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    Anatomy of Waldeyer'S Ring (Pharyngeal Lymphatic Tonsillar Ring)

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    Francia Toledano
    Waldeyer's ring is a ring of lymphatic tissue in the head and neck. It includes the pharyngeal tonsil (adenoids), tubal tonsils, palatine tonsils, and lingual tonsil. Together they provide a first line of defense against microbes entering the nasal and oral cavities. When infected or enlarged, they can cause issues like tonsillitis, adenoiditis, and airway obstruction.

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    Anatomy of Waldeyer'S Ring (Pharyngeal Lymphatic Tonsillar Ring)

    Uploaded by

    Francia Toledano
    44 views14 pages
    Waldeyer's ring is a ring of lymphatic tissue in the head and neck. It includes the pharyngeal tonsil (adenoids), tubal tonsils, palatine tonsils, and lingual tonsil. Together they provide a first line of defense against microbes entering the nasal and oral cavities. When infected or enlarged, they can cause issues like tonsillitis, adenoiditis, and airway obstruction.

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    Walde Yers

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    Waldeyer's ring is a ring of lymphatic tissue in the head and neck. It includes the pharyngeal tonsil (adenoids), tubal tonsils, palatine tonsils, and lingual tonsil. Together they provide a first line of defense against microbes entering the nasal and oral cavities. When infected or enlarged, they can cause issues like tonsillitis, adenoiditis, and airway obstruction.

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    44 views14 pages

    Anatomy of Waldeyer'S Ring (Pharyngeal Lymphatic Tonsillar Ring)

    Uploaded by

    Francia Toledano
    Waldeyer's ring is a ring of lymphatic tissue in the head and neck. It includes the pharyngeal tonsil (adenoids), tubal tonsils, palatine tonsils, and lingual tonsil. Together they provide a first line of defense against microbes entering the nasal and oral cavities. When infected or enlarged, they can cause issues like tonsillitis, adenoiditis, and airway obstruction.

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    of 14

    ANATOMY OF WALDEYERS RING (PHARYNGEAL

    LYMPHATIC TONSILLAR RING)


    Structures in
    Waldeyers Ring

    Tonsil Number
    Pharyngeal tonsil 1
    Tubal Tonsils 2
    Palatine Tonsils 2
    Lingual Tonsil 1
    Lateral Bands 2
    Definition
    Heinrich Wilhelm Gottfried von Waldeyer-Hartz (1884)

    first described the incomplete ring of lymphoid tissue, situated in the naso-
    oropharynx

    a first line of defense against microbes that enters the body via the nasal and
    oral routes
    Pharyngeal Tonsil (Adenoids)
    LOCATION: superior-posteriorly to the torus
    tubaris (elevation around the pharyngeal opening
    of the Eustachian tube), in the roof of
    the nasopharynx

    FUNCTION: screening the air that enters through


    the nostrils
    HISTOLOGICALLY: lined by pseudo-stratified
    ciliated columnar epithelium (respiratory
    epithelium)
    no crypts (invaginations in the surface of the
    tonsil) present in this tonsil
    Pharyngeal Tonsil (Adenoids)
    BLOOD SUPPLY: ascending pharyngeal and palatine
    arteries, tonsillar branch of the facial artery,
    pharyngeal branch of the maxillary artery, artery of
    the pterygoid canal and the basosphenoid artery

    VENOUS DRAINAGE: pharyngeal plexus, which


    drains indirectly to the internal jugular veins (IJV)

    INNERVATION: branches of the pharyngeal plexus

    LYMPHATIC DRAINAGE: retropharyngeal and the


    pharyngomaxillary nodes
    Tubal Tonsils (Gerlachs Tonsils or
    Eustachian Tonsils)
    LOCATION: roof of the nasopharynx; bilateral
    and posterior to the torus tubaris, in the fossa
    of Rosenmller (pharyngeal recess)
    the tonsils of the torus tubaris

    HISTOLOGICALLY: lined by pseudo-stratified


    ciliated columnar epithelium (respiratory
    epithelium)

    crypts are present and infiltrated by lymphatic


    tissue
    Tubal Tonsils (Gerlachs Tonsils
    or Eustachian Tonsils)
    BLOOD SUPPLY: branches of the
    sphenopalatine and the ascending
    pharyngeal arteries

    LYMPHATIC DRAINAGE:
    retropharyngeal and the deep
    cervical lymph nodes.
    Palatine Tonsils (The Tonsils)
    readily visible in the oropharynx when
    inflamed
    LOCATION: bilateral lymphoid aggregates
    each rest within a tonsillar cleft, bordered
    anteriorly by the palatoglossal arch and
    posteriorly by the palatopharyngeal arch
    HISTOLOGICALLY: stratified non-keratinized
    squamous epithelium
    many invaginations to increase the probability
    of exposure of foreign antigens to the
    lymphatic tissue present in the crypts
    Palatine Tonsils (The Tonsils)
    BLOOD SUPPLY: tonsillar, ascending
    pharyngeal, facial (tonsillar and ascending
    palatine branches), lingual (dorsal lingual
    branch) arteries
    VENOUS DRAINAGE: peritonsillar plexus (via
    the lingual and pharyngeal veins) to the IJV
    INNERVATION: tonsillar branch
    of glossopharyngeal nerve (CN IX) and the lesser
    palatine nerve
    LYMPHATIC DRAINAGE: jugulodigastric and
    upper deep cervical lymph nodes
    Lingual Tonsils
    numerous protrusions
    LOCATION: posterior third of tongue
    HISTOLOGICALLY: stratified non-
    keratinized squamous epithelium
    BLOOD SUPPLY: dorsal lingual branch of
    the lingual artery
    VENOUS DRAINAGE: lingual vein
    LYMPHATIC DRAINAGE: lingual vein
    INNERVATION: glossopharyngeal nerve
    Pathology
    Upper Respiratory Tract Infections (URTI)

    pharyngeal and palatine tonsils can become enlarged, resulting in adenoiditis or


    tonsillitis, respectively
    The inflammation is typically of bacterial origin.
    Consequently, hypertrophied lymphoid tissue may lead to obstruction of the airway.
    Persistent inflammation after antibiotic treatment with beta-lactamase activity can indicate
    surgical therapy.
    It should also be noted that in following a complete adenoidectomy, some patients may still
    experience symptoms of adenoiditis.
    One possible causative factor could be tubal tonsillar hypertrophy (TTH) a condition in which
    the tubal tonsils compensated for the absence of the adenoids, and became enlarged.

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