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Bronchial Asthma.doc - Word

Bronchial Asthma.doc - Word

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Published by: malyn1218 on Apr 13, 2009
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Bronchial Asthma
Female/ 18 yrsDiagnosis: Bronchial asthma
 An 18 year old girl was brought to the clinic for complaints of Bronchial Asthma.When patient reported to us, she was having a very severe attack of Asthma.She complained of breathlessness that was worse from cold drink, cold water, draft of air, monsoon, getting wet, at midnight. Her complaints were better during the dryclimate and when traveling out of Philippines. The complaints would also be relieved by taking warm drinks and tea. The cough was productive with white expectoration.The patient's peculiar features at the time of the Asthma attack were extreme anxietyand fear of death. She felt thirsty for little water at a time. She was feeling sensitive tocold and extremely restless due to the complaints. The patient also had complaints of cold with watery discharge from the nose and cracking of the joint accompanied by pain.She had a normal appetite with liking for sweets, fast food and tea and was averse toeating vegetables. She would occasionally be constipated. Her sweat was profuse inthe summers, especially in underarms.Her sleep would be frequently disturbed due to the asthma attacks and due to thoughtson her mind. She would often dream of flying, water and God.Her birth history was normal.Birth weight: 8 poundsAge of talking: 1 year Age of teething: 8 months
Bronchial Asthma
Asthma is a chronic, reversible, obstructive airway disease, characterized bywheezing. It is caused by a spasm of the bronchial tubes, or the swelling of the bronchialmucosa, after exposure to various stimuli.Asthma is the most common chronic disease in childhood. Most childrenexperience their first symptoms by 5 years of age.
Asthma commonly results from hyper responsiveness of the trachea and bronchito irritants. Allergy influences both the persistence and the severity of asthma, andatrophy or the genetic predisposition for the development of an IgE-mediated response tocommon airborne allergens is the most predisposing factor for the development of asthma.
CLASSIFICATION:1. Extrinsic Asthma - called Atopic/allergic asthma.
An “allergen” or an “antigen” is aforeign particle which enters the body. Our immune system over-reacts to these oftenharmless items, forming “antibodies” which are normally used to attack viruses or  bacteria. Mast cells release these antibodies as well as other chemicals to defend the body.Common irritants:
Cockroach particles
Cat hair and saliva
Dog hair and saliva
House dust mites
Mold or yeast spores
Metabisulfite, used as a preservative in many beverages and some foods
2. Intrinsic asthma
called non-allergic asthma
, is not allergy-related, in fact it iscaused by anything except an allergy. It may be caused by inhalation of chemicals such ascigarette smoke or cleaning agents, taking aspirin, a chest infection, stress, laughter,exercise, cold air, food preservatives or a myriad of other factors.
Gas, wood, coal, and kerosene heating units
 Natural gas, propane, or kerosene used as cooking fuel
Viral respiratory infections
Wood smoke
Weather changes
ANATOMY AND PHYSIOLOGYFunction and Structure of the Respiratory System
The main function of the respiratory system is tomove air into the lungs so that oxygen can enter the body and carbon dioxide can be exhaled.During breathing, air passes from the nose andmouth into the pharynx and through the larynxinto the trachea. The trachea bifurcates to carry air into each lung. These two tubes are the main stem bronchi; there is a single left main stem bronchusand a single right main stem bronchus for the leftand right lungs, respectively.All bronchial branching occurs as bifurcations This pattern is repeated as air moves downthe bronchi and into the periphery of the lungs. With each branching, the tubes becomesmaller in diameter and eventually microscopic, until they end in the alveolar chambersthat are, themselves, microscopic in size.Gas exchange occurs within about 300 million alveoli. The alveoli have very thin walls toallow oxygen and carbon dioxide to cross between the lung capillaries and the alveolar spaces. The central function of respiration — gas exchange — takes place in the alveoli.Besides conducting air to and from the alveoli, the bronchi also serve to protect thealveoli. The bronchi warm and moisten the air before it enters the alveoli. The alveolar structures are delicate and can easily be damaged by cold, dry air.
Clearing airborne particles
Air passages have a self-cleaning mechanism to remove small, inhaled airborne particles.Among the cells that line the inside of the respiratory passages, from the nasal liningthrough the trachea and bronchi, are those that secrete mucus and others with cilia.The purpose of mucus is to coat the lining of the airway to create a sticky surface that cancollect foreign particles from inhaled air. Mucus-secreting cells are present on the airwaysurface and in specialized mucus glands found deep within the bronchial wall. However,most cells that line the airway have cilia on their surface that constantly move in aregular, sweeping fashion. Fine airborne particles land on the airway lining and aretrapped in mucus, which is then swept upward by the movement of these cilia.Eventually, the mucus is brought far enough up in the respiratory system to be coughedout of the respiratory system or — more commonly — swallowed. This self-cleaningmechanism is called mucociliary clearance. Minute foreign particles that are not removed

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