The document provides details about the anatomy, blood supply, innervation, function, common infections, and treatment of the palatine tonsils. The palatine tonsils are located in the lateral walls of the oropharynx and are composed of lymphoid tissue containing crypts. Common infections include acute tonsillitis caused by bacteria like streptococcus. Treatment involves rest, analgesics, and a 7-10 day course of antibiotics like penicillin.

1. E.N.T
TUTORIAL REPRESENTATION
BY :- SAURABH RANJAN
BATCH:-(15-16)

2.  Palatine tonsile are 2 in number.
 Tonsils are large lymphoid tissue.
 Situated in the lateral wall of the
oropharynx between the anterior and
posterior pillars.
 They form lateral part of the Waldeyer's
ring.

3.  Tonsil has two surfaces
 1.Medial 2.Lateral
 Two poles
 1.upper 2.lower
 two developmental folds
 1.plica triangulris 2.plica semilumris
 one cleft
 Intratonsillar cleft

4.  It is covered by non- keratinising
startified squamous epithelium
 Opening of 12-15 crypts usually
plugged with
 Epithelial cell
 Bacteria
 Food Debris

5.  It present well defined fibrous capsule.
 It is also the site for collection of pus in
peritonsillar abscess.
 Fibre of palatoglossus and palatopharyngeus
muscle are attached to the capsule of the
tonsil.

6.  It extends into soft palate
 Its medial surface is covered by a semilunar
fold, extending b/w anterior and posterior
pillars and enclosing a potential space called
supratonsillar fossa

7.  It is attached to the tongue.
 A triangular fold of mucous membrane
extend from anterior pillar to the
anterioinferior part of tonsil and encloses a
space called anterior tonsillar space.

8.  It is formed by the superior constrictor and
styloglossus muscle
 The glossopharyngael nerve and styloid
process , if enlarged , may lie in relation to
the lower part of tonsillar fossa
 Outside the superior constrictor , tonsil is
related to the facial artery, submandibular
salivary gland, posterior belly of digastric
muscle medial pterygoid muscle and the
angle of mandible

9.  Tonsillar branch of facial artery.It is the
main branch
 Ascending pharyngeal artery from external
carotid
 Ascending palatine branch of facial artery
 Dorsal lingual branches of lingual artery
 Descending palatine branch of maxillary
artery

10.  Veins from the tonsils drain into paratonsillar
vein
 It joins the common facial vein and
pharyngeal venous plexus

11.  Lymphatics from the tonsil pierce the
superior constrictor and drain into upper
deep cervical nodes particularly the
jugulodigastric node situated below the
angle of mandible.

12.  Lesser paltine branches of sphenopalatine
ganglion(CN V)
 Glossopharyngeal nerve provide sensory
nerve supply

13.  Lymphoid masses of waldeyer’s ring, palatine
tonsil have a protective role
 It act as sentinels at the portal of air and
food passage
 The crypts in tonsils increase the surface
area for contact with foreign substances

14.  Mainly a disease of childhood but is also
seen in adults
 Acute infections of tonsil are classified
as
 1. Acute catarrhal or superficial
tonsillitis - mostly seen in viral infection.
 2. Acute follicular tonsillitis- infection
spread into the crypts and it filled with
purulent material, presenting at the
opening of crypts as yellowish pots

15.  3. Acute parenchymatous tonsillitis – tonsil is
uniformly enlarged and red.
 4. Acute membranous tonsillitis- it is a stage
when exudation from the crypts coalesces to
form a mambrane on the surface of tonsil

16.  Haemolytic streptococcus is the most
common infecting organism
 Others like…..
 staphylococci
 Pneumocci
 H. influenzae

17.  Sore throat
 Difficulty in swallowing
 Fever it vary from 38◦ to 40◦ C
 Earche
 Constitutional symptoms :- headache
 General body ache
 Malaise
 constipation

18.  Breath is foetid and tongue is coasted.
 Hyperaemia of pillars, soft palate and
uvula
 Tonsil are red and swollen with yellowish
spots of purulent material presenting at
the opening of crypts
 Jugulodigastric lymph node are enlarged
and tender

19.  Patient is put to bed and encouraged to take
plenty of fluids
 Analgesic (aspirin , paracetamol) are given
according to the age of the patient to relieve
local pain and down the fever.
 Anti microbial therapy- infection are due to
streptococcus , and penicillin is the drug of
choice
 patients allergic to pencillin can be treated
with erythomycin.
 Antibiotics should be continued for 7-10
days

20.  Chronic tonsillitis with recurrent acute
attacks
 Peritonsillar abscess
 Parapharyngeal abscess
 Cervical abscess
 Acute otitis media
 Rheumatic fever
 Acute glomerulonephritis
 Subacute bacterial endocarditis due to
streptococcus viridian infection.