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1. Asthma
by
Farshid Mokhberi
Shahid Beheshti University of Medical Science

2. Asthma

3. Obstructive & Restrictive Lung Diseases.
Definitions:
Obstructive: Limitation of the airflow usually resulting from an
incraese in resistance due to partial or complete obstruction at
any level. Like: Asthma , Emphysema, Chronic Bronchitis
Restrictive: Reduced expansion of lung parenchyma accompanied
by decreased total lung capacity.

4. Definition & Basics of Ashtma
Asthma is a chronic inflammatory disorder of the airways.
This feature of asthma has implications for the diagnosis,
management, and potential prevention of the disease.
 Inflammatory airways disease
 Increased responsiveness
 Increased contraction of airway smooth muscles
 Hypersecretion of bronchial mucus
 Altered airway architecture
 Altered immunologic state, e.g., atopy
 Idiopathic

5. Classification of Asthma
Intrinsic Asthma Extrinsic Asthma
Non-allergic
Usually adult onset
Often follows severe
respiratory illness
More refractory to treatment
Strong family history of allergies
 Usually onset at a young age
 History of specific allergic
association triggers (e.g. pollen,
animal dander)
 Correlation with skin and
inhalation responses to specific
antigens

6. Intrinsic asthma: the absence of atopy
Symptoms are not related to seasons of the year or
identifiable allergens.
Provoked by poorly characterized respiratory tract
infections (viral infection).
Aspirin (nonsteroidal), cold dry air also provoke
asthmatic attacks and are not associated with specific
antibody production.
Once exposed and sensitized, these asthmatic can
develop chronic asthma despite avoidance of sensitizing
chemicals.
Also demonstrate nonspecific bronchial hyperactivity.

8. Airway Inflammation in Intrinsic
TRIGGER
↓
INFLAMMATORY
RESPONSE
↓
AIRWAY CHANGES
↓
RESPIRATORY SYMPTOMS
©2010

9. Extrinsic Asthma

10. Airway Inflammation in Extrinsic
Early Phase Response
Involves Type I Hypersensitivity
IgE antibody with Mast Cells
Late Phase Response
Involves Type IV Hypersensitivity
T cell mediated response activates eosinophils, B cells, others

11. Pathophysiology
Airway inflammation
Decreased airway caliber
-Bronchoconstriction-(may cause death on its own)
-Edema of submucosal tissues
-Abnormal airway liquid (mucus plugging)
-Nonspecific hyperreactivity
Air trapping and hyperinflation (CXR and PFTs)
V/Q mismatch compensation occurs during
exacerbations

12. Airway Remodeling
Vascular
Dilation Edema
Subepithelial
Fibrosis
Epithelial
Damage
Inflammatory
Cell
InfiltrationSmooth Muscle
Hypertrophy
Mucous Gland
Hypertrophy
Mucus
Subbasement
Membrane
Thickening
©2010

13. Normal Airway Looking at
the Main Carina
Airway During Asthma
Exacerbation

14. Diagnosis

15. Asthma Diagnosis
Symptoms
Medical history
Physical Exam

16. Treatment

17. Treatment:
Acute:
B2 Agonist: Albuterol (short acting), Salmeterol (long
acting)
Bronchodilation
Chronic:
Corticosteroids: Fluticasone
Inhibits multiple inflammatory cytokines

18. Thank You

19. Refrences
http://www.webmd.com/asthma/guide/default.htm
http://www.asthma.org.uk/
http://www.mayoclinic.com/health/asthma/DS00021
http://www.nhlbi.nih.gov/health/asthma