《耳鼻喉科学 Otolaryngology》课程教学课件（PPT讲稿）pharynx and larynx_14.Abscess in relation to pharynx Carcinoma of nasopharynx

Abscess in relation to pharynx

Abscess in relation to pharynx

Peritonsillar abscess(Quinsy)Itisa collectionofpusintheperitonsillarspace which lies between the capsule oftonsiland superior constrictormuscle.Itoriginate in the peritonsillartissueasperitonsillitisand culminatesintoperitonsillarabscess.Theabscessisusuallyunilateral

Peritonsillar abscess(Quinsy) It is a collection of pus in the peritonsillar space which lies between the capsule of tonsil and superior constrictor muscle. It originate in the peritonsillar tissue as peritonsillitis and culminates into peritonsillar abscess. The abscess is usually unilateral

AetiologyAcutetonsillitis mayarise de novowithout previous history of sore throatsItformsanintratonsillarabscesswhichthenbursts through thetonsillarcapsuletoset upperitonsillitis andthenanabscess

Aetiology  Acute tonsillitis may arise de novo without previous history of sore throats.  It forms an intratonsillar abscess which then bursts through the tonsillar capsule to set up peritonsillitis and then an abscess

Cultureofthepusfromtheabscessmayrevealpuregrowthofstrept.pyogenes, staph.aureus oranaerobicorganisms

 Culture of the pus from the abscess may reveal pure growth of strept.pyogenes, staph.aureus or anaerobic organisms

ClinicalfeaturesGeneral.Theyareduetosepticaemiaand resemble any acute infection. Theyincludefever,chills andrigors,generalmalaise,bodyaches,headachenauseaandconstipation

Clinical features  General. They are due to septicaemia and resemble any acute infection. They include fever, chills and rigors, general malaise, body aches, headache, nausea and constipation

Clinicalfeatures--Local*Severepaininthroat.UsuallyunilateralOdynophagia.Itissomarkedthatthepatientcannotevenswallow his ownsalivawhich dribblesfromtheangleofhis mouth. Patient is usually dehydrated

Clinical features-Local  Severe pain in throat. Usually unilateral.  Odynophagia. It is so marked that the patient cannot even swallow his own saliva which dribbles from the angle of his mouth. Patient is usually dehydrated

Muffledand thick speech, often calledhotpotatovoiceFoul breathduetosepsisintheoralcavityandpoorhygieneIpsilateralearache.This is referred painvia CN IX which supplies both the tonsilandear Trismus due to spasm of pterygoidmuscleswhichareincloseproximitytothesuperiorconstrictor

 Muffled and thick speech, often called “hot potato voice”  Foul breath due to sepsis in the oral cavity and poor hygiene  Ipsilateral earache. This is referred pain via CN IX which supplies both the tonsil and ear  Trismus due to spasm of pterygoid muscles which are in close proximity to the superior constrictor

Examination1.the tonsil, pillars and softpalate onthe involved side are congested andswollen.Tonsil itself may not appearenlargedasitgetburiedintheoedematous2.uvula is swollen and edema andpushedtotheoppositeside

Examination  1.the tonsil, pillars and soft palate on the involved side are congested and swollen. Tonsil itself may not appear enlarged as it get buried in the oedematous  2. uvula is swollen and edema and pushed to the opposite side