How many orders of division of the bronchi form a bronchial tree. Respiratory system

Breathing is one of the main functions that ensure human life. Without water, life will last several days, without food - up to several weeks. In the absence of breathing for more than 5 minutes, brain damage from oxygen starvation is irreversible, and with a further lack of air access, death occurs. That is why it is necessary to know the structure of the respiratory organs, the functions of the human bronchi, to protect their health and to seek help in a timely manner in case of any ailments.

What do bronchi look like?

The respiratory system consists of several departments and organs. The mouth and nose, nasopharynx are involved in saturating the body with oxygen - this is called the upper Airways. Next are the lower respiratory tract, which include the larynx, trachea, bronchial tree and the lungs themselves.

The bronchi and the bronchial tree are one and the same. This organ received its name due to its appearance and building. Smaller and smaller "branches" depart from the central trunks, the endings of the branches approach the alveoli. With the help of bronchoscopy, you can see the bronchi from the inside. The picture of the mucosa shows that they are gray in color, cartilage rings are also clearly visible.

The division of the bronchi, left and right, is explained by the fact that their structure clearly corresponds to the size of the lung. The right one is wider, in accordance with the lung, it has about 7 cartilaginous rings. It is located almost vertically, continuing the trachea. The left bronchus is narrower. It contains 9-12 rings of cartilage tissue.

Where are the bronchi

The bronchial tree cannot be seen with the naked eye. It is hidden in the chest. The left and right bronchi begin at the point where the trachea branches into two trunks. This is the 5th-6th thoracic vertebra, if we talk about the approximate level. Further, the "branches" of the bronchial tree penetrate and branch out, forming a whole tree.

The bronchi themselves conduct air to the alveoli, each to its own lung. Human anatomy suggests asymmetry, respectively, the left and right bronchi are also of different sizes.

The bronchial tree has a branched structure. It consists of several departments:

• Bronchus of the first order. This is the largest part of the body, has the most rigid structure. The length of the right is 2-3 cm, the left is about 5 cm.
• Zonal extrapulmonary - depart from the bronchi of the first order. There are 11 on the right and 10 on the left.
• Intrapulmonary subsegmental regions. They are noticeably narrower than the bronchi of the first order, their diameter is 2-5 mm.
• The lobar bronchi are thin tubes, about 1 mm in diameter.
• Respiratory bronchioles - the end of the "branches" of the bronchial tree.

Branching ends at the bronchioles, because they are connected directly with the alveoli - the final components of the lung parenchyma. Through them, the blood in the capillaries is saturated with oxygen and begins to move through the body.

By itself, the tissue that makes up the bronchial tree consists of several layers. Structural features - the closer to the alveoli, the softer the walls of the bronchial tree.

1. Mucosa - lines the bronchial tree from the inside. On the surface is the ciliated epithelium. Its structure is not uniform, in the mucosa there are different cells: goblet secrete mucus, neuroendocrine - serotonin, and basal and intermediate restore the mucosa.
2. Fibromuscular - acts as a kind of skeleton of the lungs. It is formed by cartilaginous rings connected by fibrous tissue.
3. Adventitial - the outer shell of the bronchi, consists of loose connective tissue.

The bronchial arteries are separated from the thoracic aorta, and it is they that provide nutrition to the bronchial tree. In addition, the structure of the human bronchi includes a network of lymph nodes and nerves.

Bronchial functions

The importance of the bronchi cannot be overestimated. At first glance, the only thing they do is carry oxygen to the alveoli from the trachea. But the functions of the bronchi are much wider:

1. The air passing through the bronchial tree is automatically cleared of bacteria and the smallest dust particles.. The cilia of the mucosa detain all that is superfluous.
2. The bronchi are able to purify the air of some toxic impurities.
3. When dust enters the bronchial system or mucus forms, the cartilaginous skeleton begins to contract, and the cilia remove harmful substances from the lungs with the help of a cough.
4. The lymph nodes of the bronchial tree play an important role in immune system person.
5. Thanks to the bronchi, already warm air enters the alveoli, reaching required level humidity.

Thanks to all these functions, the body receives pure oxygen, which is vital for the operation of all systems and organs.

Diseases affecting the bronchi

Diseases of the bronchi are necessarily accompanied by a narrowing of the lumen, increased secretion of mucus and difficulty breathing.

Asthma is a disease that involves difficulty breathing caused by a contraction of the lumen of the bronchus. Usually attacks provoke any irritants.

The most common causes of asthma are:

• Congenital high risk allergies.
• Bad ecology.
• Constant inhalation of dust.
• Viral diseases.
• Violations in the endocrine apparatus of the body.
• Eating chemical fertilizers along with fruits and vegetables.

Sometimes the predisposition to asthmatic reactions is inherited. A sick person suffers from frequent attacks of suffocation, with a painful cough, a clear mucus appears, which is actively secreted during an attack. Some note that before asthma attacks, repeated sneezing sometimes appears.

First aid to the patient is the use of an aerosol, which is prescribed by a doctor. This measure will help restore normal breathing, or at least ease it before the ambulance arrives.

Asthma is a serious disease that requires a mandatory visit to a doctor who will conduct an examination, prescribe tests and, based on their results, prescribe treatment. Attacks that do not stop can lead to complete closure of the bronchial lumen and to suffocation.

Bronchitis

Bronchitis affects the bronchial mucosa. It becomes inflamed, there is a narrowing of the lumen of the bronchiole, a lot of mucus is secreted. The patient is tormented by a choking cough, which is at first dry, then becomes moist, less hard, sputum comes out. There are 2 stages:

1. Acute - bronchitis is accompanied by a high temperature, most often it is caused by viruses and bacteria. There is an increase in temperature. This state lasts for several days. With proper treatment acute form goes away with little to no consequences.
2. Chronic - caused not only by viruses, but also by smoking, allergic reaction working in hazardous conditions. Usually there is no high temperature, but this type of bronchitis causes irreversible consequences. Other organs suffer.

It is very important to treat the acute stage of bronchitis in a timely manner, the chronic stage is difficult to treat, relapses occur quite often, loading the human heart.

Measures to prevent bronchial diseases

Bronchial diseases affect people of any age, especially children. Therefore, it is necessary to take care of their health in advance so that you do not have to purchase and take medicines, risking suffering from side effects:

1. Immunoprophylaxis is the most important component of the prevention of bronchitis. An organism with a strong immune system is able to cope with bacteria that have entered the bronchi and remove them with mucus, while a weakened one will not be able to fight the infection. Among these measures are the correct regimen of the day, timely rest, and the absence of constant overloads.
2. Reducing harmful effects on the lungs - people with hazardous working conditions should wear appropriate respirators and masks, smokers should reduce or eliminate tobacco use.
3. During the epidemic season, you should not go to entertainment events and shopping malls, as well as other places with a large number of people. If necessary, you need to wear protective medical masks, constantly changing to fresh ones.

The health of the bronchial tree is the key to full breathing. Oxygen is vital to the body, so it is important to take care of the respiratory system. If you suspect a disease, worsening breathing, you should immediately consult a doctor.

The bronchial tree in the structure is a trachea and bronchial trunks extending from it. The combination of these branches constitutes the structure of the tree. The structure is identical in all people and does not have striking differences. The bronchi are tubular branches of the main trachea that have the ability to conduct air and connect it to the respiratory parenchyma of the lung.

The structure of the main bronchi

The first branching of the trachea is the two main bronchi, which depart from it at almost a right angle, and each of them is directed towards the left or right lung respectively. The bronchial system is asymmetric and has slight differences in the structure of different sides. For example, the main left bronchus is slightly narrower in diameter than the right, and has a greater length.

The structure of the walls of the main air-conducting trunks is the same as that of the main trachea, and they consist of a number of cartilaginous rings, which are interconnected by a system of ligaments. the only distinctive feature is that in the bronchi all the rings are always closed and do not have mobility. In quantitative terms, the difference between the versatile trunks is determined by the fact that the right one has a length of 6-8 rings, and the left one - up to 12. Inside, all the bronchi are covered

bronchial tree

The main bronchi begin to branch at their end. Branching occurs in 16-18 smaller tubular leads. Such a system, due to its appearance, was called the “bronchial tree”. The anatomy and structure of the new branches differ little from the previous sections. They have smaller dimensions and a smaller diameter of the airways. Such a branching is called share. It is followed by segmental ones, while branching into the lower, middle and upper lobar bronchi is formed. And then they are divided into systems of apical, posterior, anterior segmental pathways.

Thus, the bronchial tree branches more and more, reaching the 15th order of division. The smallest bronchi are lobular. Their diameter is only 1 mm. These bronchi also divide into terminal bronchioles ending in respiratory ones. At their ends are the alveoli and alveolar ducts. bronchioles - a collection of alveolar passages and alveoli, tightly adjacent to each other and forming the lung parenchyma.

In general, the wall of the bronchi consists of three membranes. These are: mucous, muscular-cartilaginous, adventitial. In turn, the mucosa is densely lined and has a multi-row structure, covered with cilia, secretes, has its own neuroendocrine cells capable of forming and releasing biogenic amines, as well as cells involved in the processes of mucosal regeneration.

Physiological functions

The main and most important is the conduction of air masses into the respiratory parenchyma of the lung and vice versa. The bronchial tree is also a security system for the respiratory system and protects them from dust, various microorganisms, and harmful gases. The regulation of the volume and speed of the air flow passing through the bronchial system is carried out by changing the difference between the pressure of the air itself in the alveoli and in the surrounding air. This effect is achieved through the work of the respiratory muscles.

On inspiration, the diameter of the lumen of the bronchi changes towards expansion, which is achieved by regulating the tone of smooth muscles, and on exhalation it decreases significantly. Emerging violations in the regulation of smooth muscle tone are both causes and consequences of many diseases associated with the respiratory system, such as asthma, bronchitis.

Dust particles that enter with air, as well as microorganisms, are removed by moving the mucous secretions through the cilia system in the direction of the trachea to the upper respiratory organs. The withdrawal of mucus containing impurities is carried out by coughing.

Hierarchy

The branching of the bronchial system does not occur randomly, but follows a strictly established order. Bronchial hierarchy:

• Main.
• Zonal - the second order.
• Segmental and subsegmental are the 3rd, 4th, 5th orders.
• Small - 6-15 orders.
• Terminal.

This hierarchy is fully consistent with the division of lung tissue. So, the lobar bronchi correspond to the lobes of the lung, and the segmental bronchi correspond to the segments, etc.

blood supply

The blood supply to the bronchi is carried out with the help of the arterial bronchial lobes of the thoracic aorta, as well as with the help of the esophageal arteries. Venous blood is drained through the unpaired and semi-azygous veins.

Where are the human bronchi located?

The chest contains numerous organs, vessels. Formed by the rib-muscular structure. It is designed to protect the most vital systems located inside it. Answering the question: “Where are the bronchi located?”, It is necessary to consider the location of the lungs, the blood, lymphatic vessels and nerve endings that connect to them.

The dimensions of the human lungs are such that they occupy the entire front surface chest. located in the center of this system, are located under the anterior spine, located in the central part between the ribs. All bronchial leads are located under the costal mesh of the anterior sternum. The bronchial tree (the scheme of its location) associatively corresponds to the structure of the chest. Thus, the length of the trachea corresponds to the location of the central vertebral column of the chest. And its branches are located under the ribs, which can also be visually defined as a branching of the central column.

Bronchial examination

Methods for studying the respiratory system include:

• Interrogation of the patient.
• Auscultation.
• X-ray examination.
• and bronchi.

Research methods, their purpose

When interviewing a patient, possible factors that can affect the state of the respiratory system, such as smoking, harmful working conditions, are established. On examination, the doctor pays attention to the color of the patient's skin, the frequency of breaths, their intensity, the presence of cough, shortness of breath, sounds unusual for normal breathing. They also carry out palpation of the chest, which can clarify its shape, volume, the presence of subcutaneous emphysema, the nature of voice trembling and the frequency of sounds. A deviation from the norm of any of these indicators indicates the presence of any disease that is reflected in such changes.

It is performed using an endoscope and is performed to detect changes in respiratory sounds, the presence of wheezing, whistling and other sounds uncharacteristic of normal breathing. Using this method, by ear, the doctor can determine the nature of the disease, the presence of swelling of the mucous membranes, sputum.

X-ray plays one of the most important roles in the study of diseases of the bronchial tree. A survey radiograph of the human chest allows you to distinguish the nature of the pathological processes occurring in the respiratory system. The structure of the bronchial tree is clearly visible and can be analyzed to identify pathological changes. The picture shows changes in the structure of the lungs, their extensions, bronchial openings, thickening of the walls, the presence of tumor formations.

MRI of the lungs and bronchi is performed in the anteroposterior and transverse projections. This makes it possible to examine and study the state of the trachea and bronchi in their layered image, as well as in cross section.

Treatment Methods

TO modern methods treatments include both surgical and non-surgical treatment of diseases. This:

1. Therapeutic bronchoscopy. It is aimed at removing bronchial contents and is performed in the treatment room, under the influence of local or general anesthesia. First of all, the trachea and bronchi are considered to establish the nature and area of ​​damage from the effects of inflammatory changes. Then washing is carried out with an indifferent or antiseptic solutions drugs are administered.
2. Sanitation of the bronchial tree. This method is the most effective known and includes a number of procedures aimed at cleansing the bronchial tract from excess mucus, eliminating inflammatory processes. For this, chest massage, the use of expectorants, the installation of special drainage up to several times a day, inhalations can be used.

Providing the body with oxygen, which means ensuring the body's ability to live, is carried out due to the well-coordinated work of the respiratory system and blood supply. The relationship of these systems, as well as the speed of the processes, determine the body's ability to control and implement various processes occurring in it. With a change or violation of the physiological processes of respiration, there is a negative impact on the state of the whole organism as a whole.

1.1 Cough reflex.

1.2 Pathogenesis of the inflammatory process in the bronchial tree.

The structure and function of the bronchial mucosa.

Violation of the function of the mucociliary apparatus.

2. Treatment program for acute and exacerbation of chronic bronchitis.

2.1 Antibacterial therapy.

2.2 Endobronchial sanitation.

2.3 Improvement of the drainage function of the bronchi.

2.3.1 Expectorants.

2.3.1.1 Means that stimulate expectoration.

2.3.1.2 Mucolytic drugs

2.3.1.3 Mucus rehydrators.

2.3.2 Bronchodilators.

2.3.2.1 Sympathomimetic agents

2.3.2.2 Purine derivatives

Cholinolytic agents.

2.3.3 Detoxification therapy.

3. Mucolytic drugs.

3.1 Basic requirements for modern mucolytic (mucoregulatory) drugs.

3.2 Classification of mucolytic drugs.

3.3 Mucolytic drugs of indirect action.

Mucolytic drugs of direct action.

Side effects of mucolytics.

4. Differentiated choice of drugs for acute and chronic bronchitis.

Conclusion.

List of used literature.

Cough: definition of the concept, etiopathogenetic features.

One of the most common complaints for which patients go to the doctor is cough.

Cough is a complex, multi-component reflex protective-adaptive reaction of the body, aimed at removing foreign bodies and / or pathological tracheobronchial secretions from the respiratory tract and, thus, maintaining the effective conduction of the air stream through the respiratory tract.

It is generally accepted to regard cough as a pulmonary symptom, however, it must be remembered that there are more than 53 causes of cough. Among them are not only the pathology of the bronchopulmonary system, but also diseases of the heart, paranasal sinuses, gastrointestinal tract, exposure to certain drugs and many other conditions.

1.1 Cough occurs as a result of irritation of the cough receptors of the nasal cavity, pharynx, trachea, bronchi, sensitive endings n. vagus, innervating the outer ear, pleura, diaphragm, pericardium, esophagus, stomach. Easiest cough caused by irritation of the "cough zones" of the posterior pharyngeal wall, glottis, trachea and pleura. The main irritative factors are inflammatory (mucosal edema, pathological secretion), mechanical (foreign body, enlarged lymph nodes and tumors in the mediastinum), chemical and temperature. After the transmission of nerve impulses to the cough center of the medulla oblongata, a response is formed. The cough push mechanism consists in a deep breath, and then a sudden, short, jerky, forced exhalation after simultaneous contraction of the muscles of the larynx, bronchi, chest, abdomen and diaphragm. Moreover, a cough impulse begins with a closed glottis, and then it opens.

At diagnostics productivity, that is, the presence of sputum, is an important indicator. The ineffectiveness of coughing may be due to an insufficiently pronounced cough reflex, high viscosity of sputum, insufficiently deep breathing, impaired bronchial patency, and others. reasons. With a wet cough, you need to pay attention to the color and nature of sputum, which are often pathogomonic for a particular disease. So, viscous, vitreous sputum is characteristic of bronchial asthma; rusty color - for heart failure; purulent (yellow-greenish) - for bacterial infections of the respiratory tract, and purulent, fetid, in large quantities - for lung abscess and bronchiectasis. Cough is a subjective manifestation inflammatory process in the bronchi.

Pathogenesis of the inflammatory process in the bronchial tree.

The main pathogenetic factors of chronic bronchitis are:

1. Violation of the function of the system of local bronchopulmonary protection and the immune system.

2. Structural reorganization of the bronchial mucosa.

3. The development of the classic pathogenetic triad (hypercrinia, dyskrinia, mucostasis) and the release of inflammatory mediators and cytokines.

1.3 The structure and functioning of the bronchial mucosa.

In the bronchial mucosa, the following layers are distinguished: epithelial layer, basement membrane, lamina propria, muscular and submucosal (subepithelial) layer. The epithelial layer consists of ciliated, goblet, intermediate and basal cells; there are also serous cells, Clara cells and Kulchitsky cells.

ciliated cells prevail in the epithelial layer; they have an irregular prismatic shape and shimmering cilia on their surface, making coordinated movements 16-17 times per second - in a straightened rigid state in the oral direction and in a relaxed state - in the opposite direction. Cilia move the mucous membrane covering the epithelium at a speed of about 6 mm/min, removing dust particles, microorganisms, and cellular elements from the bronchial tree (cleansing, drainage function of the bronchi).

goblet cells in the epithelial layer are presented in smaller numbers than ciliated cells (1 goblet cell per 5 ciliated cells). They secrete a mucous secretion. In the small bronchi and bronchioles, goblet cells are not normally present, but they appear under pathological conditions.

Basal and intermediate cells located in the depth of the epithelial layer and do not reach its surface. Intermediate cells are elongated, basal cells are irregularly cuboidal, they are less differentiated compared to other cells of the epithelial layer. Due to the intermediate and basal cells, the physiological regeneration of the epithelial layer of the bronchi is carried out.

Serous cells few, reach the free surface of the epithelium, produce a serous secretion.

secretory clara cells located mainly in the small bronchi and bronchioles. They produce a secret, participate in the formation of phospholipids and, possibly, a surfactant. When irritated by the bronchial mucosa, they turn into goblet cells.

Kulchitsky cells (K cells) are located throughout the bronchial tree and belong to the neurosecretory cells of the APUD system.

The basement membrane has a thickness of 60-80 microns, is located under the epithelium and serves as its basis; epithelial cells are attached to it.

The submucosal layer is formed by loose connective tissue containing collagen, elastic fibers, as well as submucosal glands containing serous and mucous cells that secrete a mucous and serous secretion. The channels of these glands are collected in the epithelial collecting duct, which opens into the lumen of the bronchus. The volume of secretion of the submucosal glands is 40 times greater than that of goblet cells.

Bronchial secretion production is regulated by the parasympathetic (cholinergic), sympathetic (adrenergic), and non-adrenergic, non-cholinergic nervous systems. The mediator of the parasympathetic nervous system is acetylcholine, the sympathetic - norepinephrine, adrenaline; non-adrenergic, non-cholinergic (NANH) - neuropeptides (vasoactive intestinal polypeptide, substance P, neurokinin A). Neurotransmitters (mediators) of the NAS system coexist in the nerve endings of parasympathetic and sympathetic fibers with classical mediators acetylcholine and norepinephrine.

Neurohumoral regulation of the submucosal glands and, consequently, the production of bronchial secretions, is carried out by the interaction of mucosal and serous cell receptors with neurotransmitters - mediators of the parasympathetic sympathetic and nonadrenergic-noncholinergic nervous system.

The volume of bronchial secretion increases mainly with cholinergic stimulation, as well as under the influence of the substance P-transmitter NANKh. Substance P stimulates secretion by goblet cells and submucosal glands. Mucociliary clearance (i.e., the function of the ciliated epithelium) of the bronchi is stimulated by excitation of β 2 -adrenergic receptors.

The system of local bronchopulmonary protection is of great importance in protecting the bronchial tree from infection and aggressive environmental factors. The local bronchopulmonary defense system includes the mucociliary apparatus; surfactant system; the presence in the bronchial contents of immunoglobulins, complement factors, lysozyme, lactoferrin, fibronectin, interferons; alveolar macrophages, protease inhibitors, bronchial-associated lymphoid tissue.

- This is a diffuse-inflammatory disease of the bronchi, affecting the mucous membrane or the entire thickness of the bronchial wall. Damage and inflammation of the bronchial tree can occur as an independent, isolated process (primary bronchitis) or develop as a complication against the background of existing chronic diseases and past infections (secondary bronchitis). Damage to the mucous epithelium of the bronchi disrupts the production of secretions, the motor activity of the cilia and the process of cleansing the bronchi. Share acute and chronic bronchitis, differing in etiology, pathogenesis and treatment.

ICD-10

J20 J40 J41 J42

General information

Bronchitis is a diffuse-inflammatory disease of the bronchi, affecting the mucous membrane or the entire thickness of the bronchial wall. Damage and inflammation of the bronchial tree can occur as an independent, isolated process (primary bronchitis) or develop as a complication against the background of existing chronic diseases and past infections (secondary bronchitis). Damage to the mucous epithelium of the bronchi disrupts the production of secretions, the motor activity of the cilia and the process of cleansing the bronchi. Share acute and chronic bronchitis, differing in etiology, pathogenesis and treatment.

Acute bronchitis

The acute course of bronchitis is characteristic of many acute respiratory infections (ARVI, acute respiratory infections). Most often the reason acute bronchitis are parainfluenza viruses, respiratory syncytial virus, adenoviruses, less often - influenza virus, measles, enteroviruses, rhinoviruses, mycoplasmas, chlamydia and mixed viral-bacterial infections. Acute bronchitis rarely has a bacterial nature (pneumococci, staphylococci, streptococci, Haemophilus influenzae, whooping cough). The inflammatory process first affects the nasopharynx, tonsils, trachea, gradually spreading to the lower respiratory tract - the bronchi.

A viral infection can provoke the reproduction of opportunistic microflora, aggravating catarrhal and infiltrative changes in the mucosa. The upper layers of the bronchial wall are affected: there is hyperemia and swelling of the mucous membrane, pronounced infiltration of the submucosal layer, dystrophic changes and rejection of epithelial cells occur. At proper treatment acute bronchitis has a favorable prognosis, the structure and functions of the bronchi are fully restored after 3-4 weeks. Acute bronchitis is very common in childhood: This fact is explained by the high susceptibility of children to respiratory infections. Regularly recurring bronchitis contribute to the transition of the disease into a chronic form.

Chronical bronchitis

Chronic bronchitis is a long-term inflammatory disease of the bronchi that progresses over time and causes structural changes and dysfunction of the bronchial tree. Chronic bronchitis occurs with periods of exacerbations and remissions, often has a latent course. Recently, there has been an increase in the incidence of chronic bronchitis due to environmental degradation (air pollution with harmful impurities), widespread bad habits (smoking), and a high level of allergization of the population. With prolonged exposure to adverse factors on the mucous membrane of the respiratory tract, gradual changes in the structure of the mucous membrane develop, increased sputum production, impaired drainage capacity of the bronchi, and a decrease in local immunity. In chronic bronchitis, hypertrophy of the glands of the bronchi, thickening of the mucous membrane occurs. The progression of sclerotic changes in the bronchial wall leads to the development of bronchiectasis, deforming bronchitis. A change in the air-conducting capacity of the bronchi significantly impairs lung ventilation.

Classification of bronchitis

Bronchitis is classified according to a number of criteria:

According to the severity of the flow:

• mild degree
• medium degree
• severe

By clinical course:

Acute bronchitis

Acute bronchitis, depending on the etiological factor, are:

• infectious origin (viral, bacterial, viral-bacterial)
• non-infectious origin (chemical and physical hazards, allergens)
• mixed origin (a combination of infection and the action of physico-chemical factors)
• unspecified etiology

According to the area of ​​\u200b\u200binflammatory damage, there are:

• bronchitis with a primary lesion of the bronchi of medium and small caliber
• bronchiolitis

According to the mechanism of occurrence, primary and secondary acute bronchitis are distinguished. By the nature of the inflammatory exudate, bronchitis is distinguished: catarrhal, purulent, catarrhal-purulent and atrophic.

Chronical bronchitis

Depending on the nature of the inflammation, catarrhal chronic bronchitis and purulent chronic bronchitis are distinguished. By changing the function of external respiration, obstructive bronchitis and a non-obstructive form of the disease are distinguished. The phases of the process during chronic bronchitis alternate exacerbations and remissions.

The main factors contributing to the development of acute bronchitis are:

• physical factors (damp, cold air, sudden temperature changes, exposure to radiation, dust, smoke);
• chemical factors (the presence of pollutants in the atmospheric air - carbon monoxide, hydrogen sulfide, ammonia, chlorine vapors, acids and alkalis, tobacco smoke, etc.);
• bad habits (smoking, alcohol abuse);
• congestive processes in the pulmonary circulation (cardiovascular pathology, violation of the mechanism of mucociliary clearance);
• the presence of foci of chronic infection in the mouth and nose - sinusitis, tonsillitis, adenoiditis;
• hereditary factor (allergic predisposition, congenital disorders of the bronchopulmonary system).

It has been established that smoking is the main provoking factor in the development of various bronchopulmonary pathologies, including chronic bronchitis. Smokers suffer from chronic bronchitis 2-5 times more often than non-smokers. The harmful effects of tobacco smoke are observed in both active and passive smoking.

Predisposes to the occurrence of chronic bronchitis long-term exposure to harmful production conditions: dust - cement, coal, flour, wood; vapors of acids, alkalis, gases; uncomfortable temperature and humidity conditions. Atmospheric air pollution by emissions from industrial enterprises and transport, fuel combustion products has an aggressive effect primarily on the human respiratory system, causing damage and irritation of the bronchi. A high concentration of harmful impurities in the air of large cities, especially in calm weather, leads to severe exacerbations of chronic bronchitis.

Repeatedly transferred SARS, acute bronchitis and pneumonia, chronic diseases of the nasopharynx, kidneys can further cause the development of chronic bronchitis. As a rule, the infection is superimposed on the already existing damage to the respiratory mucosa by other damaging factors. The damp and cold climate contributes to the development and exacerbation of chronic diseases, including bronchitis. An important role belongs to heredity, which under certain conditions increases the risk of chronic bronchitis.

Bronchitis symptoms

Acute bronchitis

Basic clinical symptom acute bronchitis - a low chest cough - usually appears against the background of already existing manifestations of an acute respiratory infection or simultaneously with them. The patient has a fever (up to moderately high), weakness, malaise, nasal congestion, runny nose. At the beginning of the disease, the cough is dry, with scanty, difficult to separate sputum, worse at night. Frequent bouts of coughing cause pain in the abdominal muscles and chest. After 2-3 days, sputum (mucous, mucopurulent) begins to come off abundantly, and the cough becomes wet and soft. Dry and moist rales are heard in the lungs. In uncomplicated cases of acute bronchitis, shortness of breath is not observed, and its appearance indicates damage to the small bronchi and the development of an obstructive syndrome. The patient's condition returns to normal within a few days, the cough may continue for several weeks. long heat speaks of the addition of a bacterial infection and the development of complications.

Chronical bronchitis

Chronic bronchitis occurs, as a rule, in adults, after repeated acute bronchitis, or with prolonged irritation of the bronchi (cigarette smoke, dust, exhaust fumes, chemical vapors). Symptoms of chronic bronchitis are determined by the activity of the disease (exacerbation, remission), nature (obstructive, non-obstructive), the presence of complications.

The main manifestation of chronic bronchitis is a prolonged cough for several months for more than 2 years in a row. The cough is usually wet, appears in the morning, accompanied by the release of a small amount of sputum. Increased cough is observed in cold, damp weather, and remission - in the dry, warm season. At the same time, the general well-being of patients almost does not change, coughing for smokers becomes a common occurrence. Chronic bronchitis progresses over time, the cough intensifies, acquires the character of attacks, becomes hoarse, unproductive. There are complaints of purulent sputum, malaise, weakness, fatigue, sweating at night. Shortness of breath joins with loads, even minor ones. In patients with a predisposition to allergies, bronchospasm occurs, indicating the development of an obstructive syndrome, asthmatic manifestations.

Complications

Bronchopneumonia is a common complication of acute bronchitis, which develops as a result of a decrease in local immunity and the accumulation of a bacterial infection. Repeatedly transferred acute bronchitis (3 or more times a year) lead to the transition of the inflammatory process into a chronic form. The disappearance of provoking factors (quitting smoking, climate change, change of job) can completely save the patient from chronic bronchitis. With the progression of chronic bronchitis, repeated acute pneumonia occurs, and with a long course, the disease can turn into chronic obstructive pulmonary disease. Obstructive changes in the bronchial tree are considered as a pre-asthma condition (asthmatic bronchitis) and increase the risk of bronchial asthma. Complications appear in the form of emphysema, pulmonary hypertension, bronchiectasis, cardiopulmonary insufficiency.

Diagnostics

Treatment of bronchitis

In the case of bronchitis with a severe concomitant form of ARVI, treatment is indicated in the pulmonology department, with uncomplicated bronchitis, outpatient treatment. Therapy of bronchitis should be comprehensive: the fight against infection, the restoration of bronchial patency, the elimination of harmful provoking factors. It is important to complete the full course of treatment for acute bronchitis in order to prevent its transition to a chronic form. In the first days of the disease, bed rest, heavy drinking (1.5 - 2 times more than normal), a milk and vegetable diet are indicated. At the time of treatment is required to quit smoking. It is necessary to increase the humidity of the air in the room where the patient with bronchitis is located, as the cough intensifies in dry air.

Treatment for acute bronchitis may include antiviral drugs: interferon (intranasal), with influenza - rimantadine, ribavirin, with adenovirus infection - RNase. In most cases, antibiotics are not used, except in cases of bacterial infection, with a protracted course of acute bronchitis, with a pronounced inflammatory reaction according to the results of laboratory tests. To improve the excretion of sputum, mucolytic and expectorant drugs are prescribed (bromhexine, ambroxol, expectorant herbal collection, inhalations with soda and saline solutions). In the treatment of bronchitis, vibration massage is used, therapeutic gymnastics, physiotherapy. With a dry, unproductive, painful cough, the doctor may prescribe medications that suppress the cough reflex - oxeladin, prenoxdiazine, etc.

Chronic bronchitis requires long-term treatment both during exacerbation and remission. With an exacerbation of bronchitis, with purulent sputum, antibiotics are prescribed (after determining the sensitivity of the isolated microflora to them), which thin the sputum and expectorant drugs. In the case of an allergic nature of chronic bronchitis, it is necessary to take antihistamines. Mode - semi-bed, necessarily warm plentiful drink (alkaline mineral water, tea with raspberries, honey). Sometimes therapeutic bronchoscopy is performed, with bronchial lavage with various medicinal solutions (bronchial lavage). Respiratory gymnastics and physiotherapy (inhalation, UHF, electrophoresis) are shown. At home, you can use mustard plasters, medical cups, warming compresses. Vitamins and immunostimulants are taken to enhance the body's resistance. Outside of exacerbation of bronchitis, spa treatment is desirable. Very useful walks in the fresh air, normalizing respiratory function, sleep and general state. If no exacerbations of chronic bronchitis are observed within 2 years, the patient is removed from the dispensary observation by a pulmonologist.

Forecast

Acute bronchitis in uncomplicated form lasts about two weeks and ends with complete recovery. In the case of concomitant chronic diseases of the cardiovascular system, a protracted course of the disease is observed (a month or more). Chronic form bronchitis has a long course, a change of periods of exacerbations and remissions.

Prevention

Preventive measures to prevent many bronchopulmonary diseases, including acute and chronic bronchitis, include: elimination or weakening of the impact on the respiratory organs of harmful factors (dust, air pollution, smoking), timely treatment of chronic infections, prevention of allergic manifestations, increased immunity, healthy lifestyle.

Everyone needs to know where the bronchi are located. This will help if therapy or diagnosis is needed. In addition, it is the bronchi that are a vital organ, without the normal operation of which a person will not live long. Human anatomy is both an interesting and complex area of ​​​​science that everyone needs to know about.

The bronchi are a paired organ that is a natural continuation of the trachea. At the level of the fourth (for males) and fifth (for females) vertebrae, the tracheal area is divided, forming two tubes. Each of them is directed to the lungs. After introduction into the pulmonary region, they are divided again: into three and two branches, respectively, the right and left parts.

The presented location corresponds to the parts of the lung, repeating its pattern. It should be noted that:

• the location where the human lungs are located has a direct impact on their shape;
• if a person's chest is narrow and long, then the epithelium and lungs will take on the designated shape;
• the presented organs of the human type are characterized by a short and wide appearance with a conjugate form of the chest, which predetermines the functions of the bronchi.

The structure of the bronchial region

All bronchial lobes are subdivided into fragments of the bronchopulmonary type. They are segments of an organ that are isolated from similar neighboring areas. In each of the presented areas there is a segmental bronchus. There are 18 similar segments: 10 on the right and 8 on the left, which confirms the figure.

The structure of each of the presented segments has several lobules, or areas inside which the division of the lobular bronchus occurs, which are located on top.

Pulmonologists claim that a person has at least 1600 lobules: 800 each on the right and left sides.

The similarity in the placement of the bronchial and pulmonary regions does not end there. The former, like the epithelium, branch further, forming secondary and tertiary bronchioles. They give rise to ducts of the alveolar type, which divide from 1 to 4 times and end in alveolar sacs. Alveoli open into their lumen, which is why human anatomy is logical. It is she who predetermines the functional significance of the represented organ.

Functional features

The function of the bronchi is multifaceted - it is the conduction of air masses through the respiratory system during inhalation and exhalation, protective and drainage functions. Due to the last two, foreign bodies come out of the respiratory system on their own, which got inside with air masses. Thus, the human anatomy removes harmful microorganisms.

The epithelium of the bronchial region includes goblet cells that contain mucus. Foreign bodies and objects stick to it, and the ciliary part of the epithelium sets the presented mucus in motion and helps to bring the object out. The presented process provokes a cough in a person, which does not always manifest itself with bronchitis. The functional significance of the bronchi may lie in other actions:

How to keep bronchial health

The structure of the bronchi must remain complete, without flaws and foreign complications. This will keep your bronchial tubes in perfect health. For this, apply medicines(bronchodilators, mucolytics and expectorants), resort to a special diet and a healthy lifestyle. The latter excludes the use of alcoholic beverages, nicotine addiction.

High physical activity is shown, that is, daily walking, hardening, exercise.

All this will strengthen the body, which cannot be achieved without constant effort.

Another condition for the health of the bronchi is the exercise breathing exercises and visiting sanatoriums. They strengthen the immune system, optimize the functioning of the pulmonary system, which positively affects the structure of the bronchi and, accordingly, the respiratory process. In this case, the epithelium and respiratory pattern will not be subject to complications in terms of general condition.

Additional Information

Non-compliance with medical recommendations and maintaining an unhealthy lifestyle provoke the formation of bronchial diseases. The most common is bronchitis, which is caused by inflammation of the bronchial walls. Pathology is formed under the influence of viruses and bacteria, some of which the body needs in minimal quantities.

Another complication is bronchial asthma, which is characterized by bouts of asphyxia, which are formed with a clear cyclicity. Allergic exposure, air pollution, all kinds of infections can become a catalyst for this. Other negative processes include:

• bronchial tuberculosis, accompanied by a forced cough with the removal of a significant ratio of sputum and aggravated breathing;
• candidiasis, which is formed with weakened protective functions of the body, when the epithelium is weakened, forming a fuzzy pattern;
• an oncological disease in which the human anatomy changes, and the pathology is accompanied by a constant cough with the release of light pink sputum and swelling.

Thus, in order for the bronchi to remain absolutely healthy, you need to know everything about their location, division into certain parts and the nuances of maintaining health. This will allow you to maintain maximum activity, heal the bronchi and lungs, making it possible to live a full life.