Accumulations of lymphoepithelial tissue in the nasopharynx of people - the tonsils and tonsils - are part of the immune system. But not any tonsils in the throat are formally correctly called glands. In total, 6 almond-shaped formations are distinguished, but of them the tonsils are only the palatine pair. In addition to them, there are also paired tubal, and unpaired lingual tonsil in the throat, pharyngeal adenoids. But, in order to understand why tonsils are needed in general, and why tonsils are needed in particular, one should consider all the functionality and tasks of this element of the immune system and the anatomical structure of the tonsils.
Structural features of the structure
The presence in the palatine porous lymphoepithelial formation of many lacunae explains what the tonsils are from the point of view of anatomy. Such depressions penetrating the structure - 10-20 lacunae in one formation - become traps for pathogenic microorganisms (viruses, bacteria, etc.) and a place for the immune system to "meet" potential microbial dangers from the outside. The entire almond structure in depth and on the surface contains follicles. In a healthy state, follicles and lacunae produce as many macrophages, plasmocytes and lymphocytes as necessary to kill the infection.
The result of the "fight" is an accumulation of pus, the composition of which includes dead cells and destroyed microorganisms.
Along the surface, the tonsils are covered with a capsule - a mucous membrane. On the reverse side, they are lined with a layer of periaminal fiber. With a complication of angina, if pus penetrates into the tissue of cellulose and capsules, a peritonsillar abscess is diagnosed.
Due to the innervating of education, almond inflammation is accompanied by pain. The blood supply is provided by the branches of the external carotid artery, which, with an exacerbation of the disease, is fraught with infection of the bloodstream, sepsis, the development of Lemierre's syndrome, streptococcal meningitis, etc.
Other lymphoepithelial formations also have their own specific structural characteristics:
- Pharyngeal (Lushka's tonsil). Represents several transverse folds of the mucous membrane, covered with ciliated epithelium.
- Lingual. Has a median groove, which divides the formation in the middle into two halves. The surface is bumpy with small depressions, at the bottom of which are the ducts of the salivary glands.
- Pipe. Differ from others in smaller size. They consist of diffuse lymphoid tissue with a small number of lymphoid nodules.
Thus, the tonsils are a kind of anatomical traps for biopathogens, which are located on the "first line of defense", which requires lymphoepithelial barriers on all pathways of possible infection.
Classification and location
Tonsils - their structure and function - make it possible to form a classification simultaneously according to several parameters. So, classification with numbering assumes division into:
- paired, which are represented by palatine (1st, 2nd) and trumpet (5th, 6th),
- unpaired, including the pharyngeal (3rd) lingual (4th).
A slight accumulation of lymphoepithelial tissue on the posterior throat wall, together with almond formations, form the so-called Valdeer-Pirogov lymphadenoid ring.
- Palatine. The most famous among the people are tonsils-tonsils, the location of which can be determined visually by looking into an open mouth. Between the 2 palatine arches in the tonsillar niches where the tonsils are located, one can notice symmetrical formations that resemble two small acorns (this is how the word "tonsils" is translated from Latin). There is a tongue between them along the axis of symmetry. The free surface of the tonsils are directed towards the pharynx and are covered with epithelium. On the other hand, the tonsils are fused with the walls of the capsule with the pharyngeal lateral surface.
- Pharyngeal (nasopharyngeal). These adenoid vegetations are located on the fornix of the posterior wall of the nasopharynx. Normally, they are not visible in the mouth, but with a significant increase they can hang behind the tongue. In this state, enlarged adenoids greatly impede breathing, contribute to hearing impairment, and can cause the development of otitis media.
- Pipe. Not far from the nasopharyngeal are tubal formations. These small tonsils of the pharynx are located in the area of the pharyngeal opening - in the mouth of the auditory tube and the nasal cavity. Their inflammation can also cause the development of otitis media and hearing impairment.
- Lingual. Unpaired formation at the base (root) of the tongue. Inflammation in this area causes pain when swallowing and trying to speak.
Functions and tasks
Tonsils in humans are formed even before birth and actively develop until the age of 15-16. After the end of puberty, their growth slows down and the progressive process is replaced by a regressive process. The tonsils are responsible for the state of local immunity, and in young children, the tonsils are involved in hematopoiesis, and also contribute to the formation of enzymes involved in oral digestion.
The functions of the tonsils as part of the immune system can be divided into barrier and immunogenic.
- Barrier. The task comes down to the destruction of microorganisms that have entered the oral cavity with breath, food, or are already inside, which is possible with caries, chronic tonsillitis, periodontitis, gingivitis. Here, macrophages produced in follicles take an active role.
- Immunogenic. T- and B-lymphocytes maturing in follicles produce antibodies (various immunoglobulins), which are responsible for the immune response.
Depending on the route of infection and the weakening of local immunity, the actual value of the tonsils may vary. So tubal formations, for example, "protect" the hearing organs, the vestibular apparatus, and from them, to a greater extent than from other tonsils, depends how high the likelihood of ear diseases is and how quickly the apparatus will recover after a previous ear disease.
The tonsils can also affect the timbre of the voice, giving speech a characteristic shade. Therefore, people whose profession is related to the voice-forming function should take this fact into account when it becomes necessary to remove the tonsils. Many singers and announcers try their best to avoid surgery, relying on conservative methods.
Hypertrophied tonsils or enlarged adenoids can also cause the characteristic "French pronouns". However, at least one lucky case of the transformation of the timbre after suffering inflammation is also known. The actor Vasily Livanov acquired his famous recognizable voice, which voiced the roles of Gena Crocodile, Carlson, Sherlock Holmes and other characters, just after suffering severe inflammation.
The development of tonsil hypertrophy, chronic tonsillitis, paratonsillitis, snoring, hypertrophy of the pharyngeal tonsil is associated with pathologies in the tonsils.
Forced removal of the tonsils reduces the body's immune defenses, but in some cases - for example, in rheumatoid arthritis - even their removal does not eliminate the pathology by 100%, since the autoimmune inflammatory process can support itself.
Inflammation causes and symptoms
The most common cause of inflammation of lymphoepithelial formations is bacterial and viral infection, and, to a lesser extent, fungal infection. In addition to a chronic focus of infection and malfunctions in the periphery of the immune system, the anatomical features of the oropharynx can cause inflammation.
Thus, the curvature of the septum provokes "improper breathing", as a result of which the cold air does not have time to warm up, and the microorganisms present in it are not filtered out by other protective mechanisms.
In this regard, several preventive tips can be given to help avoid infection:
- When in contact with a sick person, stay at a safe distance sufficient to prevent infection by airborne droplets, and avoid using infected household items.
- Avoid hypothermia, vitamin deficiency, malnutrition.
- Monitor the condition of your teeth and mouth.
Symptoms of an infection of the tonsils can appear after a few hours and are manifested in:
- characteristic tickling,
- spread of pain that interferes with swallowing,
- a noticeable increase in glands and adenomas in size,
- general malaise with an increase in body temperature,
- manifestation of hoarseness with the spread of inflammation into the glottis.
Some symptoms are specific and depend on the form of tonsillitis. In the catarrhal form, the inflammatory process affects only the outer shell of the tonsils, which leads to redness and swelling, but is not always accompanied by an increase in temperature. In the absence of proper treatment, the catarrhal form passes into the stage of lacunar or follicular disease. In the first case, pus accumulates in the lacunae, resembling plugs. In the second, when viewed, white-yellow dots are noticeable, indicating the development of abscesses. Phlegmonous inflammation is accompanied by the spread of the infectious process beyond the tonsils and leads to the development of an abscess. His treatment is carried out in a hospital.
Inflammation of the adenoids, most often, is symptomatically different from inflammation of the lingual tonsil. In the first case:
- difficulty in nasal breathing
- there is a mucous and purulent discharge from the nose,
- probably the appearance of pain in the ears,
- the temperature often rises.
In case of inflammation of the lingual tonsils:
- swallowing function is impaired,
- there is pain and discomfort in the throat,
- a high temperature is recorded,
- pain increases when trying to move the tongue (when sticking out the tongue or during speech).
The acute inflammatory process that occurs in the lymphoepithelial formations is rather quickly replaced by the chronic form, therefore, it is recommended to start treatment as soon as the first symptoms appear. Exacerbations of chronic tonsillitis can occur several times a year, with an increased risk of infection of the heart, joints, and kidneys. With proper therapy, angina in an acute form is cured in a week and a half, and the treatment of a chronic form can take several months. There are, however, birth defects (eg, the third gland) that are considered safe and do not require special treatment.
