AACN ECCO Pulmonary Practice Exam

In patients experiencing shortness of breath due to asthma, the use of accessory respiratory muscles is a notable sign. When airway obstruction occurs, as it does in asthma, the body compensates by engaging additional muscles that are not typically used during normal breathing. This includes the muscles of the neck, shoulders, and even the abdominal muscles, which help to create more power during expiration and assist with increasing airflow.

Typically, this use of accessory muscles indicates that the patient is struggling to breathe effectively and is employing every available resource to improve ventilation. In the context of asthma, where bronchospasm and mucus production can severely narrow the airways, relying on these muscles becomes essential to overcome this obstruction.

While an increased respiratory rate may also occur in asthma patients during acute episodes, it is the recruitment of accessory muscles that signifies the severity and effort involved in their breathing. The absence of wheezing sounds might indicate a different airway status, potentially leading to a more critical situation, and slow deep breathing is not characteristic of asthma exacerbations, which usually prompt rapid, shallow breaths instead. Therefore, the use of accessory muscles stands out as a clear and common sign of respiratory distress in asthmatic patients experiencing shortness of breath.