma exacerbation, this functions in aiding breathing to eliminate the difficulties or hypocapnia by reflex of the hyper ventilation to correct the hypoxemia (Porth and Matfin, 574).

Next is Beta- 2 whose presence in some drugs causes the effect of bronchodilation without the patient experiencing the negative effects associated with the Beta- 1 like the vasoconstriction which may cause heart attacks as well as tachycardia? Other causes of bronchodilation are the Anticholinergics which act by reducing the parasympathetic tone. This effect can be enhanced by the incorporation of beta agonists to cause even further bronchodilation.

For successful managing of Asthma, it is important to teach the patient together with the establishment of a affiliation with the asthma management health-care team. In addition, one is called upon to assess and monitor the severity of Asthma using the objective constraints like peak flow meter to evaluate the quantity of air that leaves or enters the lungs, proper environmental management to trim down the triggers, definition of a drug routine that controls the asthma without critical associated side effects among other things.

References

Landau E. Asthma. China: Michelle Bisson. 2009. Pp 1 - 24

Porth C. M. and Matfin G. Essentials of Pathophysiology: Concepts of Altered Health States. Philadelphia, USA: Wolters Kluwer Health. 2011. pp 540 - 90

Ress J., Kanabar D., and Pattani S. ABC of Asthma. Oxford, UK: Willey Blackwell. 2010. Pp.112-90

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