Clinical Management of Bronchial Asthma in Acute

Exacerbation, to Consider Pneumonia, Emphysema

and Chronic Obstructive Pulmonary Disease

BECURAN HIGH SCHOOL

Patient- Based Pathophysiology
Modifiable Factor: Non-modifiable Factor:
 Environment  Age (51 year old)

Inhalation of Allergens
and Irritants (Dust and
Smoke)
Presence of infectious
microorganisms in dust
particles Output of
Immunoglobulin E (IgE)
by B Lymphocytes

Exposure to pathogen or
source of infection IgE Antibodies attach to
Mast Cells and Basophilis
in the bronchial walls
Invasion of
microorganisms into the
lungs via orifices, which
connect to upper Mast Cells degranulation
respiratory tract
Clinical Management of Bronchial Asthma in Acute
Exacerbation, to Consider Pneumonia, Emphysema
and Chronic Obstructive Pulmonary Disease

BECURAN HIGH SCHOOL

Invasion of
microorganisms into the
lungs via orifices, which
connect to upper
respiratory tract

Inflammation Process

Tissue Injury Irritation of the Respiratory

Coughing
(Cause by biologic agents) Tract

Vasolidation
Difficulty of
Hyper secretion Respiratory Respiratory Breathing/
of mucus Congestion Insufficiency Dyspnea
Increased in
Permeability
Clinical Management of Bronchial Asthma in Acute
Exacerbation, to Consider Pneumonia, Emphysema
and Chronic Obstructive Pulmonary Disease

BECURAN HIGH SCHOOL

Vasolidation
Difficulty of
Hyper secretion Respiratory Respiratory Breathing/
of mucus Congestion Insufficiency Dyspnea
Increased in
Permeability

Emigration of Leukocytes

Chemotaxis Increase in neutrophil count

Phagocytosis
Clinical Management of Bronchial Asthma in Acute
Exacerbation, to Consider Pneumonia, Emphysema
and Chronic Obstructive Pulmonary Disease

BECURAN HIGH SCHOOL

Mast Cells degranulation

First Phase response (30-

60 mins) Release of
chemical mediator of
inflammation (Histamine,
Prostagladin, bradykinis,
SRS-A)

Accelerated airway smooth

Ventilation and boost Irritation of the Respiratory
muscle contraction
capillary permeability Tract
(bronchospasm)

Capillary leaks third

Increase mucus secretion
protein into tissue spaces
Wheezing SOB

Edema of the airway

Coughing
(mucosal edema) Chest Pain

Hyper secretion of mucus Respiratory Congestion

Clinical Management of Bronchial Asthma in Acute
Exacerbation, to Consider Pneumonia, Emphysema
and Chronic Obstructive Pulmonary Disease

BECURAN HIGH SCHOOL

Edema of the airway
(mucosal edema)

Impaired Expiration

Airway obstructions and

narrowing

Extend resistance to
airflow and decrease
flow rates (expiratory
flow)

Impaired Expiration

Air trapping
Clinical Management of Bronchial Asthma in Acute
Exacerbation, to Consider Pneumonia, Emphysema
and Chronic Obstructive Pulmonary Disease

BECURAN HIGH SCHOOL

Air trapping

Hyperinflation distal to
obstruction

CO2 retention

Absorption of trapped
air in the alveoli
Respiratory Increased lung
acidosis (if
volume
severe)
Alveolar sacs
collapsed (atelectasis)
Respiratory Response of the
failure lung receptor
triggering
hyperventilation
Perfusion without
ventilation shut
(ventilation-perfusion
mismatch)
Tachypnea

Emphysema