Chronic inflammation of the airways Hyperactive bronchi Shortness of breath Tightness in chest Coughing Wheezing

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2 Chronic inflammation of the airways Hyperactive bronchi Shortness of breath Tightness in chest Coughing Wheezing

3 Components of the respiratory system Nasal cavity Pharynx Trachea Bronchi Bronchioles Lungs

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5 Air enters the nose or mouth and enters trachea Trachea branches into right and left primary bronchi Primary bronchi continue to branch repeatedly until they form terminal bronchioles Terminal bronchioles end in air sacs called alveoli Gas exchange occurs between alveoli of lungs and pulmonary capillaries surrounding alveoli

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7 Structure of respiratory passageways Consist of hollow tubes enclosed by walls made up of various tissue types including An inner mucous-membrane lining A cartilage layer to support an open airway A smooth muscle layer Responsible for filtering, warming, and moistening air

8 Defined as the overall exchange of oxygen for carbon dioxide Consists of Ventilation External respiration Internal respiration Cellular respiration

9 Asthma attack occurs when Inflammation in lining of respiratory passageways interferes with air movement Airways become red and swollen Airway lining produces excess mucus Smooth muscle layer constricts and narrows lumen

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12 Oxygen and carbon dioxide easily diffuse across the permeable membranes of alveoli and blood vessels Oxygen content in alveoli is always greater than oxygen content in pulmonary capillaries Oxygen consistently moves into capillaries Carbon dioxide consistently moves into alveoli

13 An allergen is a substance that elicits an immune response in susceptible individuals Allergens and other environmental irritants result in inflammation and airway constriction Healthy airways respond by dilating, which eases air movement Asthmatic airways remain constricted

14 Not clearly understood Appears to have a genetic and environmental component

15 Genetic component If one parent has asthma, each child has a 33% chance of developing asthma If both parents have asthma, each child has a 70% chance of developing asthma

16 Environmental component Some studies show a correlation between asthma and diets high in processed foods and low in fiber, fruits, and vegetables Some believe risk of asthma increases with exposure to indoor allergens and dust mites Some associate the increased prevalence of asthma to the increased number of low-birth-weight babies and the decreased number of breast-fed infants

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18 Irritants in the air Nasal allergies Animal dander Cold or very dry air Strenuous exercise Respiratory infections Strong smells

19 Bronchodilators Short-acting 2 agonist sprays Use 15 minutes before exercise and after an episode of exercise-induced asthma Effects last up to 6 hours Long-acting bronchodilators Help control symptoms during the night or during a particularly high-pollen season

20 Corticosteroids Manage short-term airway constriction Reduce existing inflammation but do not prevent inflammation Anti-inflammatories Long-term prevention of swelling and redness in airways

21 Inhalation is an active process that involves a number of muscles, primarily the diaphragm and external intercostals Diaphragm Contracts and flattens to decrease pressure in lungs Pressure gradient pulls air in External intercostals Contract and elevate ribs and sternum to decrease pressure in lungs Pressure gradient pulls air in

22 Exhalation in healthy lungs is a passive process that results when diaphragm and external intercostals relax Increases pressure within lungs Forces air out Requires action of a number of other muscles when lung tissue is damaged (as in emphysema)

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24 Exercise places a greater demand on the already insufficient respiratory system of asthma sufferer Asthma sufferers have a high risk of exerciseinduced asthma

25 Tips to reduce the risk of exercise-induced asthma Warm up before exercise; cool down after it Participate in activities that require short bursts of energy and avoid those requiring long-duration runs Breathe through the nose as much as possible Use bronchodilators as needed and prescribed

26 Improved overall physical conditioning and functional capacity Decreased hospitalizations Improved psychological mood Decreased risk for chronic conditions

27 Administer tests in shorter increments with slower progression rates to avoid dyspnea Terminate testing in cases of arterial oxygen desaturation The preferred mode is walking, but stationary cycling without arm ergometry is also acceptable Use the 6-minute walk test for those with severe pulmonary disease

28 ACSM s aerobic training guidelines for those with controlled asthma Perform cardiovascular exercise 3 5 days/week for minutes of continuous or intermittent activity Optimal training intensity is not known COPD sufferers should follow guidelines for seniors Young people with asthma or cystic fibrosis should follow guidelines for children and adolescents Walking or stationary cycling is safe and effective

29 ACSM s aerobic training guidelines for those with moderate to severe COPD Perform exercise 3 5 days per week Initial duration might only be a few minutes; slowly increase as client s health improves Intensity should be 60 80% of peak work rate, or base intensity on dyspnea ratings Walking or stationary cycling are safe

30 Resistance training guidelines Those with controlled asthma or mild COPD may follow guidelines for the general population Those with moderate to severe COPD should follow guidelines for seniors Train the inspiratory muscles Perform on 4 5 days per week Target an intensity of 30% maximal inspiratory pressure measured at functional residual capacity Continue for a duration of 30 minutes

31 Special concerns for asthma sufferers Include a longer warmup before aerobic exercise; progress more slowly Perform a longer cool down after exercise Remember that the mode of exercise is important; EIA is more likely after certain forms of exercise

32 Activities that increase the likelihood of EIA Any activity in a cold, dry climate Outdoor running carries an extreme risk Outdoor cycling or soccer Aerobic classes with excessive arm movements Exercise intensities at or above 80 90% maximal heart rate

33 Upper body exercises Chest press Chest flies Lat pull-downs Seated rows Shoulder press Lateral shoulder raises Biceps curls Triceps extension

34 Lower body exercises Squats Leg presses Leg extensions Leg curls

35 Foods and nutrients that might affect asthma symptoms Antioxidants Folic acid Magnesium Omega-3 fatty acids Water Calcium Salt Caffeine