Pathology Of The Pharynx Flashcards
What can happen when the pharyngeal tonsils get chronically inflamed?
May obstruct passage of air from nasal cavities through chonae into nasopharynx
Why can adenoids harbour infection?
They are richly vascularised
What is the result of the adenoids ability to harbour infection?
Removing the tissue may help with symptoms, even if adenoids not that enlarged
What does chronic inflammation of the pharyngeal tonsils cause?
Mouth breathing
Nasal tone to speech
What are the complications of chronically inflamed adenoid tonsils?
Otitis media
Sinusitis
What is otitis media in chronically inflamed pharyngeal tonsils due to?
Blockage of the pharyngotympanic tube
Why does the blockage of the pharyngotympanic tube cause otitis media?
Drainage and ventilation of the middle ear cavity are impeded
What is the classic theory by which blockage of pharyngotympanic tube causes otitis media?
- Cells in middle ear are constantly reabsorbing nitrogen/oxygen
- Blocked ET causes negative pressure in the middle ear
- Transudate (sterile) drawn in from mucosa
- Bacteria can now proliferate to cause otitis media
What are the complications of otitis media?
Hearing loss
Chronic inflammation of mastoid
Cholsteatoma
Meningitis, brain abscess
What is often true of the hearing loss in otitis media?
It is temporary
What is the hearing loss in otitis media associated with?
Effusion
What can chronic inflammation of the mastoid lead to?
Necrosis of mastoid process
What is cholesteatoma?
Cyst like lesions that are linked with chronic inflammation
How can cholesteatoma progress?
Can erode surrounding structures
What does the pharyngotympanic tube provide a potential route for?
Infection in the pharynx to spread the middle ear
What is the result of the Eustachian tube providing a route for infection in the pharynx to spread into the middle ear?
Not uncommon for respiratory tract infections to be complicated by middle ear infections
How is the Eustachian tube different in children?
Shorter, wider, more horizontal
What may recurrent inflammation of the tonsils require?
Removal of the tonsils (tonsillectomy) from the tonsillar bed
Which tonsils in particular may need to be removed in tonsillitis?
Palatine
What is the problem with a tonsillectomy?
Procedure may result in profuse bleeding from the rich blood supply to the tonsil
What is the blood supply to the palatine tonsil?
Tonsillar branch of facial artery
What is the piriform fossa a common site for?
Foreign bodies entering the pharynx to become lodged
What is the piriform fossa a common site for?
Foreign bodies entering the pharynx to become lodged
What may happen if sharp objects get lodged in the piriform fossa?
May pierce mucous membrane
What is the problem with sharp objects in the piriform fossa piercing the mucous membranes?
Injury important structures such as nerves
What happens to many swallowed foreign objects?
They reach the stomach
What may happen if a swallowed foreign object doesn’t reach the stomach?
May lodge at inferior end of laryngopharynx
What is a pharyngeal pouch?
Posteromedial false diverticulum
What is a pharyngeal pouch probably due to?
Failure of the UOS to relax
Abnormal timing of swallowing
What is found between the two muscle belly components of the inferior constrictor?
Small area of weakness known as Killian’s dehiscence
When can Killian’s dihiscence cause problems?
If there is discoordination of the pharynx during swallowing
Why can discoordination while swallowing cause problems at Killian’s dehiscence?
Increased pressure within the pharynx can occur as these two muscles attempt to constrict against a closed oesophageal sphincter. This can cause part of the pharyngeal mucosa to herniate through Killian’s dehiscence, forming a pharyngeal pouch
When can pharyngeal pouches be asymptomatic?
When they are small
What are the symptoms of pharyngeal pouches?
Dysphagia
Regurgitation of food
Halitosis
What are the symptoms of pharyngeal pouches related to?
Food material collection in pouch, or disruption of swallow
