[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) › Palatine tonsils [Digestive system](https://durgical.com/en/anatomy/system/digestive-system/) · [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) # Palatine tonsils The palatine tonsils are two oval pads of lymph tissue at the sides of the back of the mouth; they catch germs and swell in tonsillitis. Official name: Palatine tonsil [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=head_neck&select=palatine_tonsils&side=r) Opens in the Durgical app, no sign-up needed. ## What it is Two oval lymph tissue pads at the sides of the back of the mouth. ## What it does Catch germs entering the mouth; they swell in tonsillitis. ## Key points - Tonsil bed: the superior pharyngeal constrictor, with the glossopharyngeal nerve on it; the [facial artery](https://durgical.com/en/anatomy/facial-artery/) loop and, further back and out, the internal carotid artery lie beyond - Peritonsillar abscess (quinsy): pus between the tonsil capsule and the constrictor; the soft palate bulges, the uvula is pushed to the other side, with trismus and a muffled voice - Post-tonsillectomy bleeding is usually from the external palatine (paratonsillar) vein; it occurs early (first 24 hours) or late, around 5–10 days, when the slough separates ## Key facts **Where** Between the palatoglossal and palatopharyngeal arches **Blood supply** Tonsillar branch of the facial artery (main) **Nerve** IX (referred ear pain after tonsillectomy) **Function** Immune surveillance (Waldeyer's ring) ## Relations **In front** Palatoglossal arch (anterior pillar) **Behind** Palatopharyngeal arch (posterior pillar) **Lateral** Capsule and loose peritonsillar tissue, the [superior pharyngeal constrictor](https://durgical.com/en/anatomy/superior-pharyngeal-constrictor/), then the parapharyngeal space with the [glossopharyngeal nerve](https://durgical.com/en/anatomy/glossopharyngeal-nerve/) and the [internal carotid artery](https://durgical.com/en/anatomy/internal-carotid-artery/) **Above** [Soft palate](https://durgical.com/en/anatomy/soft-palate/) and the supratonsillar fossa, where peritonsillar abscesses often begin **Below** [Tongue](https://durgical.com/en/anatomy/tongue/) base, with the lingual tonsil **Medial** The oropharynx; the tonsillar crypts open on this surface ## How to find it With the tongue held down, each tonsil is seen in its fossa between the two arches; its size is graded by how far it reaches toward the midline (for example on the Brodsky scale, grades 0–4). ## On imaging Contrast CT of the neck separates a peritonsillar abscess (a rim-enhancing collection) from cellulitis and shows spread into the parapharyngeal space; intraoral or neck ultrasound is also used. ## Common problems - Tonsillitis: sore throat, fever and painful swallowing; strep throat needs antibiotics. - Peritonsillar abscess; large tonsils causing snoring or sleep apnoea in children. ## How it is diagnosed Throat exam and a rapid strep test or culture. ## Treatment - Pain relief; antibiotics for strep. - Tonsillectomy for frequent infections or sleep apnoea. ## Clinical notes - One-sided enlargement of a tonsil in an adult, especially with ulceration or a neck node, raises suspicion of lymphoma or squamous cell carcinoma (often HPV-related) - Infectious mononucleosis gives large tonsils with grey exudate and enlarged posterior neck nodes - Lemierre syndrome: rare spread of a throat infection to the [internal jugular vein](https://durgical.com/en/anatomy/internal-jugular-vein/) (septic thrombophlebitis), with septic emboli to the lungs, mostly in young adults - Lymph drains to the jugulodigastric (tonsillar) node of level II, just below the angle of the [mandible](https://durgical.com/en/anatomy/mandible/); it swells in tonsillitis and is a common first site of spread of tonsil cancer ## Development From the endoderm of the second pharyngeal pouch; the supratonsillar fossa is the remnant of the pouch. ## Related conditions - [Tangier disease](https://durgical.com/en/conditions/tangier-disease/) - [Streptococcal pharyngitis](https://durgical.com/en/conditions/streptococcal-pharyngitis/) - [Peritonsillar abscess](https://durgical.com/en/conditions/peritonsillar-abscess/) - [Infectious mononucleosis](https://durgical.com/en/conditions/infectious-mononucleosis/) - [Diphtheria](https://durgical.com/en/conditions/diphtheria/) - [Head and neck squamous cell carcinoma (oral cavity and oropharynx, HPV)](https://durgical.com/en/conditions/head-and-neck-squamous-cell-carcinoma/) - [Tonsillar hypertrophy and recurrent tonsillitis (post-tonsillectomy care)](https://durgical.com/en/conditions/tonsillar-hypertrophy-and-recurrent-tonsillitis/) - [Scarlet fever](https://durgical.com/en/conditions/scarlet-fever/) - [X-linked (Bruton) agammaglobulinaemia](https://durgical.com/en/conditions/x-linked-agammaglobulinaemia/) ## Test yourself Think of the answer, then tap the question to see it. ## What forms the bed of the palatine tonsil, and which nerve lies on it? The superior pharyngeal constrictor, with the glossopharyngeal nerve on it; the internal carotid artery lies further back and out. ## What are the signs of a peritonsillar abscess (quinsy)? Bulging soft palate, uvula pushed to the other side, trismus and a muffled voice; the pus lies between the tonsil capsule and the constrictor. ## Where does post-tonsillectomy bleeding usually come from, and when? The external palatine (paratonsillar) vein; early in the first 24 hours, or late around 5–10 days when the slough separates. ## Why is ear pain common after tonsillectomy? The palatine tonsils are supplied by the glossopharyngeal nerve (IX), so pain from the tonsil bed is referred to the ear along IX. ## What does one-sided tonsil enlargement in an adult raise suspicion of? Lymphoma or squamous cell carcinoma (often HPV-related), especially with ulceration or a neck node. [Add to my cards (5)](https://durgical.app/estudiar/?add=/en/anatomy/palatine-tonsil/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** tonsilla palatina TA2 2853 **Official Spanish (DeCS)** Tonsila Palatina DeCS D014066 **English (TA2)** Palatine tonsil **Also called** tonsils ## Related - [Soft palate](https://durgical.com/en/anatomy/soft-palate/) Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=14456&filter=ths_termall&q=Palatine%20Tonsil); [Anatomy, Head and Neck, Palatine Tonsil (Faucial Tonsils)](https://www.ncbi.nlm.nih.gov/books/NBK538296/); [Anatomy, Head and Neck: Tonsils](https://www.ncbi.nlm.nih.gov/books/NBK539792/); Tratado de anatomía humana (9.ª ed.), tomo II, Libro IV Angiología, sección 5: Linfáticos. ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/palatine-tonsil/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/palatine-tonsil/