The Pathophsiology of Asthma

Chronic asthma is considered to be a chronic inflammatory disorder of the bronchial mucosa that results in constriction of airways, bronchial hyper-responsiveness, and variable airflow obstruction that is reversible. Chronic asthma on the cellular level is characterized by an increase in the secretion of mucus and bronchoconstriction stimuli. Chronic asthma can be damaging to the epithelial cells found in the lungs, which can cause the reoccurrence a lot quicker leading to more severe cases of asthma.

During the release of an inflammatory response, toxic neuropeptides and eosinophils are released, which can cause direct damage to tissue and this might result in an increased bronchial hyper-responsiveness (Huether & McCance, 2012). Oxygenation is normally compromised due to the restriction of the bronchial airway in chronic asthma. In particular, the arterial blood gas is affected in the patients by hyperventilation, which induces in hypoxemia and results in respiratory alkalosis (Gelb & Nadel, 2015).

The pathophysiology mechanism for acute asthma exacerbation is almost similar to that of chronic asthma, the bronchial airways are compromised and this causes resistance in the airway. However, there are many cells that contribute to this hypersensitivity of the airway in acute asthma exacerbation. Some of the cells that are included are T helper 2 lymphocytes, dendritic, B lymphocytes, neutrophils, basophils, eosinophils, and mast cells. During an acute exacerbation, these cells will react differently with a latent release of inflammatory cells, which causes bronchospasm, edema, and an increase in secretions.

Acute asthma exacerbation is more prominent when compared to chronic asthma attacks mainly because the patients have a late asthmatic response of their inflammatory cells. These exacerbations will also affect the arterial blood gas as is the case with chronic asthma. Patients suffering from acute asthma exacerbation will have short inspirations and long expirations, which affects the oxygenation that they receive. These patients tend to trap air resulting in a respiratory disadvantage the leads to a decrease in tidal volume and increase in carbon dioxide which leads to respiratory acidosis.

Impact of Age While asthma is a disease that affects both children and adults, it is most prevalent in children affecting 10 percent of children in the US under 17 years. Asthma in aging adults is not easily recognized because there are other age-related changes that take place in respiratory and immune physiology. These changes mask the progression of asthma until it’s too late.

There are physiological changes that occur within organs, cells, and tissues of the older adults, which result in diminished functional reserve thereby increasing the susceptibility of the individual to the disease (Hanania et al., 2011). While it is easy to diagnose the condition in children, it becomes harder to diagnose it in older adults. There is an increasingly small airway involvement, increased neutrophilic inflammation, and decreased eosinophil function in older adults (Dunn et al., 2015), which impacts the pathophysiology of chronic asthma.

Diagnosis for patients based on age would be done by first asking the patient of their background in order to ascertain that asthma is not genetic. Inquire about the symptoms to determine the severity level and rule out any other possibility. Diagnosis can also make use of chest X-ray, arterial blood gas test, pulmonary function test, or pulse oximetry. The chest X-ray will give a picture of the activity of the chest and show if there is any congestion.

The arterial blood gas test is a blood test that measures the pH, the oxygen levels, and carbon dioxide levels from an artery (Teach et al., 2015). This will check the patient's lung function and establish how well they are able to move oxygen as well as removing carbon dioxide. The pulmonary function test measure how well the lungs of the patient are functioning. This test will measure the volume of the lungs, rates of flow, lung capacity, and gas exchange.

Pulse oximetry can be used to measure oxygen saturation of the patient's blood without having to take a blood sample. It should be noted that there is no cure for asthma and all treatment is aimed at controlling or managing the disease. The recommended treatment for asthma is prescribing medication to ease the tightening of airways. Patients can also be advised to be using inhalers to get a.