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ENT > Tonsils and Adenoids > Flashcards

Tonsils and Adenoids Flashcards

1
Q

Waldeyer’s ring – contents

A 
Palatine (faucial) tonsils
Adenoids (pharyngeal tonsils)
Lingual tonsils
Tubal (Gerlach's) tonsils
Lateral bands -- lateral wall of oropharynx
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2
Q

Passavant’s ridge

Importance?

A

Bulge in posterior pharyngeal wall (superior constrictor muscle)

Abuts soft palate during swallowing and speech (prevent VPI)

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3
Q

Blood supply to tonsils

A
  • Facial artery - tonsillar and ascending palatine branches
  • Ascending pharyngeal artery
  • Lingual artery - dorsal lingual branch
  • Maxillary artery - palatine branch
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4
Q

Tonsillary pillars

A

Palatoglossus (anterior)

Palatopharyngeus (posterior)

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5
Q

MC bacteria in tonsillitis

A

GABHS, non-GABHS

BETA-LACTAMASE – Bacteroides, Haemophilus, Staph, Moraxella

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6
Q

MC viruses in tonsillitis

A

Adeno, Coxsackie, Parainfluenza, Enterovirus, EBV, HSV, RSV

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7
Q

MC ages for tonsillitis

A

4-10

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8
Q

Risk factors for PTA

A

Previous tonsillar infections
Allergies
Dental caries

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9
Q

Symptoms of PTA

A 
Sore throat 3-7 days
Fever
Dysphagia
Odynophagia
Trismus
Hot potato voice
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10
Q

Signs of PTA

A

Inflamed oropharynx
Swollen tonsil
Swollen peritonsillar area
Deviated soft palate and uvula

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11
Q

Associated diseases w/ adenotonsillar disease

A 
Quinsy
Abscess
LAD
Rhinitis
Sinusitis
Olfactory disorders
OM
Speech or hearing impairments
Dental abnormalities
Fetor oris
FTT
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12
Q

Indications for tonsillectomy

A 
OSA, SDB, Cor pulmonale
Malignancy (suspected or diagnosed)
Febrile convulsions
Persistent/recurrent hemorrhage
Recurrent acute or chronic tonsillitis
PTA
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13
Q

Indications for adenoidectomy

A 
Recurrent or chronic middle ear disease
Obstructive s/s
OSA
Obligate mouth breathing
Snoring
Recurrent or chronic infections
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14
Q

Episodes before tonsillectomy is considered

What are these called?

A

7+ in 1 year
5/yr for 2 years
3/yr for 3 years
2+ weeks missed from school or work in 1 year

PARADISE CRITERIA

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15
Q

Bifid uvula…look for what?

Why important?

Do what?

A

Submucous cleft (soft palate deficiency)

Increased risk for VPI after adenoidectomy

Do SUPERIOR adenoidectomy (leaves some tissue)

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16
Q

Contraindications for tonsillectomy/adenoidectomy

A

Blood diseases
Uncontrolled systemic disease (DM, heart, etc.)
Cleft palate
Acute infection

17
Q

Complications of tonsillectomy/adenoidectomy

A 
Airway obstruction (swelling)
Bleeding (up to 7-10 day after)
Negative pressure PE??
VPI
Pain
Weight loss
Death
18
Q

Can they grow back?

A

Residual tissue can hypertrophy and cause symptoms

19
Q

Typical age when adenotonsillectomy is ok

A

3 years old (controversy)

ENT (11 decks)

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