BRONCHIAL ASTHMA

BRONCHIAL ASTHMA                

The word ‘Asthma ’is of Greek derivation which means panting or gasping. Remarkable hyper re-activity of the air passages and excessive response by narrowing to various kinds of stimuli is characteristic of asthma.

This is a disease characterized by airway inflammation and bronchial hyper responsiveness.

The word “Asthma “is of Greek derivation and it means panting or gasping. The prefix bronchial specifies the fact that the basic problem is in the bronchi, the lower air conduits within the lungs. With the growing knowledge about asthma this condition is clearly defined and differentiated from other illnesses with breathlessness. The common features are;-

1.      Episodic breathlessness which changes in severity spontaneously or with treatment.

2.      Wheeze (whistling noise) while breathing out.

3.      Demonstrable variations in obstruction tear flow through the airways of the lungs.

Bronchial Asthma is defined as a condition characterized by recurrent attacks of difficulty in exhalation due to wide-spread reversible narrowing of airways in the lungs which varies in severity. Over a remarkable hyper-re activity of the air passages and excessive response by narrowing to various kinds of stimuli, for example, immunological, psychic, physical and chemical agents. The condition is not duke to any known specific infection.

CLASSIFICATION:

Bronchial asthma can be divided into two types depending on the precipitation factors:

Extrinsic type:  In this type, the etiological factors are present in the environment of the patients like the pollen, dust. Food particles etc. history of allergy is resent

Intrinsic type: The etiological factors are inside. Infections, psychic disturbances and hormonal factors.

Mixed type: This mixed type asthma. Here it is combination of both types.

Another type of classification is based on the season and frequency of attack.

Seasonal: The patient gets recurring symptoms of attack in a particular time and remains fine from asthma during other times. Maximum happens in cold times because at that time body builds up excessive amount of mucus and if the body does not generate enough internal metabolic heat to handle the cold climate and ads as result mucus builds up and is not expelled from the body. This is combined with spasms of the bronchi-oles and bronchi preventing sufficient air getting out. Breathlessness, wheezing, gasping and cough results.

Irregular: The symptoms of asthma occur at regular intervals through out the year and complete remission in between of varying duration for weeks to a few months.

Perennial: The symptoms start when the patient is at rest without any organic cause and later occurs at almost daily throughout the year.

Status asthmatics: In this type of asthma, the patient offers from short periods, May twenty four hours or more, even on repeated admission of oral and indictable bronchodilators. It shows signs of dehydration and prolonged hypoxia, seen more frequently in complicated steroid dependant perennial asthma.

CAUSES:

1.      Bronchi-constriction or contraction of the bronchial muscles lessening the caliber of the bronchus is irritated to cause this tightening and thus the airway obstruction.

2.      Swelling of the mucous membrane – the inner lining of the bronchus gets engorged edematous and swollen constricting partly to the reduction in the airway caliber.

3.      Secretions are poured out from the swollen mucosa into the bronchi, further decreasing the effective lumen. The secretion in asthma is sticky and is expectorated with great difficulty towards the end of the attack. The chief factor amongst these 3, is the bronchospasm that is responsible for the wheezing and the tightness of the chest.

SIGNS AND SYMPTOMS:

1. Breathlessness

2. Wheezing

3. Cough

4. Tightness in the chest

5.  Phlegm formation

7.  Obstruction of airflow due to branch spasm.