Its a case study relating to asthma

Running Head: CASE STUDY-ASTHMA         
CASE STUDY- ASTHMA        
    ASSIGNMENT- PART A
PATHOPHYSIOLOGY OF ASTHMA & CLINICAL MENIFESTATIONS OF ZACHY
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PART - A
INTRODUCTION
This part of the written paper will include a brief description about the physiology of Asthma in association to clinical description of Zachy’s health. The report illustrates different signs and symptoms of Asthma in terms of Zacy’s health reflection.
Pathophysiology of Asthma
Asthma is a chronic inflammatory disease characterized by Inflammation of Airways, obstruction of airflow, water retention in airways tissues and enhanced sensitivity of airways (Doeing,2013). The disease can be of four levels of severity depending upon the level of airways inflammation: Intermittent, Mild Persistent, Moderate persistent or Severe persistent (Doeing,2013).
The trachea is bifurcated into left and right bronchi further dividing into many intermittent bronchioles inside the lungs (Christopher, 2016). Each bronchiole has a lumen surrounded by epithelial lining which consists of mucosa and submucosa. The epithelial layer of bronchioles consists of eosinophils (WBCs), with many types of intermediate granules inside them like histamines, prostaglandins, platelet activating factor and leukotrienes. Environmental triggers like cigarette smoke perceived in the airways may induce the eosinophils to release these granules and degrade into proteins, lipids, and nucleic acids and destroy all the cell components. This generates an inflammatory response inside the bronchiolar walls, causing inflammation of smooth muscles of the bronchiolar wall, resulting in narrow pathways and increased mucus secretion inside the airways (Christopher,2016).
Due to swelling of airways, they get narrower in space which makes it difficult to breathe through for the patient. In serious conditions, Asthma results in Asthmatic Attacks or Exacerbations. Allergens in the atmosphere may adversely affect the lungs to make the airways get narrower leading to life-threatening breathlessness (Adkinson et al, 2013).
During initial days, the inflammatory changes in asthma are reversible but over the years, the changes get irreversible due to fibrosis, edema and thick basement membrane and permanently decrease the diameter of the lumen (Doeing,2013).
The causes of Asthma can be genetic or environmental. Genetically certain genes are known to be responsible for the disease. Moreover, a family history of asthma may also transmit the disease in next generation. Children of less than 12 years of age generally incept asthma due to genetic factors. Environmental factors include decreased hygienic conditions and early exposure to bacteria and virus which may change the proportion of immune cells in the body. People of older age get asthma due to environmental factors (Muglia & Oppenheimer,2017).
The substances which are known to induce Asthma vary considerably from person to person. They include air pollution, allergens, cigarette smoke, dust, cockroaches, molds and certain medicines like aspirin and beta blockers. Symptoms of asthma include chest tightness, breathlessness, coughing, wheezing, and dyspnea. Sputum from a cough may exhibit eosinophils crystals, mucus plugs or small tissues from bronchioles walls (Busk et al,2013).
For the treatment of Asthma, the person should avoid exposure to allergens, dust particles, and smoke. Medicines include antibiotics, bronchodilators, corticosteroids, beta-adrenoceptor agonists, and leukotriene antagonists. These medicines relax the smooth muscles and dilate the lumen of bronchioles (Morris, 2017).
Clinical manifestation of Zachy’s asthma
Zachy is diagnosed with Bronchiolitis or Asthma which is a normal infection of lungs with inflammation of bronchiolar airways in young children (Sullivan et al,2016). The disease is caused by viral infection mostly but in this case, asthma is caused by genetic factors and family history of infection susceptibility. Zachy is alert and oriented with no drowsiness. His clinical diagnosis observes Moderate acute exacerbations of Asthma possibly with URTI (Upper Respiratory Tract Infection). Other diagnosis reports also illustrate inflammation and obstruction in trachea and bronchioles, which is the main cause of breathlessness and chest congestion (Sullivan et al,2016).
The pathophysiological perspective of Zachy’s Condition
Zachy has a family background of genetic inheritance of asthma-related symptoms in her family. His two elder siblings have Atopy means genetic probability to have recurrent infections. His sister has ‘hay fever’ while his brother is allergic to peanuts. Hay fever is an allergic disease caused due to exposure to dust. The symptoms of Hay disease include inflammation of eye muscles with running nose (ACAAI,2014). Zachy’s mother is a smoker. So, it is obvious that during prenatal development Zachy would have been exposed to recurrent and continuous cigarette smoke. Hence, there are greater possibilities for Zachy to have inherited Asthma through the genetic pathway (Burney, Jarvis & Padilla, 2015).
Zachy has also exhibited high work of breathing (WOB). It means his lungs muscles work more vigorously to achieve the normal pace of breathing (Coates & Kowalchik, 2013). It may be due to constricted airways and reduced lumen space. His respiratory rate is 37 which is greater than 27 which is the normal respiratory rate of a healthy child. Intercostal and subcostal recessions also signify that something is obstructing the normal airway path and there is a low level of pressure in the lungs (Newell & Darling, 2014). It happens when the bronchi and bronchioles are blocked partially. Zachy also shows symptoms of Stridor in her clinical report. Stridor is a high pitch loud sound that is audible without the aid of a stethoscope. It is produced due to chronic obstruction of trachea or larynx. The problem is medically known as Laryngomalacia (Gupta et al, 2014).
The absence of fever shows the infection is not so severe while scattered wheezing shows there is an effective level of obstruction in the bronchioles, not allowing smooth passage of air. Blood pressure is normal and remaining abdomen is nontender and soft. It shows the infection is only confined to the upper respiratory system clearly depicting the case of asthma with no other lower abdominal...