ACUTE AND CHRONIC TONSILLITIS Flashcards
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 _______________.
Palatine ; two
ovoid ; lymphoid
lateral ; oropharynx ; faucial pillars.
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 _________.
medial and lateral
upper and lower pole.
non-keratinizing stratified squamous
crypts.
Anatomy of the tonsils
Crypts may be filled with _______ cells, _________ and ___________
epithelial
bacteria
food debris.
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 _____________
Well; fibrous capsule
lateral ; loose areolar tissue
plane for dissection
collection of pus; Peritonsillar abscess
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 ___________________.
superior constrictor
styloglossus
soft palate
base of the tongue
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
• Tonsillar branch of facial artery
• Ascending pharyngeal artery
• Branch of the lingual artery
• Branch of the maxillary artery
peritonsillar; common facial ; pharyngeal
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 ____________
deep upper cervical nodes
jugulodigastric node
trigeminal ;glossopharyngeal
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 ___________________.
Waldeyers ; sentinels
surface area ; larger ; shrinks
seat of infection.
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 __________.
3weeks.
school age ; pre school
neonates ; elderly.
Acute tonsillitis
Causative organisms
• ————
• ___________
• ___________ ___________
• ___________
• Pneumococcus
• ___________
• Viruses
• Bacteria
• Haemolytic streptococcus
• Staphylococcus
• Pneumococcus
• H. influenza
Types of Acute Tonsillitis
• Acute __________ or __________ tonsillitis
• Acute __________ tonsillitis
• Acute __________ tonsillitis
• Acute __________ tonsillitis
catarrhal or superficial tonsillitis
follicular tonsillitis
parenchymatous tonsillitis
membranous tonsillitis
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
Generalised inflammation; pharynx; viral
crypts; purulent; yellowish
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
whole tonsil
uniformly enlarged and red
follicular; coalesce; membrane
Symptoms of acute tonsillitis
The symptoms vary with the severity of the infection.
• ___________
• Difficulty in ___________
• Fever
• ___________ symptoms
• ___________
• General malaise
• ___________ and pains
• ___________
The symptoms vary with the severity of the infection.
• Sorethroat
• Difficulty in swallowing
• Fever
• Constitutional symptoms
• Headaches
• General malaise
• Body aches and pains
• Earache
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
•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
Treatment for acute tonsillitis
• Swab for _____
• ________
• ________
• __________
• __________
m/c/s
Bed rest
Fluids
Analgesics; Antibiotics
Complications of acute tonsillitis
• _______ tonsillitis
• _________ tonsillitis
• _______________
• _________________
• Cervical lymphadenitis with abscess
• Acute _________
• Rheumatic fever
• Subacute bacterial endocarditis
Chronic; Recurrent
Peritonsillar abscess
Parapharyngeal abscess
Otitis media
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
3weeks; complication
micro abscesses; fibrous
an acute attack
Chronic sinusitis or tooth
Types of Chronic tonsillitis
• Chronic _________
• Chronic _________
• Chronic ________
• Chronic follicular
• Chronic parenchymatous
• Chronic fibroid
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 ____________.
cheesy; yellowish spots
grossely enlarged; speech, deglutition and breathing; obstructive sleep apnoea
small; sore throats
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
sore throat
irritations; cough
Bad breath (Halitosis); pus
swallowing; Choking
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
enlargement
Yellowish; anterior pillar
Redness; anterior pillar
Investigations for chronic tonsillitis
• Swab for m/c/s
• _______ examination
• Full blood count
•_______ of __________
•_______ of _____________
Dental
X-ray of paranasal sinuses
CT scan of paranasal sinuses
Complications of chronic tonsillitis
• —————- abscess
• __________ abscess
• __________
• Tonsillar __________
• Focus of infection for:
__________
Acute __________
• Peritonsillar abscess
• Parapharyngeal abscess
• Tonsilloliths
• Tonsillar cyst
• Focus of infection for:
• Rheumatic fever
• Acute glomerulonephritis
