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Chronical bronchitis



Chronic bronchitis is a disease common among smokers and residents of megacities affected by smog (a mixture of fog, smoke and soot). The diagnosis of chronic bronchitis is made when a persistent cough with sputum production lasts for at least 3 months in 2 years. With simple chronic bronchitis, cough with sputum without signs of airway obstruction is noted. In chronic asthmatic bronchitis, there are phenomena of increased reactivity of the respiratory tract with intermittent bronchospasm and stridor. Over time, patients (especially smokers) develop chronic airway obstruction, usually in combination with emphysema. Then the disease is called chronic obstructive bronchitis. At the end of XX century. in industrialized countries, about 10-12% of residents of megacities suffer from chronic bronchitis, among rural residents the incidence is much lower.

In the pathogenesis of chronic bronchitis, an important role is played by: chronic irritation of the mucous membrane of the respiratory tract with inhaled particles and substances, as well as bacterial infections. Persons of both sexes and all ages are affected. However, most often chronic bronchitis occurs in middle-aged men. The most important predisposing factor is smoking. Back in the middle of the 20th century. in long-smokers, this disease was noted 4-10 times more often than in non-smokers.

The earliest sign of chronic bronchitis is excessive secretion of mucus in the upper respiratory tract. This is due to hypertrophy of the submucous glands of the trachea and bronchi. As the disease develops, the number of goblet cells in the lining of small bronchi and bronchioles increases, which is also accompanied by excessive production of mucus, which subsequently leads to airway obstruction. It is believed that all these changes are a reaction to tobacco smoke, sulfur dioxide or nitrogen, or other inhaled substances that pollute the air (see Chapter 9). Despite the fact that hypersecretion of mucus in the upper respiratory tract causes excessive production of sputum, it is currently believed that combined damage to the mucous membrane of small bronchi and bronchioles (diameter less than 2-3 mm) can also quickly lead to chronic obstruction of the airways.
Pathological studies of biopsy specimens of small bronchi in young smokers revealed the following: goblet-cell metaplasia of the lining with mucous plugs in the lumens, accumulation of pigment-rich alveolar macrophages, inflammatory infiltrates, fibrosis of the walls of the bronchioles. Smokers' respiratory bronchiolitis is an important component of early-onset and relatively mild airway obstruction. As obstruction of the bronchi progresses with bronchitis, emphysema begins to dominate in the picture of the disease. As for the infection, it is given a secondary, i.e. not an initiating, but a supporting role. However, infection can be the main cause of acute and severe complications.

Macroscopically, the mucous or mucopurulent contents are often found in the lumen of the bronchial tree, sometimes jelly-like or denser cylinders consisting of this content and clogging the small bronchi are sometimes visible. In the mucous membrane itself, hyperemia and edema are noted. Noteworthy is the increase in the mucus-forming glands of the trachea and bronchi, although the number of goblet cells in them increases slightly. In addition, squamous metaplasia (see Chapter 6) and dysplasia are found in the bronchial epithelium. The appearance of a large number of goblet cells, plugs from mucus, as well as inflammatory (Fig. 15.11) and fibrotic processes in the mucous membrane of bronchioles lead to their narrowing. In the most severe cases, obliteration of the lumen (bronchiolitis obliterans) is possible.

Fig. 11/15.

Chronic bronchitis with exacerbation

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In the lumen of the bronchus is a cork, consisting of exudate and mucus.



Fig. 12/15.

Chronic bronchitis, site of peribronchial pneumofibrosis

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Other symptoms of chronic obstructive pulmonary diseases are gradually added to all of these symptoms: hypercapnia (high levels of carbon dioxide in the blood and other tissues), hypoxia, and slight cyanosis. Long-existing chronic bronchitis (Fig. 15.12) leads to the development of pulmonary heart and heart failure.

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Chronical bronchitis

  1. CHRONICAL BRONCHITIS. CHRONIC PULMONARY HEART.
    In recent years, due to the deteriorating environmental situation, the prevalence of smoking, and a change in the reactivity of the human body, there has been a significant increase in the incidence of chronic non-specific lung diseases (COPD). The term KNZL was adopted in 1958 in London at a symposium convened by the pharmaceutical group Ciba. He combined such diffuse diseases
  2. Chronical bronchitis
    Chronic bronchitis is a chronic disease characterized by diffuse inflammatory damage to the respiratory tract with excessive secretion of mucus in the bronchial tree and sclerotic changes in the deeper layers of the bronchial wall, manifested by productive cough, persistent rales of various sizes in the lungs (for 3 months), in the presence of exacerbations at least two times per
  3. Chronical bronchitis
    Chronic bronchitis is a progressive diffuse inflammation of the bronchi, not associated with local or generalized lung damage, manifested by cough. You can talk about chronic bronchitis if the cough lasts for 3 months in the 1st year - 2 consecutive years. Etiology. The disease is associated with prolonged irritation of the bronchi by various harmful factors (inhalation of air contaminated
  4. CHRONICAL BRONCHITIS
    - diffuse inflammatory lesion of the bronchial tree, caused by prolonged irritation of the bronchi by various harmful agents, having a progressive course and characterized by impaired mucus formation and drainage function, which is manifested by cough, sputum separation and shortness of breath According to the WHO recommendation, bronchitis can be considered chronic if the patient coughs up phlegm on
  5. Chronical bronchitis
    Chronic bronchitis is a progressive, diffuse inflammation of the bronchi, not associated with local or generalized lung damage, manifested by coughing. You can talk about chronic bronchitis if the cough lasts for 3 months in 1 year 2 years in a row. The disease is associated with prolonged irritation of the bronchi by various harmful factors (smoking, inhalation of air contaminated with dust,
  6. CHRONICAL BRONCHITIS
    On patency of the bronchi: obstructive and non-obstructive. According to the level of damage: proximal - up to 5-6 generation of bronchi. Purulent and catarrhal. Obstructive bronchitis. If distal, then the main symptom is associated with an air trap (when inhaling, the air enters the alveoli, during exhalation the bronchi are shortened, take the form of a corrugated tube and the air does not pass back, the volume increases
  7. Chronic bronchitis in children
    Protocol code: 04-042 Profile: pediatric Stage: hospital Purpose of stage: 1. clarification of the diagnosis and elimination of the inflammatory process in the bronchi; 2. relief of symptoms of respiratory failure, general intoxication; 3. FEV1 recovery. Duration: 11 days ICD codes: J40 Bronchitis, unspecified as acute or chronic J41.0 Simple chronic bronchitis J41.1 Mucopurulent
  8. Chronical bronchitis
    CHRONIC Bronchitis (CB) is a diffuse inflammatory lesion of the bronchial tree caused by prolonged irritation of the airways by volatile pollutants and / or (less commonly) damage by viral and bacterial agents, accompanied by hypersecretion of the mucus, impaired cleansing function of the bronchi, which is manifested by persistent or intermittent cough and sputum discharge.
  9. Chronic bronchitis and emphysema
    Chronic bronchitis is a disease characterized by chronic or recurrent excessive secretion of mucus in the bronchi, leading to the appearance of a productive cough with annual exacerbations of up to 3 months or more in recent years. Emphysema is a disease caused by an increase in the air space of the end bronchioles as a result of destructive changes in their walls. Distinguish
  10. CHRONIC Bronchitis and Pulmonary Emphysema
    Chronic bronchitis is a disease characterized by chronic or recurrent excessive secretion of mucus in the bronchi, leading to the appearance of a productive cough with annual exacerbations of up to 3 months or more in recent years. Emphysema is a disease caused by an increase in the air space of the end bronchioles as a result of destructive changes in their walls. Distinguish
  11. Chronical bronchitis.
    The criterion for the diagnosis of chronic bronchitis is a productive cough for most days of three consecutive months for at least two consecutive years. In the etiology of chronic bronchitis, smoking, air pollution, occupational exposure to dust, recurrent pulmonary infections, and hereditary factors play a role. Secretion of hypertrophied bronchial glands and edema
  12. Chronic bronchitis (code J 41, J 44)
    Definition Chronic bronchitis is a diffuse, progressive non-allergic inflammatory lesion of the bronchial tree associated with prolonged irritation of the airways by harmful agents, usually characterized by a restructuring of the secretory apparatus of the mucous membrane, as well as sclerotic changes in the deeper layers of the bronchial wall and peribronchial tissue,
  13. 50. CHRONIC BRONCHITIS.
    bronchi and bronchioles. Etiology and pathogenesis. Infection. CB can develop on the basis of acute bronchitis or pneumonia. An important role in its development is played by prolonged irritation of the bronchial mucosa with chemicals, dust, and smoking. At the onset of the disease, the mucosa is full-blooded, sometimes hypertrophied, mucous glands in a state of hyperplasia. Further inflammation extends to
  14. CHRONIC OBSTRUCTIVE LUNG DISEASES / CHRONIC BRONCHITIS AND LUNG EMPHISEMA /
    Chronic obstructive pulmonary disease is a pathological condition characterized by the formation of chronic airway obstruction due to chronic bronchitis / chronic obstructive pulmonary disease and / or pulmonary emphysema / EL /. Chronic obstructive pulmonary disease is widespread. It is estimated that HB affects about 14–20% of the male and about 3–8% of the female adult population, but only
  15. CHRONIC BRONCHITIS, LUNG EMPHYSIS AND BRONCH OBSTRUCTIVE SYNDROME
    Roland G. Ingram, Jr. (Roland H. Ingram, Sr.) Chronic bronchitis and emphysema are two relatively independent diseases that often occur simultaneously and cause the development of chronic bronchial obstruction. The diagnosis of chronic bronchitis is established on the basis of anamnesis, the presence of bronchial obstructive syndrome, confirmed during functional studies
  16. Abstract. Chronic Obstructive Bronchitis, 2009
    Contents Introduction 1. The clinical picture of chronic bronchitis 2. Diagnosis of COPD 3. Prevention and treatment of chronic obstructive bronchitis Conclusion
  17. LECTURE No. 19. Respiratory diseases. Acute bronchitis. Clinic, diagnosis, treatment, prevention. Chronical bronchitis. Clinic, diagnosis, treatment, prevention
    LECTURE No. 19. Respiratory diseases. Acute bronchitis. Clinic, diagnosis, treatment, prevention. Chronical bronchitis. Clinic, diagnosis, treatment,
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