Predisposing factors:

Precipitating factors:
o Genetics
o Environmental factors
o Race
(change in temperature)
o Age o Atmospheric pollutants
o Gender o Allergens
1 gE stimulations

Mast cell degeneration

Asthma attack

Altered Increased airway Increased lung Impaired Increased

immunologic resistance compliance mucuciliary airway
response function resistance

Barrel Lungs become Productive Respiratory

Chemical chest hyperventilated Increased mucus cough muscle works
mediators are production harder
released
Whitish
Bronchial sputum
Histamine, SRS-4, narrowing
Leukotrienes, Slowed
Prostaglandins, clearance of
Bradykinins Irreversible lung
changes mucus Prolonged Altered O2 –
Mucus
expiration CO2 exchange
inflammation
Spasm bronchospasm Body Increased water
secretion malaise loss from mucus

Pleural Mucus
Audible effusion
expiratory + becomes
inspiratory increasingly
(accessory Barrel viscous
muscle chest Emphysema
breathing,
nasal flaring)
Cough
Tachypnea

Tachycardia Shortness
of breath
 Disequilibrium Disequilibrium
between elastace between elastace
and anti-elastace and anti-elastace

Increase peripheral Destruction of

vascular resistance from elastic recoil
constriction of arterioles hypoxi
Increase after load a
Over distention of
alveoli

Decrease blood
flow to organs
Restlessnes
Retention of CO2
s Respiratory acidosis
Decrease renal Beta-receptor
perfusion activation

Decrease blood
peressure Pursed
lip
breathing
Juxtaglomerular Increased CO2
cells tension in arterial
blood
Renin Decreased
capillary
Capillary bed is reduced refill from
3-4 to 5-6
Hyponatremia Hypovolemia
sec
Angiotensinogen Angiotensin I
Pulmonary blood flow is increased forcing
the right ventricle to maintain a bhigher Angina
Arteriolar blood pressure in pulmonary arty pectori
Angiotensin II
vasoconstriction s
Increase peripheral Adrenal cortex Right – sided heart failure
resistance stimulation II

Increase volume in systemic

Increase Aldosterone
venous circulation

Increase Sodium
Increase volume in
Increase reabsorption
distensible organs
blood
pressure
Increase water reabsorption Edem Ascitis
a

Increase plasma Infiltrative process

volume ECF

Fibrosis & thickening of

heart muscle
Hypertension

Ventricles loses ability to

Fatigu stretch
Headache Weaknes Dizziness
s e

Impair filling during diastole

Decrease CO2

Heart failure

Hypertrophy of the heart

Decrease
Cardiogenic Cardiomegaly
d blood
shock
pressure

Dyspnea Jugular Sinus

RR from Chest vein tachycardia
Narrowed
25cpm pain distention to 3rdrd degree
pressure
-4cpm heart block
to systole

Periphera
l cyanosis
System
shutdown

Pain Legend:
 Disease process
 Complication
 Signs & symptoms
Cool  Primary problem
clamm  Outcome
y skin

Oliguri
a