What are tonsils used for

Many people have a vague understanding of tonsils and therefore often neglect to protect them. Tonsils are located at the intersection of the respiratory tract and the digestive tract, and play a great role in physical health. People who often like to eat spicy and irritating foods and work in language-related jobs often cause greater damage to their tonsils, which can easily cause tonsillitis or swelling. So what should we do?

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Tonsils are located at the junction of the digestive tract and the respiratory tract. The mucous membrane here contains a large amount of lymphoid tissue, which is a site that often comes into contact with antigens and causes local immune responses. A mass of lymphoid tissue beneath the epithelium of the oropharynx. There are several groups of lymphoid tissues under the epithelium around the root of the tongue and pharynx, which are called palatine tonsils, pharyngeal tonsils and lingual tonsils according to their location.

Function

The palatine tonsils are the largest, and the tonsils commonly referred to are the palatine tonsils. There is a pair of palatine tonsils, located between the lingual palatine arch and the pharyngeal palatine arch. They are oval in shape and covered with stratified squamous epithelium. The epithelium sinks into the tonsil to form 10 to 20 crypts, which contain desquamated epithelial cells, lymphocytes, and bacteria. Lymph nodules and diffuse lymphoid tissue are densely distributed beneath the epithelium and around the crypts. Lymphocytes often pass through the epithelium and deposit in the oropharynx. The tonsil capsule is a layer of dense connective tissue that separates the palatine tonsils from adjacent organs and acts as a barrier to prevent the spread of palatine tonsil infection.

Tonsils can produce lymphocytes and antibodies, so they have anti-bacterial and anti-viral defense functions. The pharynx is the only way for food and air to pass through and is prone to hiding germs and foreign objects if it is frequently touched. The rich lymphatic tissue and tonsils in the pharynx perform the task of defending and protecting this special area of ​​the body. However, this area is also susceptible to infection and invasion by bacteria such as hemolytic streptococci, staphylococci and pneumococci. These bacteria are normally found in the crypts of the human pharynx and tonsils. Under normal circumstances, due to the integrity of the tonsil surface epithelium and the continuous secretion of mucous glands, bacteria can be discharged from the crypt opening along with the shed epithelial cells, thus maintaining the health of the body. When the body's resistance is reduced due to excessive fatigue, cold, etc., the epithelial defense function is weakened, and the glandular secretion function is reduced, the tonsils will be infected by bacteria and become inflamed. If tonsillitis recurs and has adverse effects on the whole body, the tonsils should be removed surgically after careful consideration of the consequences.

Structural classification

Palatine tonsils

The palatine tonsils are oval in shape, with one mucosal surface covered with stratified squamous epithelium, which sinks into the lamina propria to form crypts with 10 to 30 branches. There are a large number of diffuse lymphoid tissues and lymph nodules in the lamina propria surrounding the crypts. The stratified squamous epithelium deep in the crypt contains many T cells, B cells, plasma cells and a small number of macrophages and Langerhans cells, which is called the epithelial infiltrate. There are also some post-capillary venules in the epithelium, which are the main channels for lymphocytes to enter and exit the epithelium. There are many tunnel-like intercellular channels between epithelial cells. Some superficial channels open directly to the surface, and some channel openings are covered with a flat microfold cell (microfold cell, Mcell). Epithelial spaces are populated by T cells, which migrate and replace frequently. Intraepithelial plasma cells are often distributed near fenestrated capillaries, facilitating the secreted antibodies to enter the bloodstream. The palatine tonsils of children are more developed, and their lamina propria contain a large number of diffuse lymphoid tissue and lymph nodules. Their number and degree of development are closely related to antigen stimulation. B cells in tonsil lymphoid tissue account for 60% of the total lymphocytes, T cells account for 38.5%, and there are a small number of K cells and NK cells. There are more T cells in the diffuse lymphoid tissue, as well as scattered plasma cells, B cells and some post-capillary venules. Lymph nodules are often numerous and large, indicating that the tonsils have a close relationship with the body's humoral immune function. There are also some small lymphatic vessels in the lamina propria, through which lymphocytes can enter the lymph.

Pharyngeal tonsils

Pharyngeal tonsils, also known as adenoids, are located on the posterior wall of the pharynx. The surface is covered with pseudostratified ciliated columnar epithelium and has no crypts. The mucosa forms some longitudinal folds, there are many lymphoid tissues in the lamina propria, lymphocyte infiltration is also common in the epithelium, and the epithelium in the infiltrated part often becomes stratified squamous epithelium.

Lingual tonsils

The lingual tonsils are located at the base of the tongue and the anterior wall of the pharynx. The surface is covered with stratified squamous epithelium and some shallow crypts. There are lymphocyte infiltrations in the epithelium, and some lymph nodes and diffuse lymphoid tissue in the lamina propria, which often make the tongue mucosa move toward the surface.

symptom

It is often accompanied by symptoms such as chills, fever, and headache, and is a common disease among children and adolescents. Chronic tonsillitis is caused by repeated attacks of acute tonsillitis, which is manifested by dry throat, a feeling of blockage, sticky secretions that are difficult to cough up, and bad breath. Its repeated attacks can induce other diseases, such as chronic nephritis, arthritis, rheumatic heart disease, etc., so it must be actively treated. Patients should exercise regularly, strengthen their physical fitness, pay attention to oral hygiene, promptly treat diseases of nearby tissues, eat a light diet, avoid spicy and irritating foods, and quit smoking and drinking. Once the disease becomes a lesion that induces other diseases, or there are other surgical indications, surgical treatment should be considered. Tonsillitis is equivalent to the category of "Rumo" in traditional Chinese medicine. Acute tonsillitis is equivalent to "wind-heat Rumo", and chronic tonsillitis is equivalent to "virtual fire Rumo". Wind-heat phthisis is mostly caused by sudden climate change, imbalance of cold and heat, and weak lung defense, which causes wind-heat evil to take advantage of the opportunity to invade the throat through the mouth and nose, or due to excessive consumption of tobacco and alcohol, which causes heat in the spleen and stomach, or due to improper treatment of exogenous wind-heat, which causes evil to take advantage of the heat to spread to the lungs and stomach, burning the throat and causing this disease; virtual-fire phthisis is mostly caused by wind-heat phthisis or residual toxins after febrile disease, which causes evil heat to consume lung yin, or due to yin deficiency in the body, coupled with excessive fatigue, kidney yin deficiency, virtual fire inflammation, and steaming the throat, causing this disease. Common clinical syndromes include:

Common types: wind-heat in the lung meridian, heat accumulation in the lung and stomach, internal heat and toxicity, ascending fire, kidney yin deficiency, etc.

Common treatment methods: tea therapy, diet therapy, resection surgery, etc.