Respiratory System Disorders and Therapy From a New - Louis Bolk ...

Conclusion: In the acute asthma attack, the airways become immobilized and show
consolidation processes, functionally and in their anatomic structures. The pathophysiology
shows similar tendencies: airway remodeling hinders airway movement and crystalline
elements are present in the exudate.
2.2. A Woman with Chronic Asthma and Eczema since Childhood
A 36-year old slender woman has had moderate to severe asthma since she was a small
child. Recently, her asthma attacks in the fall have led to her being hospitalized. She will
first get a cold, and then the asthma becomes much worse and the cold progresses to a
pneumonia, which requires hospitalization. She sleeps well except when she experiences
an asthma attack. It tends to wake her up at night. She also has problems with hay fever
in the spring and summer. She has had eczema since childhood. Her bowel movements are
unformed.
Upon examination, we see a lean, blond woman of average stature who is keenly alert.
Auscultation of the lungs reveals normal breath sounds, but expiration is prolonged, it
lasts longer than inspiration. She has low lung borders in the back and her chest volume
seems relatively large. She has active bowel sounds. Blood pressure and heart sounds are
normal. Her feet, knees, and hands are cold.
She has a family with school age children and does volunteer work, but would like to take
a job as a teacher, and also do further studies. She is hard working and ambitious.
2.2.1. Signs and Symptoms of Chronic Asthmatic Disease
The general impression of this patient is one of a woman with increased alertness and
tension, though less acutely than in our previous patient. Her attention is directed towards
achieving her goals. Again, we can list the different chronic signs and symptoms of this
patient with asthmatic disease according to function: