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Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
Tonsils And  Adenoids
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Tonsils And Adenoids

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tonsilitis and adenoid

tonsilitis and adenoid

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  • 1. Tonsils and Adenoids Anatomy: Pharynx : - nasopharynx - Oropharynx - Laryngopharynx.
  • 2. Anatomy
  • 3. Definition : - Ovoid lymphoid tissue with fibrous capsule laterally over the superior constrictor muscles. Its surface is covered with stratified squamous epithiluim & crypts. It has a medulla & cortex like all other lymphoid tissues. It is part of the Walderyers ring.
  • 4.  
  • 5. Blood Supply : From upper & lower poles . - Tonsilar branch of facial artery from the ext. carotid. - Descending palatine -------- > internal maxillary artery. - Ascending palatine --------  facial artery - Ascending pharyngeal ----  external carotid. - Dorsalis linulae -------  lingual - Paratonsillar vein -----> jugular vien.
  • 6.  
  • 7. Functions :
    • - Concerned with immune
    • mechanism.
    • - 1st line of defense. The lymphoid tissues produce lymphocytes.
    • - T-cells produce plasma cells & help in antibody formation.
  • 8. Pathology :
    • Inflammatory : Bacterial (strept. & other pyogenic organisms ,viral, fungal . It can be specific or none-specific. Also can be acute or chronic .
    • Neoplastic : benign or malignant.
  • 9.  
  • 10. Ca Tonsil Lt
  • 11.  
  • 12. Acute tonsillitis
    • Acute follicular tonsillitis
    • Acute parynchymatous T.
    • Membranous Tonsillitis
  • 13.  
  • 14. Clinical Features :
    • Usually at 3-7 years age but it can occur at any age with equal sex distribution. Commoner in overcrowded areas (barracks, hostels, camps, schools...i.e infectious)
  • 15. Symptoms
    • -- Pyrexia
    • -- Pain on swallowing
    • -- Malaise
    • -- Constipation
    • -- Earache.
    • -- sore throat
  • 16. Signs:
    • - Increase in size.
    • - Follicles, membranes or congestion.
    • - enlarged tender, Jugulo-diagastric glands.
    • - Fetor (halitosis).
  • 17. Differential Diagnosis :
    • -Scarlet fever (strep.)
    • -Diphtheria
    • -Vincent's angina (B. Vincenti, fusiform bacilli & spirochaetes )
    • -agranulocytosis – marked reduction in neutrophils  ulcerations & false memb.
    • -Glandular fever (viral  marked increase in monocytes & lymphocytes=mononuclear cells).
    • - leukemia (blood picture & sternal puncture).
  • 18. Investigations:
    • TWBC + Differential.
    • Hb%
    • Swab C/ S
    • ESR
    • ASO Titer
  • 19. Treatment:
    • -Bed rest
    • -Fluids
    • -Soft diet
    • -Analgesics
    • -Antibiotics: Penicillins,cephalosporins
  • 20.  
  • 21. Complications and Sequelae :
    • Peritonsillar abscess
    • Retropharyngeal abscess
    • Para pharyngeal abscess
    • Rheumatic fever
    • Glumerulo-nephritis
    • chr. tonsillitis.
  • 22. Chronic Tonsillitis
    • -Follicular
    • -Parenchymatous
    • = Hypertrophy
    • =Atrophic
  • 23. Clinical Features :
    • - Rec. infection
    • - sore throat
    • - congested pillars
    • - irritating cough
    • -Increase in size.
  • 24. Diff. Diag. :
    • Physiological.
    • Pharyngitis
    • Malignancy
  • 25. Treatment:
    • - Conservative Medical
    • Treatment .
    • - Surgical : i.e Tonsillectomy .
  • 26. Indications for tonsillectomy:
    • - Rec. infections (> 4x per year).
    • - sleep apnoea syndrome .
    • - peritonsillar abscess.
    • - Carrier state (strep., Diphtheria bacilli).
    • - Others: Access, malign. Susp
  • 27. Complications :
    • Haemorrhage (primary, reactionary, secondary ).
    • Nasal regurg.
    • Septicaemia.
    • Operative complications.
  • 28. ADENOIDS
    • Def. : hypertrophy of the nasopharyngeal
    • tonsil sufficient to produce symptoms.
    • Commonest between the age of 3 – 7 years.
  • 29. Pathology:
    • - Simple inflammatory :
    • Infection or allergy
    • - Tuberculosis : Rare .
  • 30. Clinical Features :
    • Symptoms & Signs :
    • Nasal obstruction : - snoring , mouth breathing , nasal tone , difficult suckling in infants.
    • Adenoid facies : narrow pinched nose, open mouth, high arched palate, crowded upper incisors teeth, receding chin & idiotic look.
    • Flat or pigeon chest due to repeated respiratory infections.
    • Nasal discharge : mucopurulent .
    • E.T. obstruction : recurrent attacks of secretory or suppuritive otitis media.
    • Obstructive sleep apnea syndrome : cor pulmonale & right sided heart failure .
    • Nocturnal enuresis , hypoxemia & apathy.
  • 31. Diagnosis :
    • - Clinical .
    • - Posterior rhinoscopy
    • - X- ray.
  • 32. Treatment:
    • Medical : nasal decongestants .
    • Surgical : adenoidectomy.
  • 33. Complications :
    • Palatal scaring , Nasal speech (rhinolalia operta),
    • Nasal regurgitations.
    • - Remnants ? Recurrence.
  • 34.  
  • 35.  
  • 36.  
  • 37.  

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