The tonsils are lymphoid tissue located in Waldeyer's ring in the pharynx. They help defend against pathogens and produce antibodies. Tonsillitis can be acute, caused by viruses or streptococcus bacteria, or chronic with recurrent infections. Chronic tonsillitis presents with bad breath, sore throat, and debris in crypts. Large tonsils and adenoids can obstruct the airway and cause sleep issues. Tonsillectomy and/or adenoidectomy may be recommended for recurrent infections, airway obstruction, or chronic tonsillitis resistant to other treatments. Complications can include abscesses.
Acute epiglottitis is an acute inflammatory condition of the epiglottis and nearby structures like the arytenoids, aryepiglottic folds, and vallecula.It is a life-threatening infection that causes profound swelling of the upper airways which can lead to asphyxia and respiratory arrest.Bacterial etiology is the most common cause of epiglottitis. Soft tissue lateral xray of neck shows thumb sign. Airway management is the main concern of epiglottitis.
This is a seminar presentation conducted by 4th year medical students under supervision of a lecturer. Reference were not attached here, but all information are from google, few textbooks and also from previous ENT posting's seminar.
Acute epiglottitis is an acute inflammatory condition of the epiglottis and nearby structures like the arytenoids, aryepiglottic folds, and vallecula.It is a life-threatening infection that causes profound swelling of the upper airways which can lead to asphyxia and respiratory arrest.Bacterial etiology is the most common cause of epiglottitis. Soft tissue lateral xray of neck shows thumb sign. Airway management is the main concern of epiglottitis.
This is a seminar presentation conducted by 4th year medical students under supervision of a lecturer. Reference were not attached here, but all information are from google, few textbooks and also from previous ENT posting's seminar.
Tonsillitis slideshare for medical students NehaNupur8
complete and detail information about tonsillits , that is the inflammation of the tonsils ,present in the oral cavity , disease of oral cavity contains introduction, definition, types, causes, risk factors,pathophysiology , treatment , medical management, nursing management, nurses role, patient teaching sign and symptoms , drug therapy, diet management,
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
2. ANATOMY
• The tonsils are 3 masses of
tissue:
- lingual tonsil
- pharyngeal (adenoid) tonsil
- palatine or fascial tonsil
Together they form Waldeyer's ring
• are lymphoid tissue
• covered by respiratory epithelium -
pseudostratified ciliated columnar
epithelium
2
3. Normal Function
• Situated at the opening of the pharynx to the external
environment, the tonsils and adenoid are in a position
to provide primary defense against foreign matter.
• produce lymphocytes
• are active in the synthesis of immunoglobulins
• Lymphoid tissue of Waldeyer ring is most
immunologically active between 4 and 10 yr of age,
with a decrease after puberty.
• No major immunologic deficiency has been
demonstrated after removal of either or both of the
tonsils and adenoid.
4. Pathology
• Acute Infection
• Most episodes of acute pharyngotonsillitis are caused by
viruses .
• Group A β-hemolytic streptococcus (GABHS) is the most
common cause of bacterial infection in the pharynx .
• Chronic Infection
• The tonsils and adenoids can be chronically infected by
multiple microbes, which can include a high incidence of β-
lactamase–producing organisms.
• Both aerobic species, such as streptococci and
Haemophilus influenzae, and anaerobic species, such as
Peptostreptococcus predominate.
5. • Airway Obstruction:
• Both the tonsils and adenoids are a major cause of
upper airway obstruction in children.
• Airway obstruction in children is typically manifested in
sleep-disordered breathing, including obstructive sleep
apnea, obstructive sleep hypopnea, and upper airway
resistance syndrome.
• Sleep-disordered breathing secondary to
adenotonsillar breathing is a cause of growth failure.
• Tonsillar Neoplasm
• Rapid enlargement of one tonsil is highly suggestive of
a tonsillar malignancy, typically lymphoma in children.
6. Clinical Manifestations
• Acute Infection
• Symptoms :include odynophagia, dry throat,
malaise, fever and chills, dysphagia, referred
otalgia, headache, muscular aches, and enlarged
cervical nodes.
• Signs include dry tongue, erythematous enlarged
tonsils, tonsillar or pharyngeal exudate, palatine
petechiae, and enlargement and tenderness of
the jugulodigastric lymph nodes
7. ACUTE TONSILLITIS-TYPES
• Acute catarrhal/superficial here tonsillitis is a part of
generalized pharyngitis, mostly seen in viral infections
• Acute follicular infection spread into the crypts with
purulent material, presenting at the opening of crypts as
yellow spots
• Acute parenchymatous tonsil in uniformly enlarged
and congested
• Acute membranous follows stage of acute follicular
tonsillitis where exudates coalesce to form membrane
on the surface
11. • Chronic Infection
• Children with chronic or cryptic tonsillitis
often present with halitosis, chronic sore
throats, foreign body sensation, or a history of
expelling foul-tasting and foul-smelling cheesy
lumps.
• Examination can reveal tonsils of almost any
size and often they contain copious debris
within the crypts.
13. TYPES OF CHRONIC TONSILLITIS
• Chronic follicular tonsillitis
• Chronic parenchymatous tonsillitis :
tonsils are very much enlarged uniformly
and may interfere with speech,
deglutition and respiration, long standing
cases may develop pulmonary
hypertension
• Chronic fibroid tonsillitis
14. CLINICAL FEATURES
• recurrent attacks of sore throat
• chronic irritation in throat with
cough
• halitosis
• dysphagia
• odynophagia
• thick speech
15. SIGNS
• Tonsil may show varying degree of
enlargement depending on the type
• Flushing of the anterior pillar compared
to rest of the pharyngeal mucosa
• Enlargement of the jugulo-digastric node
soft non tender
16. Airway Obstruction
• In many children, the diagnosis of airway can be made
by history and physical examination.
• Daytime symptoms of airway obstruction, secondary
to adenotonsillar hypertrophy, include:
• chronic mouth breathing,
• nasal obstruction,
• hyponasal speech,
• hyposmia,
• decreased appetite,
• poor school performance, and, rarely,
• symptoms of right-sided heart failure.
17. • Nighttime symptoms consist of:
• loud snoring,
• choking, gasping,
• frank apneas,
• restless sleep,
• abnormal sleep positions,
• somnambulism, night terrors, diaphoresis, enuresis, and
sleep talking.
• Large tonsils are typically seen on examination, although
the absolute size might not indicate the degree of
obstruction.
• The size of the adenoid tissue can be demonstrated on a
lateral neck radiograph or with flexible endoscopy.
• Other signs that can contribute to airway obstruction
include the presence of a craniofacial syndrome or
hypotonia.
18. Treatment
• Bed rest
• Fluid intake
• Analgesics
• Antimicrobial – penicillin group, 7-10 days
• Admission if unable to take orally
• Tonsillolith or debris may be expressed manually
with either a cotton-tipped applicator or a water
jet.
• Chronically infected tonsillar crypts can be
cauterized using silver nitrate.
19. Tonsillectomy
• Tonsillectomy alone is usually performed for
recurrent or chronic pharyngotonsillitis.
• Indications for surgery remain uncertain;
there are large variations in surgical rates
among children across countries: 144/10,000
in Italy; 115/10,000 in the Netherlands;
65/10,000 in England; and 50/10,000 in the
United States.
• Rates are generally higher in boys.
20. • Potential but nonevidenced based indications include:
• 7 or more throat infections treated with antibiotics in the preceding
yr,
• 5 or more throat infections treated in each of the preceding 2 yr, or
• 3 or more throat infections treated with antibiotics in each of the
preceding 3 yr.
• The American Academy of Otolaryngology—Head and Neck
Surgery offers guidelines of 3 or more infections of tonsils and/or
adenoids per yr despite adequate medical therapy;
• the Scottish Intercollegiate Tonsillectomy Guidelines Network
recommends 5 or more episodes per yr of tonsillitis with disabling
symptoms and lasting for longer than 1 yr.
Tonsillectomy
21. • Tonsillectomy has been shown to be effective in
reducing the number of infections and the
symptoms of chronic tonsillitis such as halitosis,
persistent or recurrent sore throats, and
recurrent cervical adenitis.
• In resistant cases of cryptic tonsillitis,
tonsillectomy may be curative.
• Tonsillectomy has not been shown to offer clinical
benefit over conservative treatment in children
with mild symptoms.
22. Adenoidectomy
• Adenoidectomy alone may be indicated for the treatment of :
• chronic nasal infection (chronic adenoiditis),
• chronic sinus infections that have failed medical management, and
• recurrent bouts of acute otitis media, including those in children
with tympanostomy tubes who suffer from recurrent otorrhea.
• Adenoidectomy may be helpful in children with chronic or recurrent
otitis media with effusion.
• Adenoidectomy alone may be curative in the management of
patients with nasal obstruction, chronic mouth breathing, and loud
snoring suggesting sleep-disordered breathing.
• Adenoidectomy may also be indicated for children in whom upper
airway obstruction is suspected of causing craniofacial or occlusive
developmental abnormalities.
23. Tonsillectomy and Adenoidectomy
• The criteria for both tonsillectomy and adenoidectomy for
recurrent infection are the same as those for tonsillectomy
alone.
• The other major indication for performing both
procedures together is upper airway obstruction secondary
to adenotonsillar hypertrophy that results in sleep-
disordered breathing, failure to thrive, craniofacial or
occlusive developmental abnormalities, speech
abnormalities, or, rarely, cor pulmonale.
• A high proportion of children with failure to thrive in the
context of adenotonsillar hypertrophy resulting in sleep
disorder experience significant growth acceleration after
adenotonsillectomy.
24. COMPLICATIONS
• Peritonsillar abscess
• Parapharyngeal abscess
• Retro pharyngeal abscess
• Intra tonsillar abscess
• Tonsillar cyst
• Tonsillolith
• Focus of infection for RF, AGN