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CLINYCAL ANATOMY AND PHYSIOLOGY OF THE PHARYNX. ACUTE AND CHRONIC DISEASES OF THE PHARYNX.

PHARYNX in THE PRACTICE of GD

PHARYNX in THE PRACTICE of GD

PHARYNX in THE PRACTICE of GD

PHARYNX
1. SUPERIORLY base 2. 3. $.
of the scull. INFERIORLY esophagus. POSTERIORLY ce !"cal sp"#e. %NTERIORLY #asal ca!"t&' o al ca!"t&' la &#(.

PHARYNX
1. N%SOP)%RYN* 2. 3.
f o+ the base of the scull to the ha , palate. OROP)%RYN* f o+ the ha , palate to the uppe ep"glott"s e,ge. L%RYN-OP)%RYN* f o+ the uppe ep"glott"s e,ge to the "#fe "o e,ge of the c "co",s ca t"lage.

STRUCTURE of the PHARYNGEAL WALL (fro !ithin o"t!#r$ %


1. .U/OUS .E.0R%NE. 2. FI0ROUS TUNI/. 3. .US/UL%R /O%T1 a2 Oute c" cula la&e 1 3 Supe "o co#st "cto 4 3 .",,le co#st "cto 4 3 I#fe "o co#st "cto . b2 I##e lo#g"tu,"#al la&e 1 3 St&lopha &#geous4 3 Salp"#gopha &#geous4 3 Palatopha &#geous. $. %56ENTITI%L TUNI/.

PHARYNGEAL SPACES
7
RETROPHARYNGEAL1 3 a,!e#t"t"al tu#"c 8a#te "o 24 3 p e!e teb al fasc"a 8poste "o 24 3 fasc"al plates bet9ee# both last tu#"c. PARAPHARYNGEAL 8co#ta"#s21 ca ot", !essels' :ugula !e"#s' I*' *' *I' *II c a#"al #e !es' s&+pathet"c cha"#.

PHYSIOLOGY of the PHARYNX

7 RESPIR%TION

PHYSIOLOGY of the PHARYNX

7 S;%LLO;IN-

PHYSIOLOGY of the PHARYNX

7 RESON%TION

PHYSIOLOGY of the PHARYNX

7 PROTE/TION

PHYSIOLOGY of the PHARYNX

7 I..UNOLO-Y
FUN/TION

PERIPHERAL IMMUNE SYSTEM MUCOSA3ASSOCIATED LYMPHOID TISSUE


Le&e'( EPIPHARYNX PHARYNGEAL LYMPHOID RING

)ron*h"( (+ # #' in !o #n% G#(tro #n$ inte(tine L#r,e inte(tine #n$ #--en$i. Uro,enit#' (/(te

S0IN3 ASSOCIATED LYMPHOID TISSUE

L/ -hoi$ no$e( L/ -hoi$ $"*t( Lien

PHARYNGEAL LYMPHOID RING


7 7 7 7
PHARYNGEAL TONSIL 1 2. TU)AL TONSILS 1 3. PALATINE TONSILS 1 3. LINGUAL TONSIL 1 2.

PALATINE TONSIL
7 IMMUNOLOGY
FUNCTION 7 HEMATOPOIETIC 7 NEURO4RECEPTOR

CRYPTOLYMPHON
CAPILLARIES RETICULATED EPITHELIUM WITH FOLLICLES

SPACES OF THE LACUNE

INTRAEPITHELIAL PASSAGE

CLASSIFICATION of the TONSILLITIS


I. ACUTE (#n,in#%5
A. Pri #r/5 3 *#t#rrh#'6 3 fo''i*"'#r6 3 '#*"n#r6 3 "'*ero e 7r#no"(.

CLASSIFICATION of the TONSILLITIS


I. ACUTE (#n,in#%5 ). Se*on$#r/5
8% ton(i''iti( #t the infe*tio"( $i(e#(e( 4 $i-htheri#6 3 t"'#re i#6 3 t/-h"(6 7% ton(i''iti( #t the he #to'o,i* $i(e#(e( 4 onon"*'eo(i(6 3 #,r#n"'o*/to(i(6 3 'e"9e i#.

CLASSIFICATION of the TONSILLITIS


II. CHRONIC5
:. S-e*ifi*5
#t t"7er*"'o(i(; (/-hi'i(; (*'ero #.

). Non(-e*ifi* ((t#,e(%:
8% *o -en(#tion6 7% $e*o -en(#tion .

COMPLICATION of the TONSILLITIS


P#r#ton(i''iti( P#r#ton(i''#r #7(*e(( Ph'e, on# of the ne*9 Ton(i''o,eno"( e$i#(tiniti( Ton(i''o,eno"( (e-(i(

CHRONIC TONSILLITIS
SYMPTOMS5 2. Re$ne(( of the ton(i''#r -i''#r( of free e$,e. 3. E$e # of the ton(i''#r -i''#r( of free e$,e.

CHRONIC TONSILLITIS
SYMPTOMS5
<. Ci*#tri.e( 7et!een ton(i''#r -i''#r( #n$ -#'#tine ton(i'(. =. Re,ion#' '/ -ho$eniti(.

CHRONIC TONSILLITIS
SYMPTOMS5
>. Ton(i''#r -'",( in(i$e of '#*"ne(.

CHRONIC TONSILLITIS (STAGE%


I. COMPENSATION 1
LOCAL SYMPTOMS

II. DECOMPENSATION 4
LOCAL SYMPTOMS + LOCAL?GENERAL COMPLICATION

DECOMPENSATION STAGE

4 Re*"rrent ton(i''iti( 4 Rhe" o*#r$iti( 4 En$o*#r$iti( 4 A*"te or *hroni* ne-hriti( 4 Non(-e*ifi* #rtriti(

COMPENSATION STAGE

CONSER@ATI@E TREATMENT

DECOMPENSATION STAGE
SURGICAL TREATMENT

INDICATIONS for SURGICAL TREATMENT


LOCAL SYMPTOMS of the CHRONIC TONSILLIS + 5 2. FreA"ent ( ore th#n < ti e( # /e#r% #*"te ton(i''iti( !ith fe&er. 3. FreA"ent ( ore th#n < ti e( # /e#r% #*"te ton(i''iti( !ith fe&er #n$ o**"rren*e of the *o -'i*#tion #fter #,,r#&#tion ( rhe" o*#r$iti(; en$o*#r$iti(; ne-hriti(; #rtriti( et*%.

INDICATIONS for SURGICAL TREATMENT


LOCAL SYMPTOMS of the CHRONIC TONSILLIS + 5
<. After o**#(ion#' #*"te ton(i''iti( ( 2 ti e in >4B /e#r(% to $e&e'o- the *o -'i*#tion (rhe" o*#r$iti(; en$o*#r$iti(; ne-hriti(; #rtriti( et*%. =. C#(e( of #*"te ton(i''iti( !erenCt; 7"t #re $i(e#(e( of the he#rt; Doint(; 9i$ne/( #n$ 'o*#' (/ -to ( of the *hroni* ton(i''iti( #n$ i( the re'#tion(hi- 7et!een #,,r#&#tion of the *hroni* ton(i''iti( #n$ the(e $i(e#(e(.

INFLUENCE OF THE TONSILS ON ORGANISM


Afferent To.e i# )#*terio,eni*#' I "no4#'er,i*#'

Ne"ro4ref'e. *o -onent CNS; h/-oth#'# "( C@S Uro,enit#' (/(te G#(trointe(tin#' (/(te

Fo.i* *o -onent

Immunological *o -onent
Di(7#'#n*e of the i "ne (/(te E (/nte(i( of the i "ne *o -'e.e(E in*re#(e of the *he ot#.i( E '/(i( of the o!n ti(("e( E #nti7o$ie( to the o!n ti(("e(

TONSILOGENOUS INTOXICATION 1 $e*o -en(#tion of the *hroni* $i(e#(e(

PHARYNGEAL TONSIL
(in *hi'$ren%
H/-ertro-h/; #$enoi$iti( N#(#' &io'#tion of 7re#thin, @io'#tion of inte''e*t"#' $e&e'o- ent

Inf'# #tor/ $i(e#(e( of the no(e; n#(#' (in"(e(; W#'$e/erC( rin,

En"re(i(

ADENOID @EGETATIONS

ADENOID @EGETATIONS

EPYPHARINGITIS

SYNDROM O)STRUCTI@E SOMNOLENT APNOE

PHARYNGITIS
G.ACUTE. GG.CHRONIC5
4 C#t#rrh#'. 4 H/-ertro-hi*. 4 Atro-hi*.

I WISH YOU TO BE HEALTHY!!!

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