ACUTE AND CHRONIC TONSILLITIS Flashcards

1
Q

Anatomy of the Tonsils

The tonsils (__________ tonsils) are _____ in number (paired).

• Each tonsil is an ________ mass of ________ tissue located in the (medial or lateral?) of the ________ between the anterior and posterior _______________.

A

Palatine ; two

ovoid ; lymphoid

lateral ; oropharynx ; faucial pillars.

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2
Q

Anatomy of the Tonsils

• Each tonsil has a _________ and _________ surface; an _________ and _________ pole.

• The medial surface is lined by ____________________________ epithelium which dips into the substance of the tonsil to form _________.

A

medial and lateral

upper and lower pole.

non-keratinizing stratified squamous

crypts.

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3
Q

Anatomy of the tonsils

Crypts may be filled with _______ cells, _________ and ___________

A

epithelial

bacteria

food debris.

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4
Q

Anatomy of the tonsils

The lateral surface of the tonsil has a (poorly or well?) defined ____________.

• Between the capsule and the bed of the tonsil ( ________to the capsule) is a _____________.

• This is the ____________ of the tonsil during tonsillectomy.

• It is also the site for __________ in _____________

A

Well; fibrous capsule

lateral ; loose areolar tissue

plane for dissection

collection of pus; Peritonsillar abscess

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5
Q

Anatomy of the tonsils

The Bed of the tonsil is formed by the ________________ muscle and the ___________ muscle.

The Upper pole of the tonsil extends into the ___________.

The Lower pole of the tonsil is attached to the ___________________.

A

superior constrictor

styloglossus

soft palate

base of the tongue

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6
Q

Anatomy of the tonsils

Blood supply
• Tonsillar branch of _______ artery
• Ascending _________ artery
• Branch of the _________ artery
• Branch of the _________ artery

Venous drainage
• Veins from the tonsil to the ______________ vein to the ___________ vein to the __________ plexus

A

• Tonsillar branch of facial artery
• Ascending pharyngeal artery
• Branch of the lingual artery
• Branch of the maxillary artery

peritonsillar; common facial ; pharyngeal

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7
Q

Anatomy of the tonsils

Lymphatic drainage – lymphatics from tonsils pierce the superior constrictor and drain into the ___________________ nodes (__________ node).

Nerve supply – branch of ________ and sensory is from ____________

A

deep upper cervical nodes

jugulodigastric node

trigeminal ;glossopharyngeal

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8
Q

Functions of tonsils

• Form part of the ____________ ring which is protective as ___________ at the portal of entry of organisms.

• The crypts increase the ____________ for contact with foreign agents.

• Tonsils are ____________ in childhood and gradually ____________ in adults.

• They are removed when they become the ___________________.

A

Waldeyers ; sentinels

surface area ; larger ; shrinks

seat of infection.

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9
Q

ACUTE TONSILLITIS

• Inflammation of the tonsils of recent onset usually less than __________ .
• Acute tonsillitis typically affects _______ age children and __________ children
• It also affects adults.
• It is uncommon in __________ and the __________.

A

3weeks.

school age ; pre school

neonates ; elderly.

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10
Q

Acute tonsillitis

Causative organisms
• ————
• ___________
• ___________ ___________
• ___________
• Pneumococcus
• ___________

A

• Viruses
• Bacteria
• Haemolytic streptococcus
• Staphylococcus
• Pneumococcus
• H. influenza

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11
Q

Types of Acute Tonsillitis
• Acute __________ or __________ tonsillitis

• Acute __________ tonsillitis

• Acute __________ tonsillitis

• Acute __________ tonsillitis

A

catarrhal or superficial tonsillitis

follicular tonsillitis

parenchymatous tonsillitis

membranous tonsillitis

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12
Q

Types of acute Tonsillitis

Acute catarrhal or superficial tonsillitis
• _______________ of the ______ – usually _______

Acute follicular tonsillitis
• Infection spreads into the ______ which are filled with _______ material and present as
___________ spots on the surface

A

Generalised inflammation; pharynx; viral

crypts; purulent; yellowish

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13
Q

Types of Acute Tonsillitis

Acute parenchymatous tonsillitis
• The __________ is inflammed and the tonsils are __________ and _________

Acute membranous tonsillitis
• A stage ahead of the ______ tonsillitis when the exudates ________ to form a ___________ on the surface

A

whole tonsil

uniformly enlarged and red

follicular; coalesce; membrane

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14
Q

Symptoms of acute tonsillitis

The symptoms vary with the severity of the infection.
• ___________
• Difficulty in ___________
• Fever
• ___________ symptoms
• ___________
• General malaise
• ___________ and pains
• ___________

A

The symptoms vary with the severity of the infection.
• Sorethroat
• Difficulty in swallowing
• Fever
• Constitutional symptoms
• Headaches
• General malaise
• Body aches and pains
• Earache

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15
Q

Signs of acute tonsillitis

• ______ breath
• __________ tongue
• __________ of the soft palate, tonsil
pillars and uvula
• Tonsils are _______ , ————, with
———— spots or ________ membrane on the surface.
• _________ and ______ upper cervical
nodes
• _______ temperature

A

•Foul breath
• Coated tongue
• Hyperaemia of the soft palate, tonsil
pillars and uvula
• Tonsils are red, enlarged, with
yellowish spots or whitish membrane
on the surface.
• Enlarged and tender upper cervical
nodes
• High temperature

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16
Q

Treatment for acute tonsillitis

• Swab for _____
• ________
• ________
• __________
• __________

A

m/c/s

Bed rest

Fluids

Analgesics; Antibiotics

17
Q

Complications of acute tonsillitis
• _______ tonsillitis
• _________ tonsillitis
• _______________
• _________________
• Cervical lymphadenitis with abscess
• Acute _________
• Rheumatic fever
• Subacute bacterial endocarditis

A

Chronic; Recurrent

Peritonsillar abscess

Parapharyngeal abscess

Otitis media

18
Q

CHRONIC TONSILLITIS

Persistent inflammation of the tonsils lasting more than ________.
• It may be a __________ of acute tonsillitis.

• Pathologically, ____________ may be walled off by _______ tissue.

• Subclinical infections of the tonsils without ___________
•_________ or _________ infections may be predisposing factors.
• Mostly affects children and young adults

A

3weeks; complication

micro abscesses; fibrous

an acute attack

Chronic sinusitis or tooth

19
Q

Types of Chronic tonsillitis

• Chronic _________

• Chronic _________

• Chronic ________

A

• Chronic follicular
• Chronic parenchymatous
• Chronic fibroid

20
Q

Types of Chronic tonsillitis

Chronic follicular
• The tonsil crypts are filled with _______ material which shows on the surface as ——————

Chronic parenchymatous
• The tonsils are _________ and interfere with _______,________, and __________
leading to recurrent __________________

Chronic fibroid
• Tonsils are ________ but infected with history of repeated ____________.

A

cheesy; yellowish spots

grossely enlarged; speech, deglutition and breathing; obstructive sleep apnoea

small; sore throats

21
Q

Symptoms of chronic tonsillitis

• Recurrent episodes of ________
• Persistent _______ in the throat with ______.
• ___________(__________) due to ______ in crypts.
• Difficulty in ________
• _________ spells at night due to huge obstructive tonsils

A

sore throat

irritations; cough

Bad breath (Halitosis); pus

swallowing; Choking

22
Q

Signs of chronic tonsillitis

• Tonsils – varying degrees of __________.
•___________ exudates of surface.
• Tonsil may be small but pressure on
__________ with a spatula may express pus.
• _________ of the __________ compared to the rest of pharynx.
• Palpably enlarged upper cervical
lymph nodes

A

enlargement

Yellowish; anterior pillar

Redness; anterior pillar

23
Q

Investigations for chronic tonsillitis

• Swab for m/c/s
• _______ examination
• Full blood count
•_______ of __________
•_______ of _____________

A

Dental

X-ray of paranasal sinuses

CT scan of paranasal sinuses

24
Q

Complications of chronic tonsillitis
• —————- abscess
• __________ abscess
• __________
• Tonsillar __________
• Focus of infection for:
__________
Acute __________

A

• Peritonsillar abscess
• Parapharyngeal abscess
• Tonsilloliths
• Tonsillar cyst
• Focus of infection for:
• Rheumatic fever
• Acute glomerulonephritis