Partikel asing di mukus yang stag menempel pada adenoid
Streptococcus Group A bacteria
Memiliki lipoteichoic acid pada pili & F protein (fibronectin binding property)
-Culture test on lab result (+) -Gram staining indicated
Etiologi
Mucociliary clearance Repeated mechanism over the last 2 consecutive years -Squamous -Respiratory epithel Easily to become secondary infection (bacterial) Antigen bakteri ditangkap oleh pharyngeal tonsil pada specialized epithelium Menempel dgn gylcoprotein fibronectine receptor pada epithelial pharyngeal tonsil Infection 4-5x/year
Minum obat terus
Flora normal () fungsi menekan pertumbuhan patogen ()
Infeksi virus (flu) -2 years ago-
Kerja adenoid
Me-release exotoxin and other antigenic structure Bacterial pathogenic easily to entry and growing
cellular structures
Breathing through his mouth
Merusak epithelial palatine tonsil
Faktor resiko : -environment -host factors -diet
Adenoid enlargement
Difficult to breathing through his nose
Recurrent infection (remember what happened in the last 2 consecutive years)
-Squamous -Respiratory epithel
Mechanical defense
Tonsil become infected and enlarged
Chronic Tonsilopharyngitis
Antigen dikenali oleh lymphoid cells
Activation of B and T cells
Aggregation to site of infection
Release cytokine (co : IL 1, TNF)
Induce release inflammatory mediator (histamine, leukotrine, PGE, Nitric Oxide, bradikinin)
Memediasi respon inflamasi
Raise body temperature in the new of hypothalamic thermostate set point
Blood vessel dilatation
permeabilitas vascular
Tonsilar epithelial repair and remodeling
blod flow fever hidrostatic pressure exudation of fluid that rich of protein ( osmotic pressure)
fibrosis
Peningkatan struktur selular
Widening of the cryptae, hyperemic, full of debris Adenoid enlargement
Calor (heat) dan rubor (hyperemic pharynx)
edema Fill the entire space of nasopharyx (airway obstruction)
Tonsil membesar (T3) Pada saat menelan Tersumbatnya saluran hidung
Soft palate tertarik Pharynx berkontraksi (superior, middle, inferior contrictor muscle akan menekan sel-sel inflamasi)
Bolus bergesekan dengan sel-sel inflamasi
Proses resonansi terganggu
Getaran soft palate/uvula/ tonsillar pillar
Difficult to breath through the nose
Mensensitisasi free nerve ending of glosopharyngeal nerve and vagus nerve
Hyponasal voice
Snored while sleeping at night
Increase breathing effort increase Respiratory rate (RR)
Pain on swallowing
TONSILOPHARINGITIS ON ACUTE EXCACERBATION WITH ADENOID HYPERTHROPY - FADHLI RAJIF-A3