Anatomy Lesson - Asthma 101

Picture for a moment the airways of an adult male as a network of tiny tunnels equal to the area of a tennis court. There are muscles that wrap around and support the airways. The inside skin of the airways is lined with special cells. Also lining the airways are tiny hairs that move in a wave-like manner to wash inhaled particles and debris up and out of the airways, into the throat, where they are swallowed or coughed up.

When most people think of an asthma attack they think of someone gasping for air and rushing to the hospital. They might think of the class "geek" or someone who is constantly sucking on an inhaler. What they don’t realize is that asthma is an ongoing problem with periodic episodes of breathing difficulty.

Even people with asthma have difficulty making this distinction. They think when the attack is over, so is the asthma. They only notice problems with asthma when their breathing has become very noisy, labored, and tiresome. This is called bronchoconstriction and airway hyperreactivity.

However, between these "attacks" is the quiet, smoldering part of asthma called inflammation. Just as a sunburn develops over a period of unprotected exposure to the sun, an asthma attack builds over a period of unprotected exposure to things that irritate and inflame the airways.

An asthma episode starts out quietly and goes unnoticed until it erupts into spasms of wheezing, coughing, and, eventually, gasping for breath. The inside of the airways fill with fluid leaking from inflammatory cells and become clogged with mucus that the hair-like projections cannot clear. The muscles that wrap around the airways become twitchy, squeezing the swollen airways and irritating them further.

The swollen, tiny airways become narrowed and breathing becomes labored to the point of struggle. The harder the person works to breathe, the noisier the breathing becomes as it whistles through the constricted air spaces.

There are many ways to treat asthma and conditions leading to symptoms of asthma. Each person has a unique asthma profile. This becomes the basis of an asthma management plan developed with the physician. Be consistent. Apply the plan at home, school, and play.

The important thing to remember is that asthma can be well controlled and should not interfere with a child’s educational experience. If the asthma management plan works at home, but there are complications at school, the family, educators, and physician should explore ways to overcome any barriers that may put the child with asthma at risk.