1、Anatomy and physiologyAcute and chronic pharyngitisAcute and chronic tonsillitisTonsillectomyA n a t o my a n d p h y s i o l o g yJournal of the Association for Research in Otolaryngology Clinical otolaryngologyCurrent opinion in otolaryngology&head and neck surgeryThe LaryngoscopeJ o u r n a l o f
2、 t h e A s s o c i a t i o n f o r咽pharynx n.swallow v.咽p h a r y n x n.咽解剖咽炎扁桃体炎(英文版)-课件咽解剖咽炎扁桃体炎(英文版)-课件咽解剖咽炎扁桃体炎(英文版)-课件nasopharynxoropharynxlaryngopharynxn a s o p h a r y n x o r o p h a r y n x l a r y n g o p h咽解剖咽炎扁桃体炎(英文版)-课件nasopharynxn a s o p h a r y n xnasopharynxnasal septalpharyngeal
3、openingpharyngeal recessadenoidinferior turbinatemiddle turbinatesuperior turbinaten a s o p h a r y n x n a s a l s e p t a l p h a r y n gnasopharynxn a s o p h a r y n xoropharynxo r o p h a r y n xoropharynxuvulatonsilglossopalatine archpharyngopalatine archo r o p h a r y n x u v u l a t o n s
4、i l g l o s s o p a llaryngopharynxl a r y n g o p h a r y n xlaryngopharynxpostcricoid spacepyriform sinusl a r y n g o p h a r y n x p o s t c r i c o i d s p a c咽解剖咽炎扁桃体炎(英文版)-课件咽解剖咽炎扁桃体炎(英文版)-课件咽解剖咽炎扁桃体炎(英文版)-课件vallecula epiglotticav a l l e c u l a e p i g l o t t i c a咽解剖咽炎扁桃体炎(英文版)-课件retropha
5、ryngeal spacer e t r o p h a r y n g e a l s p a c e咽解剖咽炎扁桃体炎(英文版)-课件Waldeyers tonsillar ringpharyngeal lymphoid ringWaldeyers lymphatic ringWa l d e y e r s t o n s i l l a r r i n g p h a r y咽解剖咽炎扁桃体炎(英文版)-课件adenoidspresent at birthphysiological enlargement at 6atrophy from 10-20a d e n o i d s p
6、r e s e n t a t b i r t hdeep cleftsno cryptsd e e p c l e f t s n o c r y p t sTonsilSides of oropharynx between palatoglossaland palatopharyngeal archesT o n s i l S i d e s o f o r o p h a r y n x b e t wlong,branched cryptsl o n g,b r a n c h e d c r y p t sswallowing speechbreathingventilationi
7、mmuneprotections w a l l o w i n g s p e e c hb r e a t h i n gvA c u t e P h a r y n g i t i sVirusBacteriumEnvironmentacute pharyngitisV i r u s e t i o l o g y a c u t e p h a r y n g i t i sVirus BacteriumEnvironmentacute pharyngitisCoxackie virusadenovirusrhinovirusclose contactV i r u s e t i
8、o l o g y a c u t e p h a r y n gVirusBacteriumEnvironmentacute pharyngitisacute septic pharyngitis Group A streptococcusV i r u s e t i o l o g y a c u t e p h a r y n g i t i sVirusBacteriumEnvironmentacute pharyngitisvarious irritationV i r u s e t i o l o g y a c u t e p h a r y n g i t i sc l i
9、 n i c a l f e a t u r e sChildren prodrome or concomitantAdults acute rhinitis,acute tonsillitismealses,scarlet fever,influenzaC h i l d r e n p r o d r o me o r c o n cacutepharyngalgiaasystematicself-healableS y mp t o ms a n d S i g n s a c u t eRednessPurulenceEdemawhite punctate exudateR e d n
10、 e s s P u r u l e n c e E d e ma w h i t e p u n咽解剖咽炎扁桃体炎(英文版)-课件contagious diseasesgeneral diseasesthroat swabD i a g n o s i s c o n t a g i o u s d i s e a s e s t hlocal:warm saline gargles,Dobell solutionsystemic:bed rest,plenty of fluids,warm saline gargles,antibioticsChinese traditional medi
11、cineT r e a t me n t l o c a l:w a r m s a l i n e gC h r o n i c P h a r y n g i t i s C h r o n i c P h a r y n g i t i slocalgeneralchronic pharyngitisl o c a l e t i o l o g y c h r o n i c p h a r y n g i tlocalgeneralchronic pharyngitisl o c a l e t i o l o g y c h r o n i c p h a r y n g i tl
12、ocalgeneralchronic pharyngitisl o c a l e t i o l o g y c h r o n i c p h a r y n g i tvariableasystematicdiscomfort or pain in the throatforeign body sensation in throattiredness of voicecoughs y mp t o ms v a r i a b l e d i s c o mf o r t o r simple catarrhal pharyngitiss i g n s s i mp l e c a t
13、 a r r h a l p h a r y n g ihypertrophic pharyngitiss i g n s h y p e r t r o p h i c p h a r y n g i t i s咽解剖咽炎扁桃体炎(英文版)-课件chronic pharyngitis城门失火，殃及池鱼。D i a g n o s i s c h r o n i c p h adifficulttreatmentaetiological factor:to be sought and eradicated.warm saline garglesChinese traditional medic
14、ine:bamboo leavesd i f f i c u l t t r e a t me n t a e t i o l o g i c a lcase study Simon is a 29-year-old unemployed actor who has noted a feeling of a lump in the throat for the past 6 months.He says,It feels like a pill has got stuck and points to the area just below his larynx.His symptoms com
15、e and go.Although food has never become stuck,he says that he sometimes finds itdifficult to swallow his saliva.His grandfather died of carcinoma of the lung recently,and he admits that he is afraid that he has cancer.Examination is normal throughout.1 What is the most likely diagnosis?2 What other
16、features should be sought on directenquiry?3 Should any investigations be organized?If so,what?c a s e s t u d y S i mo n i s a 2 9-y e a r-case study Simon is a 29-year-old unemployed actor who has noted a feeling of a lump in the throat for the past 6 months.He says,It feels like a pill has got st
17、uck and points to the area just below his larynx.His symptoms come and go.Although food has never become stuck,he says that he sometimes finds itdifficult to swallow his saliva.His grandfather died of carcinoma of the lung recently,and he admits that he is afraid that he has cancer.Examination is no
18、rmal throughout.1 What is the most likely diagnosis?2 What other features should be sought on directenquiry?3 Should any investigations be organized?If so,what?c a s e s t u d y S i mo n i s a 2 9-y e a r-case study Simon is a 29-year-old unemployed actor who has noted a feeling of a lump in the thr
19、oat for the past 6 months.He says,It feels like a pill has got stuck and points to the area just below his larynx.His symptoms come and go.Although food has never become stuck,he says that he sometimes finds itdifficult to swallow his saliva.His grandfather died of carcinoma of the lung recently,and
20、 he admits that he is afraid that he has cancer.Examination is normal throughout.1 What is the most likely diagnosis?2 What other features should be sought on directenquiry?3 Should any investigations be organized?If so,what?c a s e s t u d y S i mo n i s a 2 9-y e a r-咽：鼻咽，口咽，喉咽咽隐窝咽淋巴环咽旁间隙，咽后隙会厌谷咽：
21、鼻咽，口咽，喉咽A c u t e T o n s i l l i t i sA c u t e T o n s i l l i t i sBeta hemolytic streptococcusanaerobic bacteriummild infectious!e t i o l o g y B e t a h e mo l y t i c s t r e p t osore throatdifficulty in swallowing refuse to eatfever 38-40 degreeearache either referred or acute otitis mediac
22、onstitutional symptoms headache,malaises y mp t o ms s o r e t h r o a thyperaemiapurulences i g n s h y p e r a e mi asore throatdifficulty in swallowingpyrexiageneral malaised i a g n o s i s s o r e t h r o a thalitosislymphadenopathyexudative inflammationenlargement of the tonsilsd i a g n o s i
23、 s h a l i t o s i sbed rest,plenty of fluidsanalgesics:aspirin or paracetamolantimicrobial therapyt r e a t me n t b e d r e s t,p l e n t y o f fchronic tonsillitisperitonsillar abscessparapharyngeal abscesscervical abscessc o mp l i c a t i o n s c h r o n i c t o n s i l l i tacute otitis mediar
24、heumatic feveracute glomerulonephritis:rare these dayssubacute bacterial endocarditisc o mp l i c a t i o n s a c u t e o t i t i s me d ip e r i t o n s i l l a r a b s c e s squinsyp e r i t o n s i l l a r a b s c e s s q u i n s y咽解剖咽炎扁桃体炎(英文版)-课件tonsil is pushed mediallydisplacement of uvulamor
25、e unwelltrismusf e a t u r e s t o n s i l i s p u s h e d me d i aantibiotics+steroidsI&Dt r e a t me n t a n t i b i o t i c s+s t e r o i d sJohnny Appleseed“Type a quote here.”J o h n n y A p p l e s e e d“T y p e a q u o t eretropharyngeal abscessinfantsstiff neckpalpable neck painfeverdifficul
26、ty swallowingstridorenlarged cervical lymph noder e t r o p h a r y n g e a l a b s c e s s i n f a n t sretropharyngeal abscessr e t r o p h a r y n g e a l a b s c e s sC h r o n i c T o n s i l l i t i sC h r o n i c T o n s i l l i t i srecurrent historyD i a g n o s i s r e c u r r e n t h i s
27、t o r yT o n s i l l e c t o myabsolute indicationssuspected malignancyas part of another procedurechild with obstructive sleep apnoea syndromei n d i c a t i o n s a b s o l u t e i n d i c a t i o nrelative indicationsrecurrent acute tonsillitischronic tonsillitisprevious quinsy(once or twice prev
28、iously)febrile convulsionsi n d i c a t i o n s r e l a t i v e i n d i c a t i o nbleedingextremely painfulreferred otalgia is commonp o s t o p e r a t i o n b l e e d i n g1 Positioning the patient2 Inserting a BoyleDavis gag3 Dissecting the tonsils4 HaemostasisSURGICAL STEPSS U R G I C A L S T E
29、 P S1 Positioning the patient2 Inserting a BoyleDavis gag3 Dissecting the tonsils4 HaemostasisSURGICAL STEPSS U R G I C A L S T E P S1 Positioning the patient2 Inserting a BoyleDavis gag3 Dissecting the tonsils4 HaemostasisSURGICAL STEPSS U R G I C A L S T E P S1 Positioning the patient2 Inserting a
30、 BoyleDavis gag3 Dissecting the tonsils4 HaemostasisSURGICAL STEPSS U R G I C A L S T E P S咽解剖咽炎扁桃体炎(英文版)-课件18 years old student,sore throat and lethargy PE:bilateral tonsils II degree with white membrane,cervical lymp nodesa acute pharyngitisb acute laryngitisc acute laryngopharyngitisd acute tonsi
31、llitise quinsyf grandular feverb e s t s i n g l e c h o i c e 1 8 y e a r s o l d21 years old man,emergency,left pain in throat,otalgia.PE:trismus,left tonsil shifted to median.a acute pharyngitisb acute laryngitisc acute laryngopharyngitisd acute tonsillitise quinsyf grandular feverb e s t s i n g
32、 l e c h o i c e 2 1 y e a r s o l d5 years old girl,sore throat for 3 days,increasing earache.PE:hyperemia in oropharynx,pus on the surface of tonsils a acute pharyngitisb acute laryngitisc acute laryngopharyngitisd acute tonsillitise quinsyf grandular feverb e s t s i n g l e c h o i c e 5 y e a r s o l d Johnny Appleseed“Type a quote here.”J o h n n y A p p l e s e e d“T y p e a q u o t e
