Trismus in tonsillar abscess is due to spasm of which muscle?
Ans. is 'a' i.e., Pterygoid muscle Quinsy (Peritonsillar abscess)* Quinsy consists of suppuration outside the capsule in the area around the capsule. There is collection of pus between the capsule of tonsil and the superior constrictor muscle, i.e. in the peritonsillar area. Peritonsillar abscess is a complication of tonsillitis and is most commonly caused by group A beta - hemolytic streptococcus.Clinical features of Quinsy* Clinical features are divided into1) General: They are due to septicaemia and resemble any acute infection. They include fever (up to 104degF), chills and rigors, general malaise, body aches, headache, nausea and constipation.2) Local:i) Severe pain in throat. Usually unilateral.ii) Odynophagia. It is so marked that the patient cannot even swallow his own saliva which dribbles from the angle of his mouth. Patient is usually dehydrated.iii) Muffled and thick speech, often called "Hot potato voice".iv) Foul breath due to sepsis in the oral cavity and poor hygiene.v) Ipsilateral earache. This is referred pain via CN IX which supplies both the tonsil and the ear.vi) Trismus due to spasm of pterygoid muscles which are in close proximity to the superior constrictor.Examination findings1) The tonsil, pillars and soft palate on the involved side are congested and swollen. Tonsil itself may not appear enlarged as it gets buried in the oedematous pillars.2) Uvula is swollen and oedematous and pushed to the opposite side.3) Bulging of the soft palate and anterior pillar above the tonsil.4) Mucopus may be seen covering the tonsillar region.5) Cervical lymphadenopathy is commonly seen. This involves jugulodigastric lymph nodes.6) Torticollis : Patient keeps the neck tilted to the side of abscess.
Pterygoid muscle
Prevertebral muscles
Superior constrictor
Inferior constrictor
Oral Cavity