Homesleeping healthBsc Nursing NotesBasic concepts of bronchitis, COPD

Basic concepts of bronchitis, COPD


Inflammation of lining of bronchial tubes, which carry air to and from the lungs (bronchial tubes) results in cough and mucus.

Bronchitis Types:

  • Acute Bronchitis
  • Chronic Bronchitis

Acute Bronchitis

  • Condition remains for few days to 10 days
  • Bacteria or virus that cause common cold or infection.
  • Irritants like cigarette smoke, air pollution, dust, vapours or fumes.

Chronic Bronchitis

  • Condition remains for months to years.
  • Lining of bronchial tube is constantly irritated and inflamed.
  • Cough with mucus for at least 3 months in a year.

chronic bronchitis Caused by

  • Repeatedly breathing in irritants.
  • Smoking major cause.
  • Viruses or bacteria easily infect irritated tubes.
  • Ongoing and serious

Causes and Risk factors

  • Cold and flu season
  • Viruses: Influenza Type A or B
  • Bacteria: Mycoplasma pneumoniae
  • Person inhaling irritants like dust, fumes.
  • Gastroesophageal reflux disease (GERD)
  • Weak immune system
  • Smoking
  • Unhealthy environment

Pathophysiology of bronchitis

  • Virus, bacteria, smoke or other environment pollutants irritate airways
  • Hypersecretion of mucus and inflammation
  • Bronchial walls become thickened
  • Bronchial lumen narrow, mucus plugged airways
  • Alveoli adjacent to bronchioles may become damaged and fibrosis
  • Fibrosis of bronchial and airflow limitation

Clinical features of Bronchitis

 Acute bronchitis clinical features

  • Cough with or without phlegm
  • Chest tightness
  • Fever
  • Mild headache, body aches
  • Shortness of breath
  • Wheezing sound

 Chronic bronchitis clinical features

  • Daily, productive cough for at least 3 months of the year, 2 or more years in a row.


Asthma is a common chronic inflammatory condition of the lung airways . It has three characteristics:

  • Airflow limitationàwhich is usually reversible spontaneously or with treatment
  • Airway hyper responsiveness àto a wide range of stimuli 
  • Inflammation of the bronchi àwith eosinophils, T lymphocytes and mast cells that is associated with plasma exudation, edema, smooth muscle hypertrophy, mucus plugging and epithelial damage.


  • Asthma affects an estimated 300 million individuals worldwide.
  • Annually, the World Health Organization (WHO) has estimated that 15 million disability-adjusted life-years are lost and
  • 250,000 asthma deaths are reported worldwide.

Predisposing factors

Environmental allergens

  • house dust mites;
  • animal allergens, especially cat and dog;
  • cockroach allergens;
  •  fungi
  • Viral respiratory tract infections
  • Exercise, hyperventilation
  • sinusitis or rhinitis
  • Aspirin  and NSAID hypersensitivity
  • Use of beta-adrenergic receptor blockers
  • Obesity
  • Environmental pollutants, tobacco smoke
  • Occupational exposure
  • Irritants (eg, household sprays, paint fumes)
  • Emotional factors or stress
  • Perinatal factors (prematurity and increased maternal age; maternal smoking and prenatal exposure to tobacco smoke)

Clinical features

three most common symptoms

  • cough,
  •  dyspnea, and
  • wheezing.

In some instances, cough may be the only symptom.


  • Chronic obstructive pulmonary disease (COPD) is lung disease
  • characterized by persistent airflow limitation that is usually progressive and
  • associated with an enhanced chronic inflammatory response in the airways and the lung in response to noxious particles or gases.
  • COPD Include   
    • Chronic Bronchitis
    • Emphysema
    • Irreversibale astma
    • Bronchetiasia


  • Impaired gas exchange from destruction of the walls of over distended alveoli.

Chronic Bronchitis:

  • Excessive accumulation of mucus due to inflammation and cause narrow airway.

 Irreversible asthma:

  • Inflamed and constricted airways obstruct airflow.


  •  Mucus sticks to bronchi leading to obstruction, infection and inflammation.


  • The Global Burden of Disease Study reports a prevalence of 251 million cases of COPD globally in 2016.
  • Globally, it is estimated that 3.17 million deaths were caused by the disease in 2015 (that is, 5% of all deaths globally in that year).
  • More than 90% of COPD deaths occur in low­ and middle­ income countries.
  • Nepal have reported the prevalence of COPD ranging from 23% to 43%.

Risk factors and cause of COPD

  • Smoking (Active or Passive)
  • Indoor and outdoor pollution
  • Genetic factors: alpha 1 antitrypsin deficiency
  • Socioeconomic status
  • Asthma & airway hyper-reactivity
  • Emphysema
  • Chronic bronchitis
  • Infections
  • Exposure to smoke

Pathophysiology of COPD

Due to causes and risk factors of COPD


  • Chronic coughing (sputum)
  • Dyspnea
  • Wheezing
  • Chest tightness
  • Frequent respiratory infection
  • Enlarged alveoli
  • Weight loss
  • Advanced symptoms
  • Cyanosis
  • Morning headache
  • Weight loss
  • Haemoptysis
  • Swollen feet and ankles


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