Bronchitis physical examination
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Bronchitis Main page |
Overview
Diagnosis
A physical examination will often reveal decreased intensity of breath sounds, wheeze (rhonchi) and prolonged expiration. Most doctors rely on the presence of a persistent dry or wet cough as evidence of bronchitis.
The physical examination findings in acute bronchitis can be:
General physical examination
- Clubbing on the digits
- Peripheral cyanosis
- Conjunctivitis
- Bullous myringitis
Oropharyngeal examination
- Pharyngeal erythema
- Rhinorrhea
- Lymphadenopathy
Pulmonary system
- Use of accessory muscles suggesting labored breathing.
- Rhonchi, and wheezes that change in location and intensity after a deep and productive cough.
- Presence of inspiratory stridor indicate obstruction of a major bronchi or the trachea.
Cardiovascular examination
- Sustained heave felt along the left sternal border, suggests right ventricular hypertrophy secondary to chronic bronchitis.
A variety of tests may be performed in patients presenting with cough and shortness of breath:
- A chest X-ray that reveals hyperinflation; collapse and consolidation of lung areas would support a diagnosis of pneumonia. Some conditions that predispose to bronchitis may be indicated by chest radiography.
- A sputum sample showing neutrophil granulocytes (inflammatory white blood cells) and culture showing that has pathogenic microorganisms such as Streptococcus spp.
- A blood test would indicate inflammation (as indicated by a raised white blood cell count and elevated C-reactive protein).
- Neutrophils infiltrate the lung tissue, aided by damage to the airways caused by irritation.
- Damage caused by irritation of the airways leads to inflammation and leads to neutrophils being present
- Mucosal hypersecretion is promoted by a substance released by neutrophils
- Further obstruction to the airways is caused by more goblet cells in the small airways. This is typical of chronic bronchitis
- Although infection is not the reason or cause of chronic bronchitis it is seen to aid in sustaining the bronchitis.