Chronic bronchitis is a long-term inflammatory condition of the bronchi. It is defined as excessive mucus production in the lungs for at least 3 months per year for more than 2 years. The main symptoms are cough, sputum production, wheezing, and shortness of breath. Risk factors include smoking, air pollution, occupational exposures, and previous infections. Management involves stopping smoking, using bronchodilators and inhaled corticosteroids, antibiotics for exacerbations, and lifestyle modifications like exercise and nutrition.

1. CHRONIC
BRONCHITIS
VIKASH KUMAR
GROUP-55

2. Respiratory System

3. Whatis Bronchitis ?
Bronchitis is inflammation of the bronchi (large and medium-sized
airways) in the lungs.
• Symptoms –
-coughing up mucus, - wheezing, - shortness of breath, and chest discomfort.
• Bronchitis is divided into two types:- ACUTE and CHRONIC
-Acute bronchitis is also known as a chest cold.

4. What is chronic bronchitis ?

5. CHR0NIC BRONCHITIS is defined as a condition associated with excessive
tracheobronchial mucus production to cause cough with expectation for at
least 3 months of the year, for more than 2 consecutive years.
-Chronic Bronchitis causes excessive amounts of sticky mucus to build up
in the airways, restricting amount of airflow in and out of the lungs.

7. - Middle and late adult life.
-More in males than females.
-More in smoker than in non- smokers.
-More in urban than in rural dwellers.
INCIDENCE

8. -Smoking
-Occupational hazard:-as with exposure dust, smoke and fumes, worker in
cotton mills,worker in plastic industry
-Air pollution:- dust, air pollution, coal, biomass fuels.
-Low socio-economic status
-Previous tuberculosis
- Familial and Genetic factors
RISK FACTOR

9. -Infection with rhinovirus, strep. Pneumoniae, H.influenzae A and B
-Weakened immune system
-Chemical /inhalants
-COPD

11. *Hypertrophy and Hyperplasia of the mucus- producing glands
*Goblet- cell hyperplasia
*Rreduction in ciliated cells
*Mucosal oedema and intraluminal mucus plugs
*Increased smooth musle
*reduction in the calibre of the air passages.
PATHOLOGICAL CHANGES

12. CLINICAL TYPES

13. - COUGH with sputum production
-SHORTNESS OF BREATH
-WHEEZING
-TIGHTNESS OF CHEST
-FATIGUE
-COUGHING WITH CHEST PAIN
SYMPTOMS

14. -CYANOSIS
-Slight fever and chills
-WEAKNESS
-BODY ACHES

15. DIAGNOSIS
1) Physical exam
2)Sputum test
3)Pulmonary function test
4)Chest X-ray
5)Chest CT
6)ECG

16. *Usually the patient is overweight
*At rest, there is no respiratory distress. Respiratory rate is normal
*Percussion- Normally resonant over the lung
Liver dullness and Cardiac dullness a.re normal in Position
*Auscultation- Vesicular breath sounds with prolonged expiration
inspiratory and expiratory rhonchi
Crepitations- changes in location and intensity after coughing
PHYSICAL EXAM

17. Sputum test- mucus coughed up from the lungs, to be tested on analyzing presence of bacteria
Pulmonary function test(spirometry)-
- FEV1 reduced
- FVC decreased
-Ratio of FEV1 /FVC subnormal
-PEF reduced
-RV increased
-FRC increased
-TLC increased

18. -Shows irregular pattern Broncho-vascular structure
-Thickening of bronchial wall
-May shows signs of inflammation in bronchi
CHEST X-ray

19. ◦ ECG – may show features of right atrial and ventricular hypertrophy(tall P waves, RBBB)

20. DIFFERENTIAL DIAGNOSIS
- ASTHMA
-PNEUMONIA
-EMPHYSEMA
-ALLERGIC RHINITIS

21. -RESPIRATORY FAILURE
-PULMONARY HYPERTENSION
-CARBON DIOXIDE NECROSIS
-SECONDARY POLYCYTHAEMIA
COMPLICATION

22. * Regular exercise and Nutritional management
*Stop smoking completly –use of nicotine replacement therapy (by gum, transdermal
patch in
haler). Varenicline, which is nicotinic acetylcholine receptor partial agonist.
*Bronchodilator- inhalation of Beta-2 adrenoreceptor agonist like
Salbutamol- 200 micro gm ,or Terbutaline- 500 micro gm every 6 hour.
* Inhaled Corticosteroids ( beclomethasone, fluticasone)
MANAGEMENT

23. * Oxygen Therapy- through nasal cannulae.
* Symptomatic measures - hot drinks or steam inhalation to liquefy sputum,
- Mucolytic agent –bromhexine , ambroxol
- chest physiotherapy
* Antibiotics – Azithromycin, 3rd generation Cephalosporin(ceftriaxone)
- Amoxycillin.
MANAGEMENT

24. - Stop smoking
-exercise regularly
-protect yourself from cold air
-Getting vaccination to prevent respitratory infection
-avoid other respiratory irritants
- wash hand regularly
PREVENTION