Assignment XXXXXXXXXXwords) Please provide references, separately). This is two different parts so need to be done separately. Discuss the pathophysiology of Asthma and link to the clinical...

Running Head: CASE STUDY-ASTHMA         
CASE STUDY- ASTHMA        
ASSIGNMENT 1
CASE STUDY ASTHMA
(PART A)
PART - A
Pathophysiology of Asthma and Clinical Manifestations of Zachy
Introduction
The assignment is about a case study of Zachy, an asthma patient who is a 6 year old boy suffering from breathlessness and coughing with running nose. This paper illustrates the clinical manifestations of Zachy and also the Pathophysiology of Asthma, in general.
Pathophysiology of Asthma
Source: https://www.slideshare.net/jagadishritunmishra/pathophysiology-of-asthma-50747163
Asthma can be defined as a syndrome distinguished by the obstruction of airflow. The symptoms include breathlessness, coughing, chest tightness, and wheezing. Mainly the disease has been prevalent in 15% children and 12% mature individuals (Mishra, 2015). The major risk factors associated with Asthma can be categorized into two groups: Endogenous factors and Environmental Factors. The endogenous factors can be of different types namely Obesity, Hyper-responsiveness of Airways, Atopy, some viral infections or genetic susceptibility. The environmental factors may involve indoor and outdoor allergens (air pollution, dust, pollen, spores, cockroaches and pet furs), passive smoking, occupational sensitizers, and respiratory infections(Busk et al,2013).
The Asthma can be of four types: Atopic Asthma, Drug Induced, Exercise Induced, Occupational, and Non atopic Asthma (Mishra, 2015).
When the airways swell up, the space inside them gets narrower and create problems in breathing. In critical conditions, the exertion results into asthmatic attacks known as exacerbations. The allergens widespread in the atmosphere degrade the condition even more, resulting into severe breathlessness and suffocation (Adkinson et al, 2013). The diagram below shows the changes in Bronchiolar walls during asthma.
Source: https://www.slideshare.net/jagadishritunmishra/pathophysiology-of-asthma-50747163
The patient develops long term inflammation of lower bronchioles, basement membrane thickens, epithelium of the lumen shreds off, metaplasia of goblet cells occurs, thickening and hypertrophy of smooth muscles takes place, mucosal plugs are formed in the trachea, and infiltration of mucosa takes place by activation of eosinophils and T lymphocytes (Morris,2017).
The inflammation spreads effectively from trachea to bronchioles mainly affecting the bronchi. The major cells responsible for swelling are macrophages, eosinophills, T lymphocytes, neutrophils, dendrite cells and mast cells. The initial phase of asthma involves release of granules by mast cells, vasodilation, constriction of brochioles, and enhanced permeability (Doeing,2013).
Asthma can be caused by environmental as well as genetic reasons. Certain genes cause asthma and transmit the disease from parents to offspring. Therefore, a family having history of asthma in older people may have greater susceptibility to asthma in future generations. The genetic reason is profound to be a major cause of asthma in children below 12 years of age. Low level of hygiene and exposure to viruses and bacteria may adversely affect the number of immune cells in the body. Generally old age people get asthma due to environmental reasons (Muglia & Oppenheimer,2017).
Precautions for Asthma include reducing the exposure to allergens, smoke and dust. Treatment involves medicines like corticosteroids, leukotriene antagonists, bronchodilators, antibiotics and beta-adrenoceptor agonists. They dilate the bronchiolar walls and relax the smooth muscles (Morris, 2017).
The impact of inflammation results into damage, loss and dysfunctioning of epithelium, fibrosis of epithelial layer, and hyperplasia.
Source: https://www.slideshare.net/jagadishritunmishra/pathophysiology-of-asthma-50747163
Clinical Diagnosis of Zachy’s Asthma
The clinical manifestations of Zachy shows clear indication of Bronchiolitis or Asthma that is a normal lung infection with bronchiolar inflammation in children (Sullivan et al,2016). It is mainly caused by viral infection generally but in Zachy’s case, asthma appears to be caused by genetic factors and family history of susceptibility to infection. Zachy is vigilant and active without any drowsiness. His clinical manifestations report moderate to acute Asthma attacks along with URTI or Upper Respiratory Tract Infection. Other pathological reports also show running nose, obstruction of trachea and infection in bronchioles, resulting in chest congestion and trouble in breathing (Sullivan et al,2016).
Pathophysiology of Zachy’s Asthma
Zachy has a family history of asthmatic symptoms. In Zachy’s family, her two elder siblings have a genetic probability of repeated infections known as Atopy. His sister is having Hay fever and his brother is allergic to peanuts. The Hayfever occurs due to prolonged exposure to dust and mud through the air. The symptoms of Hay fever involve swelling in eyes, with running nose (American College of Allergy, Asthma & Immunology,2014). His mother is a smoker and it is highly possible that during prenatal development, Zachy might be exposed to consistent cigarette smoke. Therefore, he is largely expected to inherit asthma genetically (Burney, Jarvis & Padilla, 2015).
Zachy shows a high level of WOB that is high work of breathing. It means that his respiratory system works more extensively to gain normal breathing air (Coates & Kowalchik, 2013). It is because of constricted and narrow airways. His RR or Respiratory Rate is 37, which is greater than 27 (standard respiratory rate of normal 6-year-old child).
Recessions of Intercostal and subcostal muscles indicates that the normal airway path is being obstructed and there is a reduced pressure in his lungs (Newell & Darling, 2014). It occurs when the trachea, bronchi and bronchioles are partially blocked. Zachy also has complaints of Stridor in his clinical report. Stridor is a loud sound with high pitch generally audible without a stethoscope. It is occurs due to long term obstruction of larynx or trachea. The condition is clinically known as Laryngomalacia (Gupta et al, 2014).
Zachy has no fever. It shows the infection is not severe enough. The dispersed wheezing signifies that there is an effective amount of bronchiolar obstruction stopping the smooth passage of respiratory air....