SCHEMATIC Precipitating Factors

Predisposing Factors
DIAGRAM • Smoking: 2-3 sticks/day x 5 years

• Sex ( Female) • Exposure to outdoor antigens

(inasal vendor, mosquito)
• Age ( the very young
and the very old) 52 • Occupational sensitizers
y.o ( barbecue vendor
• Past history of • Low Socioeconomic status
bronchial asthma

Exposure to triggering factor

and infectious particles

Entry of triggering factors and

infectious particles

Deposition on the bronchioles

and alveoli

Stimulation of alpha-
adrenergic receptors

Decrease in cyclic adenosine

monophosphate

Mast cells, neutrophils,

eosinophils, and lymphocytes
become activated
 Release of chemical mediators from IgE mast
cells

Release of histamines, leukotrienes,

interleukins and prostaglandins
Fever Nasal
Chills congestion
Myalgia Infiltration of inflammatory cells Flushing

Swelling of lining of Contraction of Hypertrophy of Increased Capillary Goblet cells lining Chemoreceptors
membranes bromchial smooth mucous membrane Permeability the airways are stimulated Ciliated
muscle that line the secrete mucus epithelial cells
airway lining the
Mucosal edema Bronchospasm Impulse are respiratory
Dyspnea Secretions transmitted to the tract move
Bronchoconstriction Leakage of fluid RBC’s, fibrin, accumulate in hypothalamus fluid and
lobes infiltrate respiratory tract debris up the
Crackles the alveoli airway to the
Excess water and larynx
plasma proteins Partial occlusion
are brought to Leukocytes & of the bronchi or
dependent areas fibrin consolidate Cough reflex
alveoli is triggered
of the lower lung within the
lobes of the lungs involved area
Decreased lung
Productive
compliance
Alveolar surfaces cough
are engaged with Nasal flaring
Airway narrowing fluid & Dyspnea
hemorrhage Use of
exudates accessory
muscles
BRONCHIAL ASTHMA Chest
tightness
 Exudates
Fluid provides coagulates
rich medium for
Fatigue
Increased work of breathing proliferation &
Anorexia Increased RR
spread of
Anxiety Tachycardia
organism
Apprehension Diaphoresis
Increased work for right side of through the
retraction Difficulty
the heart lobe
speaking
wheezing

Exhaustion Inflammation of
the pleura
Chest pain
Hypoventilation

Air trapping
PNEUMONIA
Community Acquired –
Retention of carbon dioxide Moderate risk

Hypoxia Respiratory
Acidosis
Cyanosis
Pallor
Restlessness
Cold. Clammy
skin