PALATINE TONSIL

TOMSON THOMAS
PG STUDENT
ORAL PATHOLOGY
Palatine tonsils are two oval masses of lymphoid tissue
which represents the largest accumulation of
lymphoid tissue in the Waldeyers ring .

Waldeyers lymaphatic ring
SITUATION: THE PALATINE TONSILS OCCUPY
THE TONSILLAR SINUS OR FOSSA BETWEEN THE
DIVERGING PALATOGLOSSAL AND
PALATOPHARYNGEAL ARCHES.
SURFACE MARKING
SIZE:
Variable, 10-15 mm in transverse diameter
and 20-25 mm in vertical dimension.
FEATURES
Two surfaces
Two poles
Two borders
Medial surface

It is lined by stratified squamous non keratinising
epithelium which dips into
the crypts

The crypts are 12-15 in number

Secondary crypts arise from the primary crypts and
extend into the substance of the tonsil

On of the crypts located in the upper part are larger than
the rest crypta magna


The crypts serve to increase the surface area of the tonsil

The crypts may be filled witth cheesy material
epithelial debris, food particles and bacteria

Lateral surface

It is covered by the fibrous capsule of the tonsil

The tonsillar bed is separated from the capsule by loose areolar tissue

This makes it is easy to dissect the tonsil from its bed during tonsillectomy

It is the site of collection of pus in peritonsillar abscess (quinsy)

Some fibers of palatoglossus and palatopharyngeus gets attached
to capsule of tonsil

Bed of tonsil

It is formed by the 2 muscles

Superior constrictor

Styloglossus

Upper pole

It extends into the soft palate

There is a semilunar fold of mucous membrane which covers the
medial part of the upper pole

It extends from anterior pillar to posterior pillar

It encloses a potential space supratonsillar fossa

Lower pole

It is attached to the tongue

A triangular fold of mucous membrane extends from the
anterior tonsillar pillar to the lower pole

It encloses a space anterior tonsillar space

The lower pole is separated from the tongue by the tonsillo-lingual sulcus

This sulcus may harbour carcinoma

BLOOD SUPPLY
Three arteries enter the lower pole of tonsil:
-Tonsilar branch of facial artery
-Tonsilar branch of dorsalis lingual artery
-Tonsilar branch of ascending lingual artery

Two arteries enter the upper poleof tonsil:
-Tonsilar branch of lesser palatine artery
-Tonsilar branch of ascending pharyngeal artery
Venous drainage

Blood from the tonsil drains into the paratonsillar vein which in turn
drains into the common facial vein and pharyngeal venous plexus

Lymphatic drainage

Lymphatics from the tonsil pierce the superior constrictor and drain
into the upper cervical lymph nodes especially jugulodigastric (tonsillar)
lymph node

Enlarged non tender jugulodigastric lymph node is a sign of
chronic tonsillitis

Nerve supply

Lesser palatine branch of sphenopalatine ganglion

Glossopharyngeal nerve

PS: Palatine / External palatine / Paratonsillar vein
HISTOLOGY OF PALATINE TONSIL
covered with stratified squamous epithelium and
separated from the pharynx by a capsule of dense
irregular connective tissue.
Septa from the capsule project deeply into the
tonsil in regions between crypts.
The entire space between the capsule and the
epithelium (lamina propria) is filled with
lymphocytes
Functions of tonsil

It has a protective function in that it prevents entry of pathogens
through the nasal and oral route

The crypts on the surface of the tonsil serve to increase the
surface area and increase the efficiency of protection against pathogens

It forms a part of Waldeyers lymphatic ring

APPLIED ANATOMY

Tonsils prevent infection.
Infected tonsils act as septic focus
Damage of paratonsillar vein during tonsillectomy leads to
excessive venous haemorhhage
Damage to glossopharygeal nerve leads to loss of taste sensation
Infected tonsillar pain may be referred to middle ear because of
Same nerve supply
ACUTE TONSILITIS
FOLLICULAR TONSILITIS
KISSING TONSILITIS
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