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Video transcript

when a person opens their mouth there's a lot of different things that you can see of course you know the teeth the lips the tongue you can see the back of the throat and this little dangling thing attached to the roof of your mouth which is known as the uvula but there's a couple other things in here that you might not notice very commonly in fact one of the most important organs that help fight off infection are found in the mouth and these are the tonsils the tonsils are commonly overlooked when you open up your mouth and that's probably because they're often small and hiding in between two arches these tonsils right here known as the Palatine tonsils due to their location near the palate or the roof of the mouth are often small when we become adults however in kids they're a little bit larger and they're used to help fight off infections now how do they do that well you'll notice these tonsils have these little crevices that I've drawn in here these little crevices are known as crypts these little crypts or crevices are tiny little traps and allow different things to get stuck in them for example saliva food it's probably most accurate to refer to these as traps because they'll trap all this food and often these little traps can trap bacteria or viruses that may have been traveling in little droplets so for example if somebody sneezes little droplets with virus or bacteria may be able to get into the mouth or they may enter through contact if a patient touches something infected and touches their mouth but once these tonsils have trapped this bacteria or virus the immune system is called to action these tonsils carry different immune cells that are used to fight off infection so they're very important in acquiring immunity from these infections however if the tonsils become infected themselves if the bacteria or the virus goes out of control and can't be stopped by the immune system then these tonsils may grow in size and become swollen this is known as tonsillitis inflammation of the tonsils itis refers to inflammation and swelling and of course tonsil means tonsils all this trapping and filtering of germs leads the tonsils especially prone to infection and so this can actually be a common occurrence in children particularly children about 3 to 7 years old as their immune system is still developing and also because they're touching different things and exploring different things and around other kids who may have infections they are more likely than adults to develop tonsillitis now to give you an idea where the tonsils are they're between two arches and the first of which I'm highlighting right here this arch in the front is known as the palate o glossa larch palate o meaning the palate of the mouth the roof of the mouth and glossa refers to the glosses which is the latin term for tongue so an arch that connects the roof of the mouth to the tongue so the tonsils hide between this arch and this other arch in the back which is known as the palate o4r in geol arch palate o again referring to the roof of the mouth and pharyngeal referring to the throat the pharynx pharynx is the back of the throat actually kind of as a side note tonsillitis can coincide with pharyngitis if the inflammation gets into the back of the throat then patients will have tonsil o pharyngitis inflammation of the tonsils and the back of the throat now there's also another set of tonsils that aren't visible in the mouth these guys and I'll move over here for this are located near the nasal passage and this actually makes a lot of sense when bugs and germs enter the mouth we want them to encounter this first line of defense the tonsils and those would be the Palatine tonsils but also if we inhale through our nose we want the germs to encounter tonsils as well so not only do we have the Palatine tonsils right here but we also have tonsils in our nasal passage back over here these are sometimes referred to as the pharyngeal tonsils because they're in the back of the throat but more commonly they're called the adenoids so they act to fight germs that get through the nasal passage and along with getting red and inflamed and enlarged these tonsils when they become enlarged notice they can potentially block the nasal passage making it difficult to breathe air in through the nose so redness inflammation and enlargement of the tonsils may mean tonsillitis another symptom that patients may have is called a tonsillar exudate annex a day is a whitish or yellow fluid that can be found on the tonsils during an infection this tonsillar exudate is from the immune system trying to fight off bacteria or a virus and in the process cells of the immune system release chemicals that both cause damage to pathogens and damage to cells of our body some of the chemicals that the immune system release also open up blood vessels and since tonsils are very vascular this allows extra flow of fluid into the tonsils so a mix of this extra fluid accumulating along with cellular debris and and viral or bacterial debris is called an exudate so what are the bugs and germs that cause tonsillitis well the most common cause of tonsillitis is from viral infections the viruses that are commonly implicated in tonsillitis are the viruses also implicated in the common cold these include Rhino virus Rhino think of nose of a rhino adenovirus right you can think adenoids the adenovirus can cause it coronavirus a corona you can think of a crown so something having to do with the head and also para influenza and influenza and a couple others in fact there are many different viruses that can cause the common cold these are just a couple common ones that I'm naming and that's actually why it's difficult to develop a vaccine to cure the common cold because there's many different viruses that cause it and though viruses are the most common cause of tonsillitis it's the bacteria that we often worry about in adults a bacterial infection is much less likely about 90% of tonsillitis if it's caused and adults are from a virus however bacterial infections can be more common in children and there's one bug that's implicated that's especially nasty this bacteria is known as streptococcus pyogenes also known as group a strep or more commonly group a strep can be referred to as a strep throat so a strep throat may be pharyngitis infection of the back of the throat along with tonsillitis so group a strep commonly causes tonsil o pharyngitis and i highlight this bacteria because it's particularly known to cause some interesting complications one of the more severe complications that can coincide with tonsillitis is known as a peritonsillar abscess peritonsillar abscess an abscess is a collection of fluid that contains very nasty infective material and because it's a collection of fluid it's actually very hard for the immune system to get at it so abscesses need to be drained otherwise the infection may continue unimpeded by the immune system so peritonsillar means near the tonsils so an abscess developing near the tonsils this can be very serious because it develops quickly and can make breathing difficult can cause severe pain severe infection with very high fever and what's worse this peritonsillar abscess let's say this is an abscess can spread behind the tissue to different parts of the body normally tonsillitis is limited to the surfaces of the mucosa or the surfaces of the throat mouth and nasal passage but if the abscess develops behind this tissue behind this mucosa also known as this wet surface then it can travel into other spaces and thus appear tonsillar abscess really needs to be seriously considered and should be drained immediately a group a strep infection can also lead to some other severe complications which may affect the heart the joints or the nervous system which would be the brain and the spinal cord another complication that can develop after a strep throat infection is damage to the kidneys which can lead to high blood pressure or bloody urination now for viruses treatment is supportive but with the bacterial infection antibiotics can be given and the good news is if antibiotics are given during a group strep infection then it can prevent these serious complications from occurring and so antibiotics should be given and taken for the full course of the treatment otherwise these symptoms although rare may develop