Adenotonsillar Disease Flashcards
Embryological development of the tonsils at 8 weeks?
Tonsillar fossa and palatine tonsils develop from the dorsal wing of the 1st pharyngeal pouch and the ventral wing of the 2nd pouch
Tonsillar pillars originate from 2nd/3rd arches
Embryological development of tonsils at 3-6 months?
Crypts
Embryological development of tonsils at 5 months?
Capsule
Embryological development of adenoids at 16 weeks?
Adenoids develop as a sub-epithelial infiltration of lymphocytes
What part of the tonsils develops after birth?
Germinal centres
Functions of the tonsils?
Trap bacteria and viruses on inhalation; Abs produced and this helps to prevent subsequent infections
When is significant adenotonsillar enlargement unusual?
<2 years
When do the tonsils decrease in bulk?
After the early teenage years
What is Waldeyer’s ring?
Ring of lymphoid aggregation in the sub-epithelial layer of the oropharynx and nasopharynx
Components of Waldeyer’s ring?
Tonsils (palatine tonsil)
Adenoids (pharyngeal tonsil)
Lingual tonsil
Histology of tonsils?
Specialised squamous epithelium, which invaginates to form deep crypts
Base of the tonsil is separated from underlying muscle by a dense collagenous capsule; parenchyma contains many lymphoid follicles
Histology of the adenoids?
Ciliated pseudostratified columnar epithelium; deep to this is a stratified squamous epithelium and then followed by a transitional epithelium
Different from tonsils as the adenoids have deep folds and only a few crypts
Areas lined by squamous epithelium?
Where food goes/high use/trauma: • Oral • Pharyngeal • Vocal cords • Oesophagus
Areas lined by ciliated columnar respiratory type mucosa?
Where air goes: • Nose • PNS • Larynx • Trachea
Symptoms and signs of adenoid obstructive hyperplasia?
Obligate mouth breathing and a hyponasal voice
Snoring and other signs of sleep disturbance
