tonsils, waldeyer's tonsillar ring, MALT, description of palatine tonsils, pharyngeal tonsils or Adenoids, tubal tonsils, lingual tonsils, clinicals of tonsils, tonsillectomy,

1. TONSILS
DR SANAYASEEN
ANATOMY DEPARTMENT
KIMS

2. INTRODUCTION
Tonsils are collections of lymphoid tissue facing into the
aerodigestive tract.
The set of lymphatic tissue included as:
Nasopharyngeal or adenoid tonsil,
Pair of tubal tonsils,
Pair of palatine tonsils, and
the lingual tonsil.
Are comprises of theWaldeyer's tonsillar ring

4. WALDYER’S RING
The ring acts as a first line of defence against microbes that
enters the body via the nasal and oral routes.
Waldeyer’s ring consists of four tonsillar structures (namely,
the pharyngeal, tubal, palatine and lingual tonsils) as well as
small collections of lymphatic tissue disbursed throughout
the mucosal lining of the pharynx (mucosa-associated
lymphoid tissue, MALT).

8. PALATINETONSILS
Location: in tonsilar sinus on the lateral wall of the
oropharynx. Just in front of and above of the angle of the
mandible.
 Bounded by anteriorly platoglossal fold and posteriorly by
platopharyngeal fold.
It has 2 surfaces : medial and lateral
And 2 poles: upper and lower

9. MEDIAL SURFACE:
Covered by mucous membrane which is continuous with platoglossal fold
and below with that of tongue.
Mucosa over the upper part dips into the substance of the tonsil forming a
deep intra-tonsillar clefts.That leads to secondary crypts.
LATERAL SURFACE:
Is covered by fascia forming capsule and separating it with superior
constrictors of pharynx.

10.  The tonsillar bed is separated from
the capsule by loose areolar tissue.
 This makes it easy to dissect the
tonsils from its bed during
tonsillectomy.
 It is also the site of collection of pus
in peritonsillar abscess(quincy)
 BED OFTONSIL:
is formed by two muscles
 Superior constrictors
 Styloglossus
STRUCTURES RELATEDTO
BED OFTONSIL:
Styloid process (if enlarged)
Glossopharyngeal nerve
Facial artery
Submandibular salivary gland
Posterior part of belly of
digastric
Medial pterygoid muscle
Angle of mandible

12. BLOOD SUPPLY
Tonsillar branch of facial
artery
Ascending palatine branch
of facial artery
Ascending pharyngeal
branch of ECA
Dorsal lingual branch of
lingual artery
Descending palatine
branch of maxillary artery

13. VENOUS DRAINAGE:
Paratonsillar vein into common facial and to pharyngeal plexus
LYMPHATIC:
Upper cervical lymphnodes and into jugulodigestric lymphnodes

14. PHARYNGEALTONSILS/
ADENOIDS
Location: posterior to nasal cavity, in the roof of nasopharynx.
Also known as nasopharyngeal tonsils
When they are enlarged known as adenoids
Adenoids lead to obstruction of nasopharynx forcing children to
breath through mouth.
Infection may also spread to ear though auditory tube.
Removal of adenoids is known as adenoidectomy.

16. TUBAL
TONSILS
Lymphoid tissue
located behind
opening of auditory
tube are known as
tubal tonsils.
Enlargement of
tubal tonsil causes
blockage of
Eustachian tube.

17. LINGUALTONSILS
The numerous protrusions located at the
posterior third of tongue - are collectively
known as the lingual tonsils.
They are also covered by stratified non-
keratinized squamous epithelium.
Blood supply:The dorsal lingual branch
of the lingual artery and the lingual vein
and return of these lymphatic
aggregates, while the
NERVE SUPPLY: glossopharyngeal
nerve innervates them, along with the
posterior of the tongue.

18. Type Epithelium capsule Crypts Location
Adenoids (also
termed "pharyngeal
tonsils")
Ciliated
pseudostratified
columnar (respiratory
epithelium)
Incompletely
encapsulated
No crypts, but small
folds
Roof of pharynx
Tubal tonsils
Ciliated
pseudostratified
columnar (respiratory
epithelium)
Roof of pharynx
Palatine tonsils
Non-keratinized
stratified squamous
Incompletely
encapsulated
Long, branched
Sides of oropharynx
between
palatoglossal
and
palatopharyngeal
arches
Lingual tonsils
Non-keratinized
stratified squamous
Incompletely
encapsulated
Long, unbranched
Behind terminal
sulcus (tongue)

20. CLINICAL
 Tonsillitis: infection and inflammation of tonsil
 Tonsillectomy: is surgical removal of tonsils.

23. TONSILECTOMY