• Share
  • Email
  • Embed
  • Like
  • Save
  • Private Content
Chronic bronchitis
 

Chronic bronchitis

on

  • 4,131 views

Target: UG medical students.

Target: UG medical students.

Statistics

Views

Total Views
4,131
Views on SlideShare
4,130
Embed Views
1

Actions

Likes
0
Downloads
156
Comments
1

1 Embed 1

http://www.slashdocs.com 1

Accessibility

Categories

Upload Details

Uploaded via as Adobe PDF

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel

11 of 1 previous next

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

    Chronic bronchitis Chronic bronchitis Presentation Transcript

    • CHRONICBRONCHITIS Dr.CSBR.Prasad, M.D. CSBRP-Nov-2012
    • Chronic Bronchitis - gist Damage to air ways caused mainly by chemicals Sources: Cigarette smoke, Industrial gases, Motor vehicle exhaust et.c.Definition: Persistent productive cough for at least 3 months in at least 2 consecutive years with out any identifiable cause. CSBRP-Nov-2012
    • Chronic Bronchitis Damage to air ways caused mainly by chemicals Sources: Cigarette smoke, Industrial gases, Motor vehicle exhaust et.c. CSBRP-Nov-2012
    • Chronic BronchitisImportance: CB may progress to COLD Result in cor pulmonale & heart failure Result in metaplasia / dysplasia > Carcinoma CSBRP-Nov-2012
    • CHRONIC BRONCHITISDEFINITION: Persistent productive cough for at least 3 months in at least 2 consecutive years with out any identifiable cause. Chronic asthmatic bronchitis – intermittent bronchospasm and wheezing. CSBRP-Nov-2012
    • CHRONIC BRONCHITISPathogenesis: Chronic irritation by inhaled substances (Tobacco smoke-90%, grain, cotton, Si dust) Microbiologic infections – trigger exacerbations Middle-aged men – more common Smokers – 4 to 10x more common CSBRP-Nov-2012
    • CHRONIC BRONCHITISFeatures of CB:Initially: Hypersecretion of mucus (Proteases from PMNs) Hypertrophy of submucosal glands in trachea and bronchiWith chronicity: Marked increase in goblet cells of small airwaysIncrease in globlet cells and hypertrophy of submucosal glands are of protective metaplastic reaction against the irritantsIrritants > EGF receptor stimulation > up regulation of MUC 5AC gene (a mucin gene) CSBRP-Nov-2012
    • CHRONIC BRONCHITISHypersecretion of mucus is the basis for smaller air way obstruction CSBRP-Nov-2012
    • CHRONIC BRONCHITISCigarette smoke: Plays primary initiating roleRole of infection: Plays a secondary role CSBRP-Nov-2012
    • CHRONIC BRONCHITISAction of Cigarette smoke:1. Interferes with ciliary motility2. Direct damage to epithelium3. Inhibits alveolar leucocytes to clear bacteria CSBRP-Nov-2012
    • Figure 15-9 Schematic representation of evolution of chronic bronchitis (left) and emphysema (right).CSBRP-Nov-2012
    • CHRONIC BRONCHITISMorphology: Hyperemia and edema of mucus membranes Excessive mucus / mucopurulent secretion layers the epithelial surfaces CSBRP-Nov-2012
    • CHRONIC BRONCHITISSMALL AIRWAYS SHOW: Goblet cell metaplasia with mucous plugging Clustering of pigmented alveolar MØ Inflammatory cell infiltration Fibrosis of the bronchiolar wall Bronchiolitis obliterans Bronchial epithelium may exhibit squamous metaplasia and dysplasia CSBRP-Nov-2012
    • CHRONIC BRONCHITISCharacteristic histological feature: Lymphocytic infiltration Enlargement of mucin secreting glands of trachea and bronchi i.e. Increased size of mucous glands REID Index: Normal is 0.4 Ratio of the thickness of the mucous gland layer to the thickness of the wall between the epithelium and the cartilage CSBRP-Nov-2012
    • CSBRP-Nov-2012Chronic inflammatory cells infiltration in submucosa of bronchus
    • CSBRP-Nov-2012
    • CSBRP-Nov-2012
    • Reid’s Index REID Index bc/adCSBRP-Nov-2012
    • CSBRP-Nov-2012
    • CSBRP-Nov-2012
    • CSBRP-Nov-2012
    • CHRONIC BRONCHITISClinical feature: Persistent productive cough Over the period the patient develops dyspnea on exertion With further progression – patient develops hypercapnea, hypoxemia and mild cyanosis They may land in emphysema Long standing cases – cor pulmonale and cardiac failure Death may occur due to respiratory infections CSBRP-Nov-2012
    • E N Dgoto Bronchiectsis CSBRP-Nov-2012