Tonsils and Adenoids Flashcards Preview

ENT > Tonsils and Adenoids > Flashcards

Flashcards in Tonsils and Adenoids Deck (19)
Loading flashcards...
1

Waldeyer's ring -- contents

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

2

Passavant's ridge


Importance?

Bulge in posterior pharyngeal wall (superior constrictor muscle)

Abuts soft palate during swallowing and speech (prevent VPI)

3

Blood supply to tonsils

- Facial artery - tonsillar and ascending palatine branches
- Ascending pharyngeal artery
- Lingual artery - dorsal lingual branch
- Maxillary artery - palatine branch

4

Tonsillary pillars

Palatoglossus (anterior)
Palatopharyngeus (posterior)

5

MC bacteria in tonsillitis

GABHS, non-GABHS
BETA-LACTAMASE -- Bacteroides, Haemophilus, Staph, Moraxella

6

MC viruses in tonsillitis

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

7

MC ages for tonsillitis

4-10

8

Risk factors for PTA

Previous tonsillar infections
Allergies
Dental caries

9

Symptoms of PTA

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

10

Signs of PTA

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

11

Associated diseases w/ adenotonsillar disease

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

12

Indications for tonsillectomy

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

13

Indications for adenoidectomy

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

14

Episodes before tonsillectomy is considered

What are these called?

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

15

Bifid uvula...look for what?

Why important?

Do what?

Submucous cleft (soft palate deficiency)

Increased risk for VPI after adenoidectomy

Do SUPERIOR adenoidectomy (leaves some tissue)

16

Contraindications for tonsillectomy/adenoidectomy

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

17

Complications of tonsillectomy/adenoidectomy

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

18

Can they grow back?

Residual tissue can hypertrophy and cause symptoms

19

Typical age when adenotonsillectomy is ok

3 years old (controversy)