Tonsil (Viva)

TONSIL


Q.1 What is the position of tonsil?

Tonsil occupies tonsillar fossa between diverging palatoglossal fold in front and palatopharyngeal fold behind.

Q.2 What are the structures forming tonsillar bed?

  • Pharyngobasilar fascia.
  • Superior constrictor and palatopharyngeus muscle.
  • Buccopharyngeal fascia.
  • In the lower part, styloglossus and 9th cranial nerve.

Q.3 What are the boundaries of pharyngomaxillary space? What is its clinical importance?

It is a triangular space bound by

  • Superiorly: Base of skull
  • Medially: Superior constrictor of pharynx
  • Laterally: Fascia covering medial pterygoid and submandibular gland.

Importance:
Infection can spread into it from palatine tonsil or peritonsillar abscess.

Q.4 What is ‘plica triangularis’?

It is a triangular vestigial fold of mucous membrane covering anteroinferior part of the tonsil.

Q.5 What is Waldeyer’s ring?

It is a lymphatic ring which guards entry to digestive and respiratory passages. It is formed by six masses of lymphoid tissue: 2 palatine tonsils, 2 tubal tonsils, 1 pharyngeal tonsil and 1 lingual tonsil. These are connected together by scattered lymphoid tissue.

Q.6 What is adenoid?

Pathological enlargement of pharyngeal tonsil.

Q.7 How does a tonsil differ from a lymph node?

  • Lined by squamous epithelium.
  • No subcapsular lymph space.
  • No afferent lymphatics.
  • Do not have a complete capsule.

Q.8 What is the arterial supply of tonsils?

  • Tonsillar branch of facial, mainly
  • Ascending palatine branch of facial
  • Dorsal lingual branch of lingual
  • Ascending pharyngeal branch of external carotid and
  • Greater palatine branch of maxillary.

Q.9 Hemorrhage during tonsillectomy occurs from injury to which vessels?

It can result from injury to ascending palatine branch of the facial artery, which is separated from tonsil only by superior constrictor muscle or external palatine vein descending on the lateral side of tonsil from soft palate between the capsule and superior constrictor.

Q.10 What is the lymphatic drainage of tonsils?

Jugulo-digastric node

Q.11 How hemorrhage after tonsillectomy is checked?

By removal of the clot from the raw bed.

Q.12 Why tonsillitis causes referred pain in the ear?

Because of the common nerve supply, i.e., by glossopharyngeal (IX cranial) nerve.

Q.13 How palatine tonsil develops?

These develop in relation to the lateral part of the second pharyngeal pouch by endodermal proliferation and lymphocyte collection.