TONSILS (Palatine/ Faucial Tonsils)
Waldeyer’s ring of Lymphoid Tissue
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Refers to the ring of lymphoid tissue at the oropharyngeal isthmus.
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Formed by:
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Pharyngeal tonsil (adenoids)
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Tubal tonsil (Gerlach tonsil)
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Palatine tonsil – most conspicuous parts of the waldeyer’s ring.
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Lingual tonsil
PALATINE TONSILS/ FAUCIAL TONSIL
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Collection of lymphoid tissue present in the submucosa of oropharynx.
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Two palatine tonsils (right or left) lies in the tonsilar sinus (tonsilar fossa).
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Tonsillar fossa bounded by the palatoglossal fold in front & the palatopharyngeal fold behind.
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Tonsils are lined by non- keratinized stratified sq. epithelium.
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Medial surface of each tonsil has 15-20 crypts, the largest of which is called Intratonsillar cleft or crypta magna.
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Plica triangularis is a fold of mucous membrane covering anteroinferior part of tonsil.
TONSILAR BED
Formed from within-outwards by:-
- Pharyngeal fascia
- Superior constrictor & palatopharyngeus muscle
- Styloglossus
- Buccopharyngeal fascia
BLOOD SUPPLY OF TONSILS
- Palatine tonsil is supplied by 5 arteries:
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Tonsillar branch of facial artery (chief artery)
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Ascending pharyngeal artery from ECA
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Ascending palatine branch of facial artery
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Dorsal linguae branches of lingual artery
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Descending palatine branch of maxillary artery
NERVE SUPPLY
- Lesser palatine branches of sphenopalatine ganglion & Glossopharyngeal N (major supply)
- Glossopharyngeal nerve also gives sensory supply to middle ear.
- Pain from the tonsils can be referred to middle ear along Glossopharyngeal nerve.
LYMPHATIC DRAINAGE
- jugulodigastric nodes (upper deep cervical nodes).
Exam Important
- Tonsils are derived from 2nd branchial pouch.
- Tonsils reach their maximum size by 5 years.
- Main source of arterial supply to tonsil is tonsilar branch of facial artery.
- Glossopharyngeal and lesser palatine nerves supply palatine tonsil.
- Referred pain from tonsil to middle ear is due to Glossopharyngeal nerve.
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