The document discusses pharyngitis and laryngitis, detailing their definitions, classifications, causes, symptoms, diagnosis, management, and nursing care. Pharyngitis can be caused by infections (viral or bacterial) or non-infectious factors, while laryngitis primarily affects the voice box, often leading to hoarseness and discomfort. Both conditions require symptomatic treatment and may necessitate antibiotics for bacterial infections; nursing management emphasizes hydration, voice rest, and monitoring for complications.

1. Pharyngitis and Laryngitis

2. PHARYNGITIS

3. Pharyngeal Anatomy
 Continuation of the digestive tract from
oral cavity.
 Funnel shaped fibromuscular tube
 Approximately, 15 cm long
 Common route for food and air

5.  Subdivided into 3 regions:
-Nasopharynx
-Oropharynx
-Laryngopharynx or hypopharynx

6. PHARYNGITIS
 What is it?
- Pharyngitis, or sore throat, is
discomfort, pain, or scratchiness
in the throat. It often makes it
painful to swallow.
- Most of common infectious
agents are Group A
Streptococcus and various viral
agents.
- Often co-exists with tonsillitis

7. Pharyngitis

8. PHARYNGITIS

9. Classification
 1) Infectious
Pharyngitis caused mainly by
-Viruses
-Bacterias
-Fusobacterium necrophorum
-Diphtheria
-Fungal
-Others

10. Viral Pharyngitis
 A throat infection
which tested negative
for streptococcus, thus
presumably of viral
origin.Note the white
exudate on the
tonsils which frequently
also occurs with a viral
infection.

11.  2)Non- infectious
Pharyngitis may also be caused by
mechanical, chemical or thermal irritation,
for example cold air or acid reflux. Some
medications may produce pharyngitis
such as antipsychotics.

12. Classification
 Acute Pharyngitis
- Sudden painful inflammation of pharynx.
-Incidence of viral pharyngitis peaks
during winter and early spring in regions
with warm summers and cold winters.
-Viral pharyngitis spreads easily in the
droplets of coughs and sneezes and
uncleaned hands that have been exposed
to contaminated fluids.

13. Acute Pharyngitis
 Etiology
 Viral >90%
 Rhinovirus – common cold
 Coronavirus – common cold
 Adenovirus – pharyngoconjunctival
fever;acute respiratory illness
 Parainfluenza virus – common cold; croup
 EBV – infectious mononucleosis
 HIV

14. Acute Pharyngitis
 Etiology
 Bacterial
 Group A beta-hemolytic streptococci (S.
pyogenes)*
 most common bacterial cause of pharyngitis
 accounts for 15-30% of cases in children and 5-
10% in adults.
 Mycoplasma pneumoniae
 Arcanobacterium haemolyticum
 Neisseria gonorrhea
 Chlamydia pneumoniae

15. Chronic Pharyngitis
 It is persistent inflammation of
pharynx.
 Common in adults who work in dusty
surroundings, use their voice to excess,
suffer from chronic cough or habitually
use alcohol or tobacco.
 It may be either hypertrophic, atrophic
or chronic glandular( clergyman’s sore
throat)

16. Clinical manifestation
(Strep.)
 Rapid onset
 Headache
 GI Symptoms
 Sore throat
 Erythma
 Exudates
 Palatine petechiae
 Enlarged tonsils
 Anterior cervical
adenopathy
&Tender
 Red& swollen uvula

17. Clinical manifestation
(Viral)
 Gradual onset
 Rhinorrhea
 Cough
 Diarrhea
 Fever

18. Diagnosis
 Strep:
Throat culture(Gold standard)
Rapid Strep. Antigen kits
 Infectious Mono.:
CBC(Atypical lymphocytes)
Spot test (Positive slide
agglutination)
 Mycoplasma:
Cold agglutination test

19. Differential diagnosis
 Retropharyngeal abscesses
 Peritonsilar abscesses
 Epiglotitis
 Thrush

20. Management
 The majority of time treatment is
symptomatic. Specific treatments are
effective for bacterial, fungal, and
herpes simplex infections.

21. Medications
 Analgesics such as NSAIDs and acetaminophen can help
reduce the pain associated with a sore throat.
 Steroids (such as dexamethasone) have been found to be
useful for severe pharyngitis.
 Viscous lidocaine relieves pain by numbing the mucus
membranes.
 Antibiotics are useful if a bacterial infection is the cause of
the sore throat. For viral infections, antibiotics have no effect.
 Oral analgesic solutions, the active ingredient usually being
Phenol, but also less commonly Benzocaine, Cetylpyridinium
chloride and/or Menthol.

22. The following tips may help your sore
throat feel better.
 Drink warm liquids such as lemon tea or
tea with honey.
 Gargle several times a day with warm salt
water (1/2 tsp of salt in 1 cup water).
 A cool-mist vaporizer or humidifier can
moisten and soothe a dry and painful
throat.

23.  Suck on hard candies or throat
lozenges. Young children should not be
given such products because they can
choke on them.
 Try over-the-counter pain medications,
such as acetaminophen

24. Complication
Complications may include:
 Blockage of the airway (in severe cases)
 Sore (abscess) around the tonsils or
behind the throat

25. NURSING MANAGEMENT

26.  Encourage bed rest during febrile stage
of illness,instruct frequent rest periods
once patient is up and about.
 Instruct patient about secretions
precautions (eg. Disposal of used tissue
properly) to prevent spread of infection.
 Apply an ice collar for symptomatic relief.
 Perform mouth care to prevent fissures
of lips and inflammation in mouth.

27.  Advice patient of importance of taking
the full course of antibiotic therapy.
 Inform patient and family to watch for
that may indicate development of
complications, including nephritis and
rheumatic fever.

28.  Encourage patient to drink plenty of
fluids,and encourage gargling with
warm salt water to relief throat
discomfort.Using lozenges may help to
keep the throat moist.

29. LARYINGITIS

30. DEFINATION
Laryngitis is swelling and irritation (inflammation)
of the voice box (larynx) that is usually associated
with hoarseness or loss of voice.

33. AETIOLOGY
INFECTIOUS:
Viral
Bacterial
 Bacterial invasion is secondary.
 Viral laryngitis is common in winter season
and is easily transmitted to others.

34. Bacteria involved:
Streptococcus
pneumoniae
Hemophilus influenzae
Hemolytic streptococci
Staphylococcus aureus

35. NON INFECTIOUS
Inhaled fumes
Allergy
Polluted atmospheric conditions
Vocal abuse
Iatrogenic trauma

36. Predisposing factors
 Smoking
 Psychological strain
 Physical stress

37. Clinical features:
Symptoms:
 Hoarseness which may lead to complete loss of
voice.
 Discomfort or pain in the throat, particularly
after talking.
 Dry, irritating cough which is usually worse at
night
 General symptoms of headache, cold rawness or
dryness of throat, malaise and fever if laryngitis
has followed viral infection of the upper
respiratory tract.

38. Signs:
 In early stages-
Erythematic and edema of epiglottis, aryepiglottic
folds, arytenoids and vocal cords near normal.
 In late stages-
 Increased hyperemia and swelling
 Vocal cord becomes reddened and swollen.
 Sticky secretions are seen between the cords and
interarytenoid region
 In case of vocal abuse, sub mucosal hemorrhages
may be seen.

39. CLINICAL DIAGNOSIS
 Signs of acute URTI.
 Dry thick sticky
secretions.
 Dusky red and
swollen vocal cords.
 Diffuse congestion of
laryngeal mucosa.

40. DIFFERENTIAL DIAGNOSIS
 Acute epiglottises
 Acute laryngo tracheo bronchitis.
 Laryngeal perichondritis
 Laryngeal edema
 Laryngeal diphtheria

41. Chronic
Laryngitis
 Presents as diffuse lesion or produce
localized effects in larynx
 Chronic infections in the surrounding
areas, vocal abuse smoking, alcohol,
irritant fumes are held etiological
factors.
.

42. Chronic
Laryngitis
Histopathologically there are
mucosal thickening and
infiltration of plasma cells and
leukocytes. connective tissue
elements are increased.

43. TREATMENT
HOME TEATMENT
 Rest your voice. You do not have to
stop speaking entirely, but use your
voice as little as possible. Speak softly
but do not whisper because
whispering can actually irritate your
larynx more than speaking softly.
Avoid talking on the telephone or
trying to speak loudly.

44.  Try not to clear your throat. This can cause
further injury and inflammation to your
larynx. Taking a nonprescription
cough suppressant medicine may help if
you have a dry cough that does not
produce mucus.
 Stop smoking and stay away from
secondhand smoke. Cigarette smoke
irritates the throat and larynx and makes
existing inflammation worse.

45.  Use a humidifier in your home.
Humidity helps to thin the mucus in the
nasal membranes that causes stuffiness
or postnasal drip.
 Drink plenty of fluids.
 Relieve nasal stuffiness. The nose helps
to humidify inhaled air, which keeps
mucus at its proper consistency. A
saline nasal wash may help.

46. TREATMENT Cont
DEFINITIVE
 Cough sedative
 Antibiotics: when there is secondary
infection with fever and toxemia or
purulent expectoration .
 Analgesics
 Steroids: for laryngitis followed by thermal
or chemical burns.

47. To improve vocal hygiene
 Drinking lot of fluids - Drink 7-9 glasses of
water per day; also good are herbal tea.
 Maintaining good general health - Exercise
regularly.
 Avoiding smoking - They are bad for the heart,
lungs and vocal tract.
 Eating a balanced diet - Include vegetables,
fruits and whole grain foods.
 Avoid dry, artificial interior climates.
 Do not eat late at night - may have problems
when stomach acid backs up on the vocal cords.
 Use a humidifier to assist with hydration.

48. Complication :-
 Peritonsillar
abscess,sinusitis,otitis media,
meningitis.

49. NURSING MANAGEMENT

50.  Administer antibiotics.
 The nurse instructs the patient to rest
the voice and to maintain a well
humidified environment.
 If laryngeal secretions are present
during the acute episodes, expectorant
agents are suggested along with a daily
fluid intake of 2 to 3 liters.

51.  The nurse instructs the patient about the
signs and symptoms that require
contacting the health care provider: loss
of voice with sore throat that makes
swallowing difficult,hemoptysis and noisy
respirations.
 It is important to report continued
hoarseness after voice rest or laryngitis
that persists for longer than 5 days
because of the possibility of malignancy

52. THANK YOU