Chronic bronchitis is characterized by a decline in lung function, heart failure, and potential cancerous development due to dysplasia of the respiratory epithelium. It involves mucus hypersecretion in the large airways due to hypertrophy of submucosal glands and increased goblet cells. This causes chronic inflammation and long-term airway obstruction due to fibrosis. Infections do not initiate chronic bronchitis but can cause acute exacerbations by preventing mucus clearance. Changes in the mucous membrane include hyperemia, edema, hyperplasia and an increased Reid index. Clinical features include persistent cough, sputum, dyspnea, and potentially hypoxemia, cyanosis and cardiac failure over the

1. Chronic
bronchitis(COPD)
By_ Rathod Mihirsinh Ambarishbhai
To_ Aruna ma’am, proof. Internal disease

2. Chronic bronchitis
• Decline in lung function
• Heart failure
• Atypical metaplasia
• Dysplasia of respiratory
epithelium, may led to
cancerous development.

3. Features of chronic
bronchitis. • Mucus hypersecretion:-
in large airways.
hypertrophy of
submucosal gland in
trachea and bronchi.
inflammatory
mediators:- histamine, IL-
13.
inc. in goblet cell is
protective rxn against
smoke&pollutant.

4. inflammation
• Cellular damage, eliciting acute
and chronic inflammatory
response involving the
neutrophils, lymphocytes and
macrophages.
• Leads to chronic airways
obstruction due to long standing
inflammation by fibrosis.
These features are common
dominator in COPD and
emphysema.

5. infection
• Does not initiate it but produce acute
exacerbations.
• Chronic bronchitis does not only
damage airways lining but also cilia,
preventing clearance of mucus.

6. morphology
• Changes in mucus membrane:-
Hyperemia, edema, hyperplasia
increase Reid index(ratio of thickness of
mucus gland layer is to thickness of wall wall
between epithelium and cartilage.

7. Clinical features
• Persistence cough, sparse
sputum.
• Dyspnea of exertion
• On time hypercapnia,
hypoxemia, and mild
cyanosis(blue blotters) may
develop
• Long standing chronic
bronchitis may led to cardiac
failure.

8. How Is
Bronchitis
Diagnosed
?
• During the first few days of illness,
bronchitis symptoms are similar to that of
a common cold. Healthcare providers
diagnose bronchitis by asking patients
questions about symptoms and doing a
physical examination. Though they rarely
order additional tests, if you have a fever,
your physician may order a chest X-ray
to rule out pneumonia.

9. osculation
• Coarse crackles heard at
the beginning of
inspiration are commonly
heard in patients with
COPD, especially those
with chronic bronchitis.
These crackles have a
“popping-like” character,
vary in number and timing
and may be heard over any
lung region.
• Palpation:- no specific
alteration.

10. percussion
• Percussion also reveals decreased
excursion of the
diaphragm (bilateral). Breath sounds
are diminished bilaterally. Coarse
crackles, rhonchi and expiratory
wheezes are heard bilaterally. Most of
these sounds clear with coughing.

11. Treatment
Most cases of bronchitis go away on their own. The infection simply has to run
its course over several weeks. Treatment options your doctor may suggest are:
Resting and getting plenty of fluids
Drinking lots of water, which helps loosen chest congestion
A cough suppressant and/or pain reliever
A humidifier or steam
Antibiotics are not effective for treating viral infections, but if your doctor
suspects that you have a bacterial infection, they may prescribe one.

12. Quiz question 1.
•4.0
•5.0
•6.0
•8.0
Q. What is
the normal
value for
Reid index in
normal
lungs?

13. Quiz question 2
•IL-13
•Histamine
•None of above
•Both of the above
What are the
inflammatory
mediators for
the chronic
bronchitis?