Psychological disorders

Mrs Clarke is 45years old. Over the past 10years she has developed long-standing asthma. Mrs Clarke has worked as a traffic warden for nearly 30years and has smoked averagely 5-10 cigarettes since she was 18years regularly. Over the past 5years her asthma has worsened especially during the night she suffers with sever coughing making it hard to sleep, leaving her regularly tired and finding it hard to carry on working. Mrs Clarke also gets short breath or breathless in the early mornings making it feel like she can’t get her breath when working a long day Mrs Clarke sometime get chest tightening after prolonged crying or laughing which also brings on her wheezing.

Mrs Clarke is a single parent with three children who finds it hard to cope, she also refuses to give up her cigarettes saying they never done her any harm and are the only good things she has. She has required hospitalisation once before as a result of her asthma resulting in exacerbation of her chronic obstruction pulmonary disease (COPD) due to a chest infection. E2: A clear description of the physiology of asthma Asthma is not a disease but a chronic inflammatory condition of the airways. Typical symptoms are coughing, wheezing, tightness of the chest and shortness of breath. Every asthma sufferer is different but three characteristics are common: airflow limitation, increased mucous production and inflammation of the airways.

There is an increase in the sensitivity to triggers such as pollen, dust mites and cigarette smoke. The body, in effect, over-reacts to the presence of these foreign bodies in the airways. Furthermore, an increase in mucous production is often triggered leading to wheezing and further restriction of the airways. Smooth muscle surrounding the airways goes into spasm. Because there is no supportive cartilage these spasms can actually close off the air passages. This makes breathing out much more difficult than breathing in and the lungs become over-inflated.

The airways also become inflamed. Over time, this inflammation can lead to scarring of the airways and a further reduction in airflow. This inflammation will also lead to the airways becoming more irritable which may cause an increase in coughing. The Lungs The body’s breathing apparatus is known as the Respiratory Tree. The tree trunk (trachea) branches downward into a series of medium sized branches (bronchi) that separate into smaller branches (bronchioles). At the end of each bronchiole is a pouch of air sacs, known as alveoli, which resemble a bunch of grapes. It is within the alveoli that gas exchange takes place.

The lungs allow oxygen to enter the blood. When we breathe, the lungs deliver air to the alveoli. Tiny blood vessels flowing by the alveoli pick up oxygen and carry it throughout the body, nourishing the cells and tissue. Simultaneously excess carbon dioxide passes from the tissue cells into the blood vessels. It passes into the alveoli and it is breathed out. ere is an increase in the sensitivity to triggers such as So What Goes Wrong?

Asthma attacks develop from an involuntary response to a trigger, such as:  Asthma causes an inflammatory response in the lungs. Airway linings swell up, the smooth muscle surrounding them contracts and excess mucus is produced. Airflow is now restricted, making it difficult for oxygen to get through to the alveoli and into the bloodstream. All asthmatics share the problem of breathing difficulties. The way in which these difficulties present varies. Symptoms may include one, all or a combination the following: breathlessness, difficulty in exhaling, wheezing, “tight” or “heavy” chest, persistent cough, excessive amount of phlegm, a chronically blocked or running nose, extreme tiredness.

What determines the severity of an asthma attack? The severity of an attack is determined by how restricted the airways become. When an asthmatic’s airways become chronically inflamed then only a slight trigger can cause a major reaction in the airways. When the inflammation is reduced, you might need to be exposed to two or three triggers before a restriction is noticed. As a general rule, the longer an attack persists then the more dangerous it becomes. Oxygen levels can become low and even life-threatening.

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