Bronchitis physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Bronchitis Main page
Patient Information
Overview
Causes
Classification Acute bronchitis Chronic bronchitis
Differential Diagnosis

Overview

Bronchitis is an inflammation of the bronchi (medium-size airways) in the lungs. Acute bronchitis is usually caused by viruses or bacteria and may present as cough with sputum that last several days or weeks (10 days). Other symptoms like shortness of breath, chest discomfort, and sore throat can also be found. Chronic bronchitis is not necessarily caused by infection and is generally part of a syndrome called chronic obstructive pulmonary disease (COPD); it is defined clinically as a persistent cough that produces sputum (phlegm) and mucus, for at least three months in two consecutive years. In late stages, the disease may present with blue discoloration of body (cyanosis) and difficulty in breathing (dyspnea).

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.