PART 14 — PHARYNX & TONSILS

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Study use: Rapid revision of pharyngeal anatomy, Waldeyer ring, tonsillar and adenoid disease, deep-neck infections, pharyngeal infections, nasopharyngeal/oropharyngeal malignancy, pyriform-sinus injury, and Zenker diverticulum. Management is intentionally concise and should be interpreted with airway status, age, infection severity, anatomy, pathology, and specialist assessment.

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Priority Guide: 🔴 Core / Must Know | 🟠 Important | 🟡 Additional

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🎯 High-Yield Overview

• Pharynx extends from the skull base to the lower border of cricoid cartilage at about C6.
• Hypopharynx = posterior pharyngeal wall + pyriform sinus + postcricoid region; vallecula is not a hypopharyngeal subsite.
• Waldeyer ring = pharyngeal/adenoid + tubal + palatine + lingual tonsils.
• Palatine tonsil: crypta magna, tonsillar branch of facial artery, and CN IX relation are classic anchors.
• Adenoid hypertrophy → mouth breathing + snoring + hyponasal speech + high-arched palate/adenoid facies + OME/CHL.
• GAS pharyngitis → fever + tonsillar exudate + tender anterior cervical nodes + absence of cough; penicillin/amoxicillin is the classic treatment.
• Quinsy → hot-potato voice + trismus + uvula pushed away.
• Retropharyngeal abscess → young child + posterior pharyngeal bulge/neck stiffness; danger = airway compromise + mediastinitis.
• Diphtheria → adherent gray membrane that bleeds + bull neck; antitoxin is urgent.
• Nasopharyngeal carcinoma → EBV + Rosenmüller fossa + painless neck node + unilateral OME/CHL.
• HPV-related oropharyngeal SCC classically involves tonsil/base of tongue.
• Zenker diverticulum → Killian dehiscence + dysphagia + regurgitation + halitosis.

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RED FLAGS: Stridor, drooling, respiratory distress, rapidly progressive neck swelling, toxic appearance, severe trismus, inability to handle secretions, or deep-neck infection → airway first. Persistent unilateral tonsillar/pharyngeal mass or neck node requires malignancy assessment.

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1. PHARYNX ANATOMY & WALDEYER RING

2. PALATINE TONSIL, ADENOIDS & TONSILLECTOMY

3. ACUTE PHARYNGITIS, CHRONIC TONSILLITIS & INFECTIOUS MONONUCLEOSIS