Pathology Of The Pharynx Flashcards

1
Q

What can happen when the pharyngeal tonsils get chronically inflamed?

A

May obstruct passage of air from nasal cavities through chonae into nasopharynx

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2
Q

Why can adenoids harbour infection?

A

They are richly vascularised

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3
Q

What is the result of the adenoids ability to harbour infection?

A

Removing the tissue may help with symptoms, even if adenoids not that enlarged

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4
Q

What does chronic inflammation of the pharyngeal tonsils cause?

A

Mouth breathing

Nasal tone to speech

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5
Q

What are the complications of chronically inflamed adenoid tonsils?

A

Otitis media

Sinusitis

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6
Q

What is otitis media in chronically inflamed pharyngeal tonsils due to?

A

Blockage of the pharyngotympanic tube

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7
Q

Why does the blockage of the pharyngotympanic tube cause otitis media?

A

Drainage and ventilation of the middle ear cavity are impeded

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8
Q

What is the classic theory by which blockage of pharyngotympanic tube causes otitis media?

A
  • Cells in middle ear are constantly reabsorbing nitrogen/oxygen
  • Blocked ET causes negative pressure in the middle ear
  • Transudate (sterile) drawn in from mucosa
  • Bacteria can now proliferate to cause otitis media
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9
Q

What are the complications of otitis media?

A

Hearing loss
Chronic inflammation of mastoid
Cholsteatoma
Meningitis, brain abscess

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10
Q

What is often true of the hearing loss in otitis media?

A

It is temporary

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11
Q

What is the hearing loss in otitis media associated with?

A

Effusion

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12
Q

What can chronic inflammation of the mastoid lead to?

A

Necrosis of mastoid process

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13
Q

What is cholesteatoma?

A

Cyst like lesions that are linked with chronic inflammation

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14
Q

How can cholesteatoma progress?

A

Can erode surrounding structures

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15
Q

What does the pharyngotympanic tube provide a potential route for?

A

Infection in the pharynx to spread the middle ear

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16
Q

What is the result of the Eustachian tube providing a route for infection in the pharynx to spread into the middle ear?

A

Not uncommon for respiratory tract infections to be complicated by middle ear infections

17
Q

How is the Eustachian tube different in children?

A

Shorter, wider, more horizontal

18
Q

What may recurrent inflammation of the tonsils require?

A

Removal of the tonsils (tonsillectomy) from the tonsillar bed

19
Q

Which tonsils in particular may need to be removed in tonsillitis?

A

Palatine

20
Q

What is the problem with a tonsillectomy?

A

Procedure may result in profuse bleeding from the rich blood supply to the tonsil

21
Q

What is the blood supply to the palatine tonsil?

A

Tonsillar branch of facial artery

22
Q

What is the piriform fossa a common site for?

A

Foreign bodies entering the pharynx to become lodged

23
Q

What is the piriform fossa a common site for?

A

Foreign bodies entering the pharynx to become lodged

24
Q

What may happen if sharp objects get lodged in the piriform fossa?

A

May pierce mucous membrane

25
Q

What is the problem with sharp objects in the piriform fossa piercing the mucous membranes?

A

Injury important structures such as nerves

26
Q

What happens to many swallowed foreign objects?

A

They reach the stomach

27
Q

What may happen if a swallowed foreign object doesn’t reach the stomach?

A

May lodge at inferior end of laryngopharynx

28
Q

What is a pharyngeal pouch?

A

Posteromedial false diverticulum

29
Q

What is a pharyngeal pouch probably due to?

A

Failure of the UOS to relax

Abnormal timing of swallowing

30
Q

What is found between the two muscle belly components of the inferior constrictor?

A

Small area of weakness known as Killian’s dehiscence

31
Q

When can Killian’s dihiscence cause problems?

A

If there is discoordination of the pharynx during swallowing

32
Q

Why can discoordination while swallowing cause problems at Killian’s dehiscence?

A

Increased pressure within the pharynx can occur as these two muscles attempt to constrict against a closed oesophageal sphincter. This can cause part of the pharyngeal mucosa to herniate through Killian’s dehiscence, forming a pharyngeal pouch

33
Q

When can pharyngeal pouches be asymptomatic?

A

When they are small

34
Q

What are the symptoms of pharyngeal pouches?

A

Dysphagia
Regurgitation of food
Halitosis

35
Q

What are the symptoms of pharyngeal pouches related to?

A

Food material collection in pouch, or disruption of swallow