Tonsils

• Waldeyer's Ring: circle of lymphoid tissue consisting of palatine (fauceal) tonsils, pharyngeal tonsils (adenoids), lingual tonsils, and tubal tonsils of Gerlach (near fossa of Rosenmuller)

• tonsils increase in size between 1—3 years old (after exposure to antigens), peak between 3—7 years old, involute after puberty

• Arterial Supply

1. lingual artery ^ dorsal lingual branch (lower pole)

2. facial artery ^ ascending palatine artery and tonsillar artery (main supply, lower pole)

3. external carotid artery ^ ascending pharyngeal artery (upper pole)

4. internal maxillary artery ^ greater palatine artery and descending palatine artery (upper pole)

• Venous Drainage: lingual and pharyngeal veins ^ internal jugular vein

• Lymphatics: no afferent lymphatics, drainage into superior deep cervical and jugular digastric lymph nodes

• Histology/Tonsillar Zones

1. Reticular Cell Epithelium: squamous layer, contain antigen-presenting cells (M-cells) which transport antigen to the lymphoid germinal center

2. Extrafollicular Area: contain T-cells

3. Lymphoid Follicle: composed of the Mantle Zone (mature B-cells) and the Germinal Center (active B-cells)

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