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.
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.
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.
6.
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
10.
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
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)