Should You Worry About Swollen Testicles?

Nov 21, 2019 9:00 AM

The testicles are a very sensitive part of the body, and discovering that one or both testicles are swollen can be a cause for alarm. Luckily, understanding what a swollen testicle means and how to treat it can go a long way to easing the mind and fixing the problem.

Common Causes

There are several reasons why a testicle would be swollen:

• Infection: The testicle and epididymis, the part of the testicle that stores sperm, can sometimes become infected, causing pain and swelling that starts quickly and gets worse.
• Fluid Buildup: An injury or infection can cause fluid to build up around the testicle, causing painful swelling. This is called a hydrocele.
• Varicocele: A varicocele is essentially varicose veins of the scrotum and can result in testicular swelling and aching.
• Trauma: An impact or other injury can cause the testicle to swell and be painful. How bad this is depends on the trauma and whether the testicle stays intact or is ruptured.
• Cancer: Testicular cancer can cause the testicle to swell up and feel hard, but often without causing pain.

When to See a Doctor

When it comes to testicular swelling, the first rule of thumb is that you should see a doctor when you notice the swelling and it concerns you, or if it the swelling or pain become uncomfortable. You should also see a doctor if:

• You Feel No Pain: Pain or discomfort should accompany testicular swelling if you have an infection and often with buildup of fluid. No pain, along with a firm, swollen testicle, could be a warning sign of cancer.
• The Swelling Is Not Going Away: If the swelling persists, it is likely a sign that you have something that requires medical attention.

Simple Treatments

If your swollen testicles are the result of injury, fluid buildup or varicocele, then lying down and elevating the scrotum, perhaps by putting a folded towel underneath it to lift it, will allow fluid and/or blood to flow out and will often make you feel better.

Complications

Swollen testicles can potentially impact fertility or the ability of the testicle to make testosterone, particularly if the reason is cancer, severe trauma, infection, or varicocele. In some cases, this is just temporary, such as in the case of an easily treated infection, but in some cases where there is permanent damage to the testicular tissue, it may be more difficult to have children or for the testicle to make normal levels of testosterone. In cases where there is cancer, the testicle is removed completely, which can also impact fertility and testosterone balance.

Testicular Self-Examination

A simple, quick way to keep your testicles healthy is to perform a testicular self-exam every month or so. By doing this, you become familiar with your testicles and can identify changes that might be signs of cancer or infection. If you find something early, you can seek medical help before it becomes a bigger problem.

Inflammation of the Testicle (Orchitis)

What Is Orchitis?

Orchitis is inflammation of one or both of a man’s testicles, usually because of an infection.

Orchitis can result from the spread of bacteria through your blood from somewhere else in your body. It also can be a progression of epididymitis, an infection of the tube that carries semen out of your testicles. This is called epididymo-orchitis.

Orchitis Symptoms

Most cases of orchitis are acute, which means you have sudden, severe pain in one or both testicles that may spread to your groin (the area where your upper thigh meets your lower belly). You also may have:

• Testicles that appear tender, swollen, and red or purple
• A heavy feeling in the swollen testicle
• Blood in your semen
• High fever
• Nausea
• Vomiting
• Pain with urination
• Pain from straining with a bowel movement
• Pain with intercourse
• Feeling ill

With epididymo-orchitis, the symptoms are similar and may start quickly (acute) or slowly (chronic).

• Orchitis causes an area of pain and swelling in the testicle for one to several days.
• Later, the infection spreads to involve the whole testicle.
• You may also have discharge from your penis and pain or burning before or after you pee.

When to get medical care

Most cases of orchitis caused by bacteria need treatment right away. If you notice redness, swelling, pain, or inflammation of the scrotum or testicle, call your doctor right away. These can also be symptoms of a serious condition called testicular torsion, which is when one of your testicles is twisted.

Go to your local emergency department if you can’t talk to or see your doctor quickly, or if symptoms get worse even with treatment.

Orchitis Causes

Bacteria and viruses can cause orchitis.

• Bacteria that commonly cause orchitis include Escherichia coli, Staphylococcus, and Streptococcus. You can also have a prostate infection along with orchitis. Epididymitis (inflammation of the tube on the back of the testicle) can lead to orchitis, as well.
• Bacteria that cause sexually transmitted diseases (STD), such as gonorrhea, chlamydia, and syphilis, can cause orchitis in sexually active men, usually those ages 19 to 35. You may be at risk if you have many sexual partners, if you’re involved in high-risk sexual behaviors such as unprotected sex, if your partner has had an STD, or if you have a history of STDs.
• The virus that causes mumps can cause orchitis, as well. Most common in young boys (but rare in those younger than 10), orchitis begins 4 to 6 days after mumps begins. A third of boys with mumps will get orchitis and then a condition called testicular atrophy (shrinking of the testicles). That’s why it’s important for all children, boys especially, to get the vaccine that protects against mumps.
• You may be at risk for nonsexually transmitted orchitis if you haven’t had proper vaccination against mumps, if you get urinary tract infections, if you are older than 45, or if you often have a catheter put into your bladder.

Orchitis Diagnosis

Your doctor may do a series of tests including:

Orchitis Treatment

Medical treatment for orchitis

Most cases of orchitis — and epididymo-orchitis — need antibiotics to cure the infection and prevent its spread.

• Most men can be treated with antibiotics at home for at least 10 days. If your prostate is involved, you’ll probably need a longer course of medication.
• If you have a high fever, nausea, or vomiting, or if you’re very ill, you may need to be admitted to a hospital to get antibiotics directly into a vein (IV).
• Mumps orchitis will clear up over 1 to 3 weeks. Just treat your symptoms with home care.
• Young sexually active men should make sure all of their sexual partners are treated. Avoid sex or use condoms until all partners have finished their full course of antibiotics and are symptom-free.

Home remedies for orchitis

Home care, along with the right medical treatment, can help ease the symptoms of orchitis. Ask your doctor about:

• Taking over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil or Motrin), naproxen (Aleve, Naprosyn), or acetaminophen (Tylenol)
• Elevating your scrotum with snug-fitting briefs or an athletic supporter
• Using ice packs. Don’t put ice directly on your skin, which may cause burns from freezing. Wrap it in a thin cloth and then put it on your scrotum. The ice packs may be applied for 15 or 20 minutes at a time several times a day for the first day or two.

Follow-up care for orchitis

See your doctor again at the end of your antibiotic treatment to make sure you’re healed. Call your doctor or go to the emergency room if symptoms get worse at any time during treatment.

Orchitis Complications

Without treatment, orchitis can lead to serious health issues like:

• The affected testicle can shrink (testicular atrophy).
• The infected tissue can fill with pus (scrotal abscess).
• You may make less testosterone or have problems with fertility.

Orchitis Prevention

You can do a few things to lower your chances of orchitis:

• Don’t have sex in high-risk situations where you may be exposed to STDs.
• Use condoms to lower your risk of STDs.
• Make sure you’ve been vaccinated against mumps.
• Get your prostate examined during your yearly physical if you’re over 50.

Outlook for Orchitis

The longer you put off treatment, the more likely you are to have long-term damage. Untreated orchitis can lead to infertility, the loss of one or both testicles, and severe illness or death.

Epididymitis – Better Health Channel

The epididymis is a series of small tubes that collects and stores sperm. It is attached to the back of each testicle. One of the most common causes of pain in the scrotum is epididymitis – inflammation of these coiled tubes – which may be due to an infection. Epididymo-orchitis is the spread of the infection to the testicle.

Epididymitis is usually a secondary bacterial infection that can be triggered by a range of conditions, such as a urinary tract infection or a sexually transmissible infection (STI). The bacteria in the urethra (the tube carrying urine and sperm from the penis) move through the urinary and reproductive structures to the epididymis. 

Treatment options include antibiotics and bed rest. Some men develop chronic epididymitis, which is inflammation even when there is no infection.

Symptoms of epididymitis

The symptoms of epididymitis include: 

• swollen (enlarged), red or warm testicle
• feeling of heaviness in the affected testicle
• tenderness or pain in the affected testicle 
• pain in the abdomen or pelvis
• frequent urge to urinate
• burning feeling when urinating
• discharge from the penis
• blood in the urine
• pain when ejaculating
• slight fever
• chills.

Causes of epididymitis

Most cases of epididymitis are caused by bacterial infection. Causes include: 

• urinary tract infections
• sexually transmissible infections (STIs), such as chlamydia or gonorrhoea
• recent genito-urinary surgery, including prostatectomy (the surgical removal of all or part of the prostate gland)
• the use of a urinary catheter
• some congenital kidney and bladder problems.

Complications of epididymitis

If left untreated, acute epididymitis can lead to a range of complications, including: 

• chronic epididymitis – the inflammation can become persistent, even when there is no bacterial infection present
• abscess – a ball of pus can accumulate inside the epididymis or nearby structures, requiring surgery to drain the pus
• destruction of the epididymis – the inflammation can permanently damage or even destroy the epididymis and testicle, which can lead to infertility
• spread of infection – the infection can spread from the scrotum to any other structure or system of the body.

Diagnosis of epididymitis

It can be hard to tell the difference between epididymitis and testicular torsion, especially in younger men. Testicular torsion is when the testicle has twisted and cut off its supply of blood. Testicular torsion is a surgical emergency. Sometimes, epididymitis and testicular torsion occur at the same time. 

Epididymitis can be diagnosed using a number of tests, including: 

• physical examination
• medical history
• urine tests
• STI tests
• blood tests
• ultrasound of the testes.

Treatment for epididymitis

The treatment options for epididymitis include: 

• antibiotics
• antibiotics for any sexual partners (if an STI was the cause)
• bed rest
• pain-relieving medication
• cold compresses applied regularly to the scrotum
• elevation of the scrotum
• a stay in hospital (in cases of severe infection)
• a check-up afterwards to make sure the infection has cleared up.

Chronic epididymitis

Some men develop chronic epididymitis, which is inflammation even when there is no infection. The cause is not known, but it is thought that hypersensitivity of certain structures, including nerves and muscles, may cause or contribute to the condition.

Some of the known risk factors for chronic epididymitis include genito-urinary surgery, exposure to STIs and past acute epididymitis. However, a man without these risk factors can still develop the condition.

Diagnosis of chronic epididymitis

Tests are needed to distinguish chronic epididymitis from a range of other disorders that can cause constant scrotal pain, such as testicular cancer, enlarged scrotal veins (varicocele) or a cyst in the epididymis. Tests can include physical examination and ultrasound.

Treatment for chronic epididymitis

Chronic epididymitis is difficult to treat. Antibiotics should not be used, as there is no infection. Treatment options include: 

• frequent warm baths
• non-steroidal anti-inflammatory medication (NSAIDs)
• medication to alter nerve messages to the scrotum
• rarely, surgery to remove the affected epididymis
• stress management techniques.

Where to get help

Hydrocele | Michigan Medicine

Topic Overview

What is a hydrocele?

A hydrocele is a painless buildup of watery fluid around one or both testicles that causes the scrotum or groin area to swell. This swelling may be unsightly and uncomfortable, but it usually is not painful and generally is not dangerous. Although hydroceles are common in newborns, they can also occur at any age in later life. See a picture of a hydrocele.

What causes a hydrocele?

The cause of most hydroceles is unknown.

Hydroceles in newborns may mean there is an opening between the abdomen and the scrotum. Normally such openings close before birth or shortly after.

Hydroceles that appear later in life may be caused by an injury or surgery to the scrotum or groin area. Or they can be caused by inflammation or infection of the epididymis or testicles. In rare cases, hydroceles may occur with cancer of the testicle or the left kidney. This type of hydrocele can occur at any age but is most common in men older than 40.

What are the symptoms?

Often a hydrocele does not cause symptoms. You may notice enlargement of your scrotum. Symptoms, when present, can include pain, swelling, or redness of the scrotum or a feeling of pressure at the base of the penis.

How is a hydrocele diagnosed?

A hydrocele is usually diagnosed by an exam of the scrotum, which may appear enlarged. As part of the exam, your doctor will shine a light behind each testicle (transillumination). This is to check for solid masses that may be caused by other problems, such as cancer of the testicle. Hydroceles are filled with fluid, so light will shine through them (transillumination). Light will not pass through solid masses that may be caused by other problems, such as cancer of the testicle. An ultrasound may be used to confirm the diagnosis of a hydrocele.

How is it treated?

Hydroceles are not usually dangerous and are treated only when they cause pain or embarrassment or when they decrease the blood supply to the penis (rare). Treatment is not usually needed if a hydrocele does not change in size or gets smaller as the body reabsorbs the fluid. Hydroceles in men younger than 65 may go away by themselves. But hydroceles in older men do not usually go away.

Fluid can also be removed from a hydrocele with a needle (aspiration). But hydroceles that are aspirated often return, and surgery may then be needed. Aspiration is recommended only for men who are not physically able to have surgery because of the risk of infection and recurrence.

If the hydrocele gets larger or causes discomfort, surgery to remove the hydrocele (hydrocelectomy) may be needed.

What Are Some Causes of Testicle Pain?

If you or a loved one is experiencing testicular pain, the multispecialty team of experts in the Urologic Oncology Program are here to help.

The testicles are very sensitive. Even a very minor injury can cause intense pain in the scrotum, the testicle itself or in the coiled tube the delivers sperm and supporting tissue behind it (epididymis). For instance, a direct blow from a kick, punch, sporting mishap or car accident can result in extreme – but usually temporary – pain, swelling and bruising.

Many men are inclined to ignore testicular pain and hope that it will simply go away. However, if a man experiences severe testicular pain from a severe trauma or for no apparent reason, he should see a physician right away. Some conditions that cause this symptom require prompt medical attention. These include: 

• A hematocele – A direct blow to the scrotum can cause blood to collect in between its multiple layers. Depending on the level of discomfort it causes, a hematocele may need to be drained during a minor surgical procedure.
• Inflammation of the epididymis (epididymitis) – This common cause of testicular pain usually results from a urinary tract or sexually transmitted infection. In older men, it can be caused by an enlarged prostate gland.
• Inflammation of a testicle (orchitis) – Usually caused by a bacterial infection, orchitis often accompanies epididymitis that has been left untreated for several days.
• Varicoceles – The veins that transport oxygen-depleted blood back to the heart can fail, allowing blood to build up in the scrotum.
• Testicular torsion – A testicle can sometimes twist inside the scrotum. When this happens, the blood vessels within the spermatic cord also become twisted, which can inhibit blood flow to the affected testicle. This is a medical emergency that requires immediate treatment to save the testicle.
• Inguinal hernia – Intestinal or fatty tissue can sometimes push through a weak point in the abdominal muscles and slide into the scrotum, causing pain and swelling.
• Kidney stones – Pain from kidney stones can sometimes project downward into the scrotal area.
• Testicular tumor – Though relatively rare, lumps and masses can develop in the testicles and create discomfort. 

Men who would like to have their testicular pain evaluated are welcome to consult with the multispecialty team of experts in the Urologic Oncology Program at Moffitt Cancer Center. We offer a full range of diagnostic tests in a convenient setting and provide our patients with prompt and accurate results. 

To learn more about Moffitt’s services, call 1-888-MOFFITT or complete a new patient registration form online. No referrals are required.

Testiscular problems in boys – Boston Children’s Answers

It’s not uncommon for baby and toddler boys to have testicular problems. (Adobe Stock)

Testicular problems can be a source of alarm for parents of boys, but they’re actually quite common. Here, Dr. Erin McNamara, a pediatric urologist in the Department of Urology at Boston Children’s Hospital, explains testicular abnormalities and shares when to consider surgery.

Undescended testicles

Before a baby boy is born, his testicles form in his abdomen. During the third trimester of pregnancy, the testicles travel from the abdomen and into the scrotum. An undescended testicle doesn’t complete this process of descent. 

What
to look for: The
best time to examine your son is while he soaks in a warm bath. If you’re
unable to see or feel both testicles, make an appointment with a pediatric
urologist.

What next: If your son is diagnosed with an undescended testicle, his clinicians will usually observe him until he turns 6 months old. If the testicle still hasn’t descended on its own by then, they will perform a type of day surgery called an orchiopexy. This procedure releases the testicle from the attachments hindering its descent and tacks it down in the scrotum so it can develop appropriately.

Testicular pain

Testicular pain can occur at any time and is usually either caused by torsion or epididymitis. Common in pre-pubertal boys, testicular torsion occurs when a testicle is not attached well to the scrotum. If your son complains of testicular pain but doesn’t have torsion, he will most likely have a type of inflammation called epididymitis.

What
to look for: If
your son complains of a swollen scrotum and sharp pain, either with or without
nausea and vomiting, take him to your local emergency department immediately.

What
next: If
a physical exam and ultrasound reveal that your son has testicular torsion, a
pediatric urologist will perform a simple surgery to untwist the testicle and
sew both testicles in place so they can’t turn again in the future. In rare
cases, the testicle may need to be removed if the blood supply is completely cut
off for a long period of time. If epididymitis is the source of pain, over-the-counter
pain relievers, elevation, icing, and rest can help relieve symptoms until they
resolve.

Swollen scrotum

A swollen scrotum can be a sign of either a hydrocele or an inguinal hernia. A hydrocele occurs when fluid moves from the abdomen into the scrotum and surrounds the testicle. This occurs when the inguinal canal (the passage from a boy’s abdomen to his genitalia) doesn’t close as it should at birth. When intestinal segments come down through an open inguinal canal, they can cause a bulge in the scrotum called a hernia.

What
to look for: If
your child has a bulge on one side of his groin and is uncomfortable, call your
pediatrician. Try pushing gently on the bulge when your son is calm and lying
down, and you will likely see the bulge get smaller or go back into the
abdomen. However, if the bulge is red or very
hard, it can be a sign that blood flow has been cut off, which requires urgent
attention. In that case, you should take your son immediately to your local
emergency department.

What next: Clinicians typically wait to surgically repair a hydrocele until the child is a year old, in case the issue resolves on its own. Because the risk of reoccurrence is high for hernias, that your son will likely need to undergo surgery within a few weeks of being diagnosed.  

Learn about the Department of Urology.

What are the signs and symptoms of orchitis in men with mumps?

Author

Germaine L Defendi, MD, MS, FAAP Associate Clinical Professor, Department of Pediatrics, Olive View-UCLA Medical Center

Germaine L Defendi, MD, MS, FAAP is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Coauthor(s)

Cem S Demirci, MD Consulting Staff, Division of Endocrinology/Diabetes, Connecticut Children’s Medical Center

Disclosure: Nothing to disclose.

Walid Abuhammour, MD, MBA, FAAP, FIDSA Adjunct Professor, Department of Pediatrics, Hashemite University, Jordan; Head of Pediatric Infectious Diseases, Department of Pediatrics, Al Jalila Children’s Hospital, UAE

Walid Abuhammour, MD, MBA, FAAP, FIDSA is a member of the following medical societies: American Academy of Pediatrics, International Society for Infectious Diseases, International Society for Infectious Diseases, Jordan Medical Association, Jordan Pediatric Society, Michigan Infectious Disease Society, Michigan State Medical Society, National Arab American Medical Association, Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Chief Editor

Russell W Steele, MD Clinical Professor, Tulane University School of Medicine; Staff Physician, Ochsner Clinic Foundation

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, Southern Medical Association

Disclosure: Nothing to disclose.

Acknowledgements

Gary J Noel, MD Professor, Department of Pediatrics, Weill Cornell Medical College; Attending Pediatrician, New York-Presbyterian Hospital

Gary J Noel, MD is a member of the following medical societies: Pediatric Infectious Diseases Society

webmd.com”>Disclosure: Nothing to disclose.

Eileen C Quintana, MD Assistant Professor, Departments of Pediatrics and Emergency Medicine, St Christopher’s Hospital for Children; Adjunct Clinical Professor, Pediatrics and Emergency Medicine Departments, Temple University Hospital, Pediatric Emergency Dept, Philadelphia, PA

Eileen C Quintana, MD is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Mark R Schleiss, MD American Legion Chair of Pediatrics, Professor of Pediatrics, Division Director, Division of Infectious Diseases and Immunology, Department of Pediatrics, University of Minnesota Medical School

Mark R Schleiss, MD is a member of the following medical societies: American Pediatric Society, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, and Society for Pediatric Research

webmd.com”>Disclosure: Nothing to disclose.

Hosseinali Shahidi, MD, MPH Assistant Professor, Departments of Emergency Medicine and Pediatrics, State University of New York and Health Science Center at Brooklyn

Hosseinali Shahidi, MD, MPH is a member of the following medical societies: American Academy of Pediatrics, American College of Emergency Physicians, and American Public Health Association

Disclosure: Nothing to disclose.

Garry Wilkes, MBBS, FACEM Director of Emergency Medicine, Calvary Hospital, Canberra, ACT; Adjunct Associate Professor, Edith Cowan University; Clinical Associate Professor, Rural Clinical School, University of Western Australia

Disclosure: Nothing to disclose.

webmd.com”>Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Grace M Young, MD Associate Professor, Department of Pediatrics, University of Maryland Medical Center

Grace M Young, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Emergency Physicians

Disclosure: Nothing to disclose.

90,000 Scrotal edema – causes, examination and treatment in Astrakhan | Symptoms

Edema (accumulation of excess fluid in the body)
Signs: Swelling that is like a sponge to the touch. occurs on both sides of the scrotum. remains depressed after pressing and releasing, often in men with swelling in the legs and sometimes in the abdomen. In men with heart failure, severe liver or kidney problems.

Hematocele (accumulation of blood in the scrotum)
Signs: Swelling, which is painful and tender, develops after injury.

Dropsy testis or hydrocele (accumulation of fluid in the scrotum)
Signs: Swelling that is soft to the touch, does not disappear when lying down, and cannot be pushed back into the abdomen.

Inguinal hernia (hernia in the groin)
Signs: Usually in men with a painless bulge in the groin that persists for a long time, often in those who already have a hernia. A swelling that is soft to the touch and looks like a balloon can often be felt over the scrotum, usually enlarging when standing or when pressure in the abdomen increases.Sometimes disappears when lying down, may be pushed back into the abdominal cavity. Sometimes it is accompanied by pain that develops gradually or occurs suddenly, most often in cases where the swelling cannot be pressed back into the abdominal cavity.

Lymphatic edema (accumulation of lymphatic fluid, congenital or due to an infectious disease caused by tropical insect bites)
Signs: Elastic swelling of the entire scrotum. When you click on this area, the fossa does not remain.

Spermatocele (cyst in the epididymis)
Signs: A hard lump on the top of the testicle.

Testicular cancer
Signs: A hard lump attached to or part of the testicle. Dull aching pain or, in case of bleeding from a tumor, sudden sharp pain is possible.

Varicocele (dilatation of the veins through which blood flows from the testicle)
Signs: Swelling that feels like a pouch of worms usually appears on the left side.Pain and swelling may occur when standing. Possibly shrunken testicle (testicular atrophy).

Tonsillitis: symptoms and treatment | Throat Encyclopedia HEXORAL®

08/25/2021

180 321

9 minutes

Contents:

Inflammation of the tonsils, or tonsillitis, is a common disease. The palatine tonsils are located at the crossroads of the respiratory and digestive tracts and are constantly faced with a huge number of irritants and microorganisms ¹ entering the body through the mouth and nose.Sometimes this leads to the development of an inflammatory process. Let’s see what signs you can suspect tonsillitis, and how to treat it in adults.

Up to contents

A little bit of anatomy and physiology

The palatine tonsils are located on the lateral walls of the pharynx and resemble large almond kernels in shape. The second name – “tonsils” – the tonsils received because of the similarity with acorns, which in Latin are called “glandulae”. Since in Latin tonsils are “tonsilla”, their inflammation is called tonsillitis.

Palatine tonsils belong to the organs of the immune system and are small accumulations of lymphoid tissue ² . The part of the glands protruding into the pharynx has depressions (lacunae), in the walls of which there are numerous slit-like pockets (crypts) ¹ . The surface of the crypts is the “working area” of the tonsils. Here, the main physiological processes take place: the immune cells of the phagocytes absorb the microbes that have entered the tonsils, “study” them, send the information received to the higher departments of the immune system, and then kill the infection ¹ .If the microbes are very aggressive and there are many of them, and even the immunity is weakened, an infectious inflammation of the tonsils develops – tonsillitis.

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Causes of tonsillitis

Depending on the nature of the course, tonsillitis can be:

• acute (it is also called angina),
• chronic ^1,2,3 .

The cause of acute inflammation of the tonsils is an infection ¹ . It can be viral, bacterial or mixed ^1.2 .

The viral nature of angina prevails in adults and children over 15 years old ^1.2 . It usually develops with ARVI, which are caused by rhinoviruses, adenoviruses, parainfluenza viruses ¹ . In this case, tonsillitis is accompanied by rhinitis, pharyngitis, laryngitis and other respiratory diseases ¹ .

Children 5-15 years old often have bacterial tonsillitis, and in the first place (up to 30% of cases) among them is the most dangerous type of angina caused by group A beta-hemolytic streptococcus ¹ .In adults, this type of tonsillitis is much less common ¹ , and among the bacteria-causative agents of the disease, streptococci of other groups, corynebacteria, haemophilus influenzae, neisseria, staphylococci ¹ prevail.

The cause of chronic tonsillitis is also an infection, but, unlike acute processes, it is caused by less aggressive pathogens ² . In this case, there may be no acute inflammation of the tonsils, the process is initially chronic in nature and is hidden behind frequent acute respiratory viral infections and inflammatory diseases of the oral cavity and pharynx (nonanginous form of chronic tonsillitis) ² .

Chronic inflammation leads to the death of the functional, that is, lymphoid, tissue of the tonsils and its replacement by connective tissue ¹ . The tonsils gradually lose their protective functions, often become easy prey for microbes and viruses, become inflamed and turn into a breeding ground for infection ¹ and an irritant for the immune system. As a result of chronic tonsillitis, immune disorders often occur, leading to the development of infectious-allergic and autoimmune diseases ^1.2 .

Back to Contents

Tonsillitis Symptoms

The main symptom of both viral and bacterial tonsillitis is a sore throat that worsens when swallowing and while talking ¹ . Sometimes it reaches such a degree of severity that it is difficult to take even a small sip of water, let alone a meal.

Sore throat can be supplemented by:

• increased body temperature, up to high fever;
• redness of the tonsils and the appearance of plaque or blistering rashes on them;
• Soreness of the anterior cervical lymph nodes ¹ .

If a runny nose and cough are present along with this, it is most likely that the inflammation of the tonsils is of a viral nature ¹ .

General intoxication caused by infection is expressed in the appearance of weakness, daytime sleepiness, lethargy, headache, aching muscles and joints ¹ .

Depending on the picture that can be seen when examining the throat, angina is catarrhal, follicular, lacunar ¹ .

With catarrhal angina, the tonsils become red and swollen ¹ .With follicular, they increase sharply in volume, whitish dots appear on their surface – follicles filled with pus, which shine through the inflamed mucous membrane ¹ . With lacunar angina, the surface of the tonsils is covered with pus, which protrudes from the lacunae ¹ .

Sore throats caused by beta-hemolytic streptococcus are characterized by the appearance of purulent films on the glands, which are firmly associated with the underlying tissues ¹ . When the films are rejected on the tonsils, bleeding erosions and ulcers are formed ¹ .

Tonsillitis associated with the Coxsackie virus proceeds as a herpetic sore throat, in which many small bubbles filled with cloudy mucus appear on the tonsils ¹ .

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Features of chronic tonsillitis

Chronic tonsillitis proceeds with exacerbations, during which the same symptoms appear as in angina ^2.3 .

During the calm period ³ :

• discomfort in the throat bothers almost 98% of patients;
• putrid breath is noted by up to 88% of patients;
• plugs and purulent plaque on the tonsils are found by doctors in almost 84% of cases;
• adhesions between the tonsils and arches are detected in about 60% of patients;
• enlargement and soreness when palpating the cervical lymph nodes are diagnosed in 62% of cases;
• joint pains concern every third patient;
• subfebrile temperature (up to 38 ⁰ C) is noted by 18% of patients;
• heart pain – about 8% of patients with chronic tonsillitis ³ .

Depending on the stage of development, the disease can proceed in the following forms ^2.3 :

1. The simple form, in fact, is the initial stage of the disease, in which the pathological process is mainly limited to the tonsils ^2.3 .
2. Toxic-allergic form:

• Stage I: signs of general intoxication appear, such as low-grade fever, weakness, fatigue, as well as joint aches and pain in the heart associated with functional disorders.
• Stage II: complications of tonsillitis, such as paratonsillar abscess, sepsis, rheumatism, heart defects, etc., join general intoxication. ^2.3 . In this case, the symptoms of these diseases complement the picture of tonsillitis.

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Treatment of tonsillitis

The appearance of symptoms of tonsillitis is a reason to see a doctor. Self-medication in this case is unacceptable. Only a doctor can determine the form of the disease, establish its causes and choose the right treatment.

For tonsillitis caused by bacterial microflora, and especially group A beta-hemolytic streptococcus, antibiotics are prescribed ^{1 , 2} . In addition to them, doctors recommend local treatment – irrigation and gargling with drugs based on antiseptics and analgesics that destroy the infection, which relieve pain ^1.2 . In mild cases and with negative streptococcus tests, treatment is generally limited to local therapy ^1.2 .

HEXORAL ^{® 4,5,6,7,8} can be used as a combined preparation for local therapy of tonsillitis. The HEXORAL ^® line includes solutions for rinsing and irrigation of the throat, as well as lozenges with various active ingredients and flavors.

The HEXORAL ^® solution is based on the antiseptic hexetidine. It is active against most bacteria and some viruses, is able to have a mild analgesic effect ⁴ . It can also help clear tonsils and relieve sore throat.

HEXORAL ^® aerosol has a special nozzle, thanks to which the solution can be evenly distributed over the entire mucous membrane of the pharynx ⁵ .

The lozenges HEXORAL ^® TABS ⁶ , HEXORAL ^® CLASSIC ⁷ and HEXORAL ^® TABS EXTRA ⁸ can also be added to the traditional treatment of tonsillitis. The last of these drugs contains the powerful anesthetic lidocaine and can be useful for combating severe sore throat ⁸ .

Conservative treatment is also indicated for patients with simple form of chronic tonsillitis ^2.3 . It includes not only drug therapy, but also such medical procedures as washing the lacunae of the palatine tonsils, introducing antibacterial and antiseptic drugs into them, as well as various physiotherapy procedures that help cleanse the tonsils and stimulate their protective functions ³ . Preparations HEXORAL ^® can also be used as agents for local therapy of tonsillitis ^4,5,6,7,8 .

Chronic tonsillitis in a neglected form – an indication for surgical treatment , that is, tonsil removal surgery ^2.3 .

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The information in this article is for reference only and does not replace professional medical advice. Consult a qualified professional for diagnosis and treatment.

Literature

1. S. Ya.Kosyakov, I.B. Angotoeva. Modern ideas about tonsillopharyngitis.Medical Council, No. 17, 2015, pp. 32-36.
2. T.S.Polyakova, E.P. Polyakova. Chronic tonsillitis: diagnosis, treatment, prevention. Russian medical journal, No. 2, 2004, pp. 65-68.
3. G.R. Kaspranskaya, A.S. Lopatin. Chronic tonsillitis: different views on an old problem. Medical Council, No. 5-6, 2013, pp. 69-71.
4. Instructions for use of the drug HEXORAL ^® solution.
5. Instructions for use of the drug HEXORAL ^® aerosol.
6. Instructions for use of the drug HEXORAL ^® TABS.
7. Instructions for use of the drug HEXORAL ^® CLASSIC.
8. Instructions for use of the drug HEXORAL ^® TABS EXTRA.

Tonsil cancer: treatment, symptoms, diagnosis

Laser microsurgery for tonsil cancer may become one of the methods of treatment along with standard surgery.Studies have shown that treating tonsil cancer using this method for small tumors is effective and safe. In particular, there is a significant decrease in postoperative complications.

Cancer of the tonsils is a malignant tumor originating from the mucous membrane of the root of the tongue, palatine tonsil, posterior pharyngeal wall, palatine arches and soft palate. Tonsil cancer refers to tumors of the head and neck.A malignant neoplasm develops in the lymphoid tissue of the oropharynx, grows without a clear border, often looks like an infiltration or ulcer. In relation to this disease, the term “cancer of the tonsils” (tonsils – palatine tonsils) is sometimes used. Tonsil cancer is rare and usually develops rapidly and metastasizes rapidly. Before other organs, regional lymph nodes are affected by metastases.

The tumor is easily detected by examining the oral cavity. The formation usually occurs on one amygdala; cases where cancer develops on both tonsils are extremely rare.The disease mainly affects men from 54 to 75 years old. In 95% or more of cases, squamous cell carcinoma and varieties of this type of cancer with ulcerative growth are observed.

Diagnostics

To diagnose tonsil cancer, an initial examination is performed, blood tests and tests for tumor markers are performed. A biopsy from the tumor is mandatory to verify the diagnosis.Computed tomography (CT) plays an important role in determining the extent of the tumor and the presence of metastases in the lymph nodes.

PET-CT is the latest research method used to determine the stage of the disease in order to clarify the treatment tactics. The use of PET-CT allows you to evaluate the result of the treatment, as well as to identify a possible relapse of the disease.

Histological verification for LISOD patients is performed at the Opti-Path Gemeinschaftspraxis fur Pathologie reference laboratory partner in Germany.The established correct diagnosis guarantees further adequate treatment.

Treatment

Consultants of the LISOD Information Service will provide you with full information on the diagnosis and treatment of this type of cancer:

• 0-800-500-110 (toll-free for calls to
  from landline telephones within Ukraine)
• or +38 044 520 94 00 90 240 – daily
  from 08:00 to 20:00.

Surgical treatment consists in the maximum removal of the tonsil tumor and the affected lymph nodes.

In addition, radiation therapy may be indicated for large tumor sizes and low differentiation, for large lymph nodes or when the lymph node capsule has germinated. In such cases, a combination of chemotherapy and radiotherapy is warranted.

Chemoradiation therapy is currently highly effective as an independent method.The use of the targeted drug Cetuximab in conjunction with radiation therapy or chemotherapy enhances the effectiveness of treatment. Chemotherapy is indicated as an independent treatment only for advanced tonsil tumors.

Follow-up is important with repeated frequent examinations every two to three months. Most relapses occur in the first two years after treatment ends. In case of relapses, repeated surgery, radiation, or a combination of both is used.

Symptoms

Initially, the tumor is asymptomatic, especially when the root of the tongue is affected, where it is located under the mucous membrane and grows deeper.Sometimes the first manifestation of cancer of the root of the tongue and tonsils are metastases to the cervical lymph nodes. Pain, swallowing disorder, and a sensation of volume in the throat are also characteristic.

As the disease progresses, an admixture of blood in the saliva may appear, soreness and enlargement of the lymph nodes are noted. Characterized by purulent-mucous discharge, difficulty in nasal breathing, congestion and pain in the ears. When the neoplasm spreads upward and sideways, destruction of the bone of the base of the skull may occur; cranial nerves are involved in the process, neurological symptoms occur, such as blindness, paralysis of the muscles of the soft palate, vocal cord, eye muscles.

Risk factors

• Smoking: Tonsil cancer is most common in people who smoke; the longer the smoking history, the higher the risk of getting tonsil cancer.
• Alcohol abuse.

Questions and Answers

The section publishes questions from patients and answers from our specialists.Each person’s question concerns a specific problem related to their illness. The patients are answered by Israeli clinical oncologists and the chief physician of LISOD, MD, professor Alla Vinnitskaya.

Experts’ answers are based on knowledge of the principles of evidence-based medicine and professional experience. The answers correspond exclusively to the information provided, are for informational purposes only and do not constitute a medical recommendation.

The main purpose of section is to provide information to the patient and family so that they can make a decision about treatment with their doctor.The proposed treatment tactics may differ from the principles stated in the answers of our specialists. Do not hesitate to ask your doctor about the reasons for the differences. You need to make sure you are getting the right treatment.

Good afternoon.My sister was diagnosed with stage 3 tonsil cancer. Please tell me what treatment is needed for this disease. Thank you in advance.

Combined radiation and chemotherapy gives excellent results (especially at a young age, when the development of the tumor is most often associated with the human papillomavirus (HPV).

Hello! In April of this year, my husband was diagnosed with Ca of the left palatine tonsil T2N0M0.The tonsil was removed, a month later, they underwent examination for PET-CT, revealed a residual tumor at the site of the removed tonsil, and on the left lymph node. Received radiation therapy. Please tell me if a relapse can start three months after exposure? Can this disease be cured at all? Thank you in advance!

Yes, tonsil carcinoma is well treated with radiation or combined radiation and chemotherapy. At the stage that you indicated (T2N0M0), a complete cure is possible in a large percentage of cases.
Three months is a short period, and if the disease is still determined three months after the end of radical treatment, one should not talk about tumor recurrence, but about the continuation of the disease (the so-called persistent carcinoma) and, most likely, there was no complete cure. In these cases, the disease, even if not visually detected, remains at the microscopic level and inevitably reappears.

Hello, my dad has squamous cell carcinoma of the nasopharynx, T2N2M0, with swollen lymph nodes in the lower jaw.Please tell me which treatment is correct? Thank you in advance.

Standard treatment for such tumors: combined chemoradiotherapy.

Good afternoon again, I already wrote to you, thank you for your answer. But I have one single question and I hope the last one, please tell me what is the likelihood of throat cancer at the age of 25 and can an ENT doctor detect it during a routine examination (notice changes in the tonsils or larynx) without a speculum? Where I don’t read it, it’s written everywhere that throat cancer in men occurs at the age of 50.Is this statement true? Thank you in advance.

At age 25, throat cancer is likely, although less likely than in older people. A routine examination by an ENT doctor is not enough to detect a tumor.

Hello! Please tell me, my husband (50 years old) has squamous cell carcinoma of the floor of the mouth, as well as signs of submandibular lymphadenopathy on the right.We just had an ultrasound scan. Is treatment possible or is it just necessary to do the operation right away? Thank you in advance. Irina.

Treatment algorithms depend on the stage of the disease. In the absence of distant metastases (usually in the lungs) and an operable tumor, primary excision +/- plastic replacement of the defect with dissection of the lymph nodes of the neck (unilateral or bilateral if indicated) is recommended.After the operation, radiation therapy is used in cases of large primary tumors (T3-4) close to surgical margins, multiple nodes, perineural or lymphatic-vascular invasion, as well as involvement of lymph nodes at levels IV – V. Postoperative chemotherapy + radiation therapy is indicated when the resection margins are involved and the tumor leaves the lymph node capsule. For inoperable tumors, either chemotherapy + radiation therapy or, as an option, first several cycles of chemotherapy and then chemotherapy + radiation therapy is indicated. If there are signs of residual mass in the neck area 6-12 weeks after treatment on CT / MRI or PET, surgical removal is performed.

Glaucoma of the eye – symptoms, causes and treatment of the disease in Moscow

If diagnosed – GLAUKOMA.What do you need to know about the disease?

About 70 million people in the world live with a diagnosis of glaucoma. This disease, called the “secret robber of vision”, can pass without any manifestations: without causing pain or other inconvenience. But if left untreated, glaucoma leads to progressive loss of vision up to complete blindness. If vision is lost in glaucoma, it is no longer possible to return it, this is an irreversible process. This means that the doctor (and you) is faced with the task of making a diagnosis in time and stopping the disease at the initial stage.

What is glaucoma and how does it develop?

Glaucoma is a group of eye diseases that lead to excessive accumulation of fluid inside the eye and increased intraocular pressure. In order to understand what glaucoma is, the symptoms and treatment of this disease, you need to know the anatomical structure of the eye and the factors affecting the formation and movement of fluid, which is the source of “nutrition” for the lens of the eye.

1. Intraocular fluid produced by the ciliary body, passing through the pupil into the space between the cornea and the iris of the eye (anterior chamber), washes the lens.
2. In this space, a zone of the anterior chamber angle is distinguished – an anatomical zone located along the ring, along which the transparent cornea passes into the sclera. Here, in a circle, the area of ​​attachment of the iris (iris) passes.
3. The anterior chamber angle is also divided into zones. The main one is the trabecular zone. Behind it is the main Shlemovy canal – the outflow canal. Trabeculae stretched between the cornea and the iris filter the intraocular fluid, and the Shlemov canal, located in a circle, acts as a drainage system that removes the intraocular fluid.
4. The eye is a closed system. Therefore, the liquid “does not pour out” from the intraocular space and has no opportunity to leave it if the drainage system fails. Fluid builds up, resulting in increased intraocular pressure. This situation is similar to a situation where a downpipe is clogged.

What is the danger of increased intraocular pressure?

Imagine a balloon that is filled with too much air. After some time, it can burst from the inability to cope with the air pressure on its walls.

Unlike a ball, the eye is a fairly strong organ, so it does not burst. Nevertheless, by squeezing the surrounding tissue, it touches the optic nerve most exposed to such an effect, which is the conductor of visual information entering the brain.

Prolonged exposure to nerve cells leads to their death, the supply of signals from the eye to the brain is interrupted and partial or complete blindness may occur.

What does “angle-closure” and “open-angle” glaucoma mean? What are the possible options for glaucoma?

Glaucoma is divided into open-angle, closed-angle, congenital, primary and secondary.

Congenital glaucoma occurs due to problems in the structure of the anterior chamber angle, as a result of which the outflow of intraocular fluid is impaired. Secondary glaucoma is a consequence of eye diseases such as inflammation, trauma, previous surgery, etc.

How is glaucoma treated?

When diagnosed with glaucoma, treatment methods can be therapeutic and surgical. Surgical treatments include laser treatments and classic surgery. Early diagnosis allows for more gentle treatments and better results.The patient needs to visit a doctor 2-3 times a month, who will measure eye pressure and check the effectiveness of treatment.

• therapeutic method. This is usually initial glaucoma. Treatment – drops, which are prescribed to the patient, lower the intraocular pressure. Be sure to use drops every day to control the fluid accumulating in the eye;
• laser treatment. Using a YAG laser – a solid-state laser (Y3Al5O12 yttrium aluminum garnet doped with neodymium ions is used as an active medium), the laser surgeon will individually select which of the laser surgery options you need.
• surgical method. The operation consists in creating additional pathways for the outflow of intraocular fluid, thereby achieving normalization of intraocular pressure. One of the promising techniques is non-penetrating deep sclerectomy in combination with allodrainage. Such a surgical procedure can restore the balance between production and the outflow of fluid in the eye.

If a doctor recommends an operation, then you should not postpone, timely treatment gives the best results.And preventive examinations help to identify the disease at an early stage.

Good to know about LATEX ALLERGY (lateksallergi)

What is latex?

Latex is the processed sap of the Hevea rubber tree ( Hevea brasiliensis ) with the addition of a number of chemicals to provide the desired properties. This milky juice flows out of the cut in the bark in the same way as milk flows out of dandelion stalks, celandine and milkweed. Synthetic latex is made from synthetic rubber.The word latex is synonymous with natural rubber.

Latex is found in many consumer products and medical materials such as balloons, elastic bands, stockings, shoes, rubber boots, air mattresses, car and bicycle tires, rubber gloves, baby pacifiers, scuba diving suits, elastic garments, anesthesia, drainage and infusion aids, bottle caps, inhalation masks and catheters, and much more.

Special care is required when latex is used in products such as condoms and cervical caps.In addition to sexual problems, latex allergy can lead to very serious body reactions. Durex offers Avanti condoms with a latex-free guarantee. Synthetic products such as latex paint do not contain natural rubber.

Latex allergy symptoms

Symptoms can be both immediate reactions to IgE antibodies and delayed allergic reactions with the appearance of contact eczema.

The most common symptoms of latex allergy are eczema changes in the skin in the form of swelling, redness, sores and itching.Watery blisters and cracking of the skin may also occur. Respiratory disorders such as irritation of the mucous membranes of the nose and eyes and asthma attacks are quite common.

Latex cross-reacts with proteins found in exotic fruits and thus can provoke oral allergic syndrome (itching and swelling in the mouth, nose, throat and lips). The most dangerous in this regard are banana, avocado and kiwi, but papaya, figs, potatoes, tomatoes and chestnuts can cause cross-reactions.Between 30 and 80% of latex allergy sufferers get symptoms from eating these foods. In addition, latex can cross-react with sap from trees and leaves, as well as dust from Benjamin’s ficus. Cross-reaction occurs between plant proteins found in latex and food. In sensitive individuals, latex can cause life-threatening reactions (anaphylactic shock).

Who can be allergic to latex?

Only a few years ago, this type of allergy was observed only in representatives of the indigenous population of some countries (for example, Indonesia) who collected natural wood latex.

Later, allergies began to be observed in children who underwent surgery and, accordingly, contact with the doctor’s latex gloves. The discovery of the human immunodeficiency virus (HIV) has led to a sharp increase in the use of rubber gloves, which in turn has led to an increase in the number of latex allergy sufferers, especially among healthcare workers. The prevalence of this type of allergy among healthcare workers is around 7%. This figure is expected to rise due to the increasing use of rubber gloves in this occupational group over the past 10-15 years.Cleaners and dentists are also at risk.

Latex allergy treatment

After a diagnosis of latex allergy is established, close contact with this material must be completely excluded. Individuals with food cross-reactions should also avoid contact with latex.

The onset of allergic (anaphylactic) shock is most often accompanied by the usual allergic symptoms for the patient. They can come on gradually or suddenly and be life-threatening.Persons with such severe allergies that there is a danger of anaphylactic shock should have an epinephrine syringe (EpiPen) with them for immediate injection in case of symptoms. You must immediately call an ambulance. Antiallergic vaccination (hypersensitivity) is not intended to treat latex allergy.

How is the diagnosis made?

Examination for suspected latex allergy is primarily carried out by a dermatologist or pediatrician.A detailed medical history will be helpful. Relevant testing methods may be the Pirquet test or applying a latex piece to the forearm to check for skin response. In addition to skin tests, an immunoglobulin (IgE) blood test can provide useful information.

Prevention of allergies

Latex allergy is an incurable disease, and you can only fight with its symptoms. The best thing is to try to avoid developing allergies. Many latex products can be replaced with vinyl products.The hypoallergenic label on some products does not mean that they are lower in latex allergens than non-hypoallergenic products.

Use rubber gloves without talcum powder, low in allergens / soluble proteins, rubber additives and endotoxins. Practice shows that the transition to the use of such gloves leads to a decrease in the number of cases of allergies and gives allergy sufferers with mild symptoms the opportunity to continue working at the same workplace.It also matters for patients. Manufacturers should be required to supply such gloves with regulatory documentation.

If the gum is fused with the cheek

The gum was sewn to the cheek – Question to the dentist

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Why do gums hurt? Causes and Treatment of Gum Pain

Causes of Gum Pain

Painful gums are a common problem. Pain, swelling, or bleeding of the gums can be caused by a variety of conditions.

Read to learn about 12 causes of gum pain.

Good oral hygiene includes brushing and flossing.However, if you are too aggressive, you can irritate and even damage your gums, especially if you use a toothbrush with stiff, stiff bristles.

If your gums hurt after brushing, use a soft-bristled brush that will usually brush your teeth as well as hard-bristled teeth and are recommended by the American Dental Association. Also, be less aggressive when brushing and flossing your teeth.

If your gums are red, swollen, and bleeding, chances are that you have gum disease (periodontal disease).This is usually due to not flossing and not brushing your teeth often enough. The most common type of gum disease is gingivitis. A less common but more severe type is periodontitis.

Early detected gingivitis can be treated with good oral hygiene. To stop sore gums, brush and floss your teeth twice a day and use a mouthwash. If left untreated, gingivitis can progress to periodontitis, which can lead to tooth loss.

Mouth ulcers – also known as mouth ulcers, are painful, non-contagious sores that appear on the gums and elsewhere in the mouth. They are sometimes red, but may have a white coating.

The cause of the ulcer is unknown, but it is believed to be caused by a viral or bacterial infection. Ulcers are more common in people with autoimmune diseases.

There are no specific medical recommendations for the treatment of ulcers. They tend to disappear within 14 days.If your mouth sore lasts more than three weeks, see your dentist.

Smoking tobacco products such as cigarettes and cigars can damage the gums. The use of smokeless tobacco, such as chewing tobacco or snuff, can be even more harmful. If you use tobacco, this may be why your gums hurt.

To improve gum health, stop using tobacco products. Not only do they damage the gums, but they can also cause cancer.

Some people have allergic reactions to ingredients in toothpaste, mouthwash, and other oral hygiene products.This could be the reason that your gums hurt.

If you think you may be allergic to an oral hygiene product, try to find out what is causing the reaction: simply eliminate one product at a time to determine the one causing the symptom. Once you identify the product, discontinue it. usage.

Sore gums may be an allergic reaction to food rather than oral hygiene.

The elimination diet can help you determine which food allergies are damaging your gums.To try this diet, stop eating certain foods for 30 days and then bring them back again to see what happens.

A quicker way to determine which food or other substance is causing a reaction is to see an allergist. They can help you determine the cause of your reaction and recommend treatment, which is likely to include avoidance.

Sometimes you can burn your gums with hot food, such as pizza or coffee, and forget about the incident.Later, soreness of the burned area is felt.

Unless you continue to irritate the burn with hot food or aggressively brushing your teeth, the gum tissue will usually heal within 10 days to two weeks.

For many women, hormonal changes can affect the health of the gums at different times in their lives, including:

• Puberty. The influx of hormones during puberty can increase blood flow to the gums, which can lead to swelling and tenderness.
• Menstruation. Shortly before each period, some women may have swollen and bleeding gums. This problem usually goes away after your period starts.
• Pregnancy. From the second or third month of pregnancy to the eighth month, some women develop swollen, painful, and bleeding gums.
• Menopause. In some women during menopause, the gums are unusually dry, which can cause soreness and the possibility of bleeding.

If you notice gum pain associated with one of these hormonal disorders, ask your dentist to review your situation and recommend treatment.

Infection at the root of a tooth can form an abscess. This can lead to inflammation and swelling of the gums. If the dentist diagnoses an abscess, they will also recommend treatment. A root canal procedure is often required.

Incorrect dentures and partial dentures irritate the gums. This constant irritation can lead to tissue damage and gum disease.You can work with your dentist to adjust the fit of dentures or partial dentures and relieve gum pain.

Good oral health is supported by good nutrition, which includes getting enough vitamin B and vitamin C.

Vitamin deficiency can lead to a number of conditions, such as scurvy, which can cause swollen and sore gums and other symptoms.

Maintaining a healthy, balanced diet that meets the RDA for vitamins and minerals can help treat vitamin deficiency.

Oral cancer usually presents as an ulcer that does not heal. Cancer can appear on the gums, the inside of the cheeks, the tongue, and even the tonsils.

If you have a sore in your mouth that does not heal within two weeks, visit your dentist for a diagnosis. Cancer treatments often include surgery to remove cancer cells or tumors, radiation therapy, and chemotherapy.

There are a number of reasons why you may experience gum pain, but many can be avoided by maintaining a healthy lifestyle, including good oral hygiene.

If you have persistent pain, swelling, or sores on your gums that last longer than a couple of weeks, make an appointment with your dentist for a complete diagnosis and treatment recommendations.

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Causes of Swollen Cheeks, Diagnosis and Treatment

Edema is an enlargement of areas of the body, often due to inflammation or fluid accumulation. It can happen in joints and limbs, as well as in other parts of the body, such as the face.

Puffy cheeks can make your face noticeably puffy or round.The swelling can develop without pain or with symptoms such as soreness, itching, or tingling. It may feel like you have swelling of your mouth inside your cheek.

Although a puffy face can change your appearance, puffy cheeks are not always serious and may indicate a minor health problem or a medical emergency such as anaphylaxis. It can also be a symptom of a serious underlying medical condition, such as cancer.

Read to learn about common causes of swollen cheeks and how to reduce swelling.

Cheek swelling may occur gradually over several hours or appear out of nowhere. There is no single cause for this change in appearance, but rather multiple plausible explanations.

Preeclampsia

Preeclampsia causes an increase in blood pressure during pregnancy, which often begins after about 20 weeks. This condition can cause sudden swelling of the face and hands.

Ambulance

If left untreated, complications of preeclampsia include organ damage and maternal and child death.Call 911 or go to the emergency room if you are pregnant and experiencing:

• sudden swelling
• blurred vision
• severe headache
• severe abdominal pain

cellulite

This bacterial skin infection usually affects lower legs, but the face can also develop, causing the cheeks to become swollen.

Cellulite occurs when bacteria enter the skin through an injury or rupture.It is not contagious, but can be life-threatening if the infection spreads into the bloodstream. See your doctor for any skin infection that doesn’t get better or gets worse.

Other symptoms of cellulite include:

Anaphylaxis

Anaphylaxis is a life-threatening allergic reaction. Your body goes into shock, after which the airway narrows and you experience swelling around your face, tongue, or throat, which can cause swollen cheeks.

Other symptoms of anaphylaxis include low blood pressure, weak or fast pulse, fainting, nausea, and shortness of breath.

Ambulance

If you think you or someone else has anaphylaxis, call 911 immediately and use an epinephrine EpiPen to stop a severe allergic reaction.

Tooth abscess

Tooth abscess is a purulent pocket that forms in the mouth. It is caused by a bacterial infection and is characterized by pain and swelling around the cheeks.

If left untreated, an abscess can lead to tooth loss or the infection can spread throughout the body.Symptoms include:

See your dentist if you experience severe pain in your mouth.

Pericoronitis

This condition refers to inflammation of the gum tissue, usually affecting the gums around the developing wisdom tooth. Symptoms of pericoronitis include swollen gums and cheeks, a discharge of pus, and a bad taste in the mouth.

Mumps

Mumps is a type of viral infection that can also lead to swollen cheeks. This infection affects the salivary glands, causing swelling on one or both sides of the face.Other symptoms include:

• fever
• headache
• muscle pain
• pain when chewing

Complications of mumps include:

If you have mumps, see your doctor about any pain or swelling of the testicles, or if you develop neck stiffness, severe abdominal pain, or severe headache.

Injury to the face

Injury to the face can also cause swelling of the cheek, which can occur after a fall or blow to the face.Trauma to the face can sometimes lead to bone fractures.

Signs of a facial fracture include bruising, swelling, and soreness. See your doctor after a facial injury if you have severe bruising or pain that persists.

Hypothyroidism

In hypothyroidism, the body does not produce enough thyroid hormone. It can also cause facial puffiness. Other symptoms include fatigue, weight gain, muscle weakness, joint stiffness, and impaired memory.

Cushing’s Syndrome

In this condition, the body produces too much of the hormone cortisol. Cushing’s syndrome can cause weight gain in various parts of the body, including the face and cheeks.

Some people with Cushing’s syndrome also bruise easily. Other symptoms include purple or pink stretch marks, acne, and slow-healing wounds. If left untreated, this condition can cause high blood pressure, type 2 diabetes, and bone and muscle loss.

Long-term steroid use

Long-term use of the steroid prednisone (used to treat autoimmune diseases) is another possible cause of swollen cheeks and is another cause of Cushing’s syndrome. This medication may cause weight gain and fatty deposits on the sides of the face and the back of the neck.

Other steroid side effects include headache, thinning of the skin, and anxiety.

Swelling of the salivary gland

Swelling of the salivary gland can also cause swelling of the cheeks, as well as of the mouth, jaw and neck.One side of the face can also change in size or shape. Other symptoms of a tumor in this part of the body include:

• facial numbness
• facial weakness
• trouble swallowing

Some salivary gland tumors are benign. However, malignant tumors are cancerous and can be life-threatening. See your doctor if you have an unexplained swelling on your cheeks, especially if the swelling is accompanied by facial numbness or weakness.

Certain conditions that cause swelling of the cheek affect both sides of the face. Others cause swelling on only one side of the face. Common causes of one-sided cheek swelling include:

• tooth abscess
• facial trauma
• salivary gland swelling
• cellulite
• pericoronitis
• mumps

Edema affecting not only the cheeks but also the gums may indicate a major dental problem.Common causes of swollen gums and cheeks include pericoronitis or tooth abscess.

Some people with swollen cheeks experience pain, but others do not have tenderness or inflammation. Conditions that can cause swelling without pain include:

• anaphylaxis
• hypothyroidism
• long-term steroid use
• Cushing’s syndrome

Children may also develop swollen cheeks. Some of the more likely causes include:

• mumps
• cellulitis
• Cushing’s syndrome
• trauma
• tooth abscess
• long-term steroid use
• anaphylaxis

Since there is no single cause of swollen cheeks, there is no single test to diagnose the main problem.

A doctor can diagnose some conditions based on a description of your symptoms and a physical examination. These include anaphylaxis, mumps, cellulitis, and tooth abscess.

Sometimes other tests are needed to diagnose the cause, including:

Be specific when explaining the symptoms. Your description will help doctors narrow down the possible causes, which will help them determine which diagnostic tests should be performed.

Treatment for swollen cheeks varies and depends on the underlying medical problem.

Home Remedies

The swelling may not go away completely until the cause of the symptom is corrected, but the following measures can help reduce swelling on the cheeks:

• Cold compress . Cold therapy reduces swelling and can stop the pain, numbness of the area. Apply a cold compress to your cheeks for 10 minutes and break for 10 minutes. Don’t put ice directly on your skin. Instead, wrap the cold compress in a towel.

• Head rise. Elevation reduces blood flow to the swollen area and reduces swelling. Sleep straight in a chair or raise your head with extra pillows in bed.

• Reduce salt intake. Eating salty foods may increase fluid retention and make puffy cheeks worse. Prepare food with salt substitutes or herbs.

• Cheek massage. Massaging this area will help remove excess fluid from this part of the face.

Treatments

Depending on the underlying cause, medications to correct hormonal imbalances may be needed to treat swollen cheeks.This is often the case if you have been diagnosed with hypothyroidism or Cushing’s syndrome.

If you are taking steroids such as prednisone, reducing the dosage or stopping the drug may also reduce the swelling. However, do not stop taking your medication without first talking to your doctor.

Your doctor may also prescribe an antibiotic if a tooth or skin infection is the underlying cause.

Antihistamines (oral or intravenous) can treat an allergic reaction by reducing facial swelling.

If you have preeclampsia, you will need medicines to lower your blood pressure and possibly corticosteroids or anticonvulsants to prolong your pregnancy. If these medications don’t work, you may need to have your baby early.

If you have a tumor of the salivary gland, the benign growth can be surgically removed. Radiation therapy or chemotherapy may also be required for malignant (cancerous) growth.

Other possible treatments for swollen cheeks:

See your doctor for any cheek swelling that persists or gets worse after a few days.You should also see your doctor for any accompanying symptoms such as:

• severe pain
• difficulty breathing
• high blood pressure
• dizziness
• severe stomach pain.

An increase in the puffiness of one or both cheeks can be alarming. But swelling on the cheeks is not always indicative of a serious problem. At the same time, never ignore unexplained puffiness.

.

Mucous cyst: causes, symptoms and diagnosis

What is a mucous cyst?

A mucous cyst, also known as a mucocele, is a fluid-filled swelling that occurs on the lip or mouth.

A cyst develops when the salivary glands of the mouth become clogged with mucus. Most cysts are found on the lower lip, but they can form anywhere in the mouth. They are usually temporary and painless. However, cysts can become permanent if left untreated.

Mucous cysts most often result from injuries of the oral cavity, for example:

• lip biting (most common cause)
• cheek bite
• piercing
• accidental rupture of the salivary gland
• adjacent teeth causing chronic damage

Bad Oral hygiene and the habit of biting lips or cheeks due to stress can also increase the risk of developing mucous cysts. In some people, these cysts occur because of a bad reaction to toothpaste that prevents tartar formation.

Mucous cysts are most common in people between the ages of 10 and 25. However, these cysts can occur in people of any age. They are also the same in both women and men.

Symptoms of a mucous cyst vary depending on how deep the cyst is in the skin and how often the cyst occurs. Most cysts are not painful, but they can be uncomfortable. Frequent cysts can become painful over time.

Symptoms of a cyst near the surface of the skin include:

• swelling
• bluish color
• soft
• lesions less than 1 centimeter in diameter

Symptoms of a cyst in the deeper layers of the skin include: shape

If a cyst appears in or around your mouth, see your doctor.You will need to get a correct diagnosis so that your doctor can rule out more serious conditions. You should also see your doctor if the cyst becomes large and uncomfortable. Although most mucous cysts are less than 1 centimeter in diameter, in rare cases, cysts up to 3.5 centimeters in size can develop.

Smaller, painless cysts are often not found until you see your dentist. This is especially true for mucous cysts that develop in the mouth. Your dentist may refer you to a doctor for biopsy and other diagnostic tests.

In most cases, your doctor will allow the mucous cyst to heal on its own. If the cyst has not disappeared after two months, see your doctor again.

Doctors rely on clinical symptoms to make a diagnosis. Your doctor may also ask if you have a history of lip biting injuries. Your answer will help your doctor make an accurate diagnosis.

In some cases, a cyst biopsy may be required to make a positive diagnosis.During this procedure, your doctor will take a small sample of tissue and examine the tissue under a microscope. By looking at the cells, doctors can determine if the cyst is malignant or not.

Doctors may request a biopsy when:

• Mucosal cyst is larger than 2 centimeters
• The appearance of the cyst indicates an adenoma (cancer) or lipoma
• No history of trauma

Treatment is based on the severity of the mucous cyst. Sometimes cysts may not need treatment and will heal on their own over time.Superficial cysts often resolve on their own. To prevent infection or tissue damage, do not try to open or remove cysts at home. Frequent or recurring cysts may require further treatment.

Treatments used for mucosal cysts that are not very severe include:

• Laser therapy . A small, focused beam of light is used to remove the cyst.
• Cryotherapy . This product removes the cyst by freezing its tissue.
• Intrafocal corticosteroid injection. This treatment injects a steroid into the cyst to reduce inflammation and speed up healing.

To prevent recurrence or to treat particularly severe cysts, your doctor may recommend surgical removal of the cyst or even the entire salivary gland.

Healing of a mucosal cyst may take a week to two years after treatment, depending on the type and severity of the cyst.

Even after healing, the only way to ensure the cyst does not come back is to surgically remove it. Avoid habits such as lip or cheek biting to prevent future cysts from forming.

Often, the recovery of a mucosal cyst simply takes time. You should check the cyst from time to time to make sure it is not infected or enlarged. Rinsing with warm salt water can speed up the healing process.

If you bite your lips or cheeks regularly, you may also consider giving up these habits.Keep a journal and write down how often you bite – this is most likely related to stress, anxiety, or boredom. Once you’ve identified the triggers, you can try to find ways to stop biting your lips and cheeks. Chewing sugar-free gum is just one way to satisfy the urge to bite without hurting yourself.

While home remedies may be helpful in healing some mucous cysts, it is important to avoid self-diagnosis. Your doctor can make sure the bumps are not related to something more serious, such as oral cancer.

Once identified and correctly diagnosed, mucous cysts recover quickly. These are benign (benign) cysts, so they do not pose a serious health problem. The biggest complications of mucosal cysts are pain and discomfort. If you suspect a mucous cyst is in or around your mouth, get it checked immediately.

.

Exercise IV. Analyze the structure, semantics and functions

Originality

9.The man stood in the middle of the street, behind him was an abandoned boulevard drenched in dawn. (..) brightness and elaboration of the created image

10. When she betrayed Daniel to his fate, she felt joy arising in her heart. (A.B.) expressiveness

Exercise II: Indicate the metonyms, indicate the type of relationship between the named object and the implied object they represent, also note the degree of their originality and their syntactic function:

1.He walked around her room, after his presentation, examining her paintings, her bronze and clay, asking the creator of this, the artist of where the third thing came from. (Doctor)

2. She wanted to have many children, and she was glad that everything was so that the Church approved. Then the little girl died. Nancy broke up with Rome on the day her child died. It was a secret break, but Catholics do not break with Rome by accident. (J.O’H.)

3. “Evelyn Glasgow, get up from your chair now.”The girl looked up from the book. “What’s happened?”

“Your atlas. The skirt will have a lot of folds in the back. ” (E. F.)

4. Except for the lack of youth, the guests did not have a common theme, they seemed strangers among strangers; indeed, as they entered the room, each face did its best to hide the horror of seeing others there. (TC)

5. She saw around her, clustered around white tables, many bright red lips, powdered cheeks, cold hard eyes, self-assured arrogant faces and insolent breasts.(A.B.)

6. Dina, slender, fresh, pale eighteen, was lithe and fragile at the same time. (..)

7. The man looked rather old at forty-five, because he was already saddled. (KP)

8. The gourmet master was lively and cheerful fifty. (TR)

9. “It was easier to take on the role of a character without telling too many lies, and you brought a fresh perspective and mind to the work.” (P.)

10. “Several wonderful pictures in this room, gentlemen.Holbein, two Van Dycks and, if I’m not mistaken, Velasquez. I’m interested in pictures. ” (Ch.)

Exercise III. Analyze the various cases of wordplay, indicate what type is used, how it is created, what effect it adds to the pronunciation:

1. After a while, he nervously crept to the door of the living room. (A. T.) zeugma

2 I’m looking for two things in a man. Responsive character and full lips. (I.Sh.) Zeugma

3.Dorothy, on my statement, covered her mouth with her hand to contain her laughter and chewing gum. (Jn.B.)

4. I believed that all men were brothers; she thought all men were husbands. I gave up all the mess. (Jn.B.) zeugma

5. In December 1960, in the famous special edition Naval Aviation News, , it was explained why the “ship” is called “she”: because all around he is always bustling about; because usually a gang of men goes with her; because it has a waist and it remains; because it takes a good man to treat her right; because it shows its topsides, hides its bottom and, when entering the port, always goes to the buyers. “(N.) zeugma

6 . When I die, I hope they will tell me:

“His sins are crimson, but his books have been read.” (HB)

7. Most women in London nowadays seem to furnish their rooms with nothing but orchids, foreigners and French novels. (OZ)

8. Now I am full of poetry. Rot and poetry. Rotten poetry. (H) pun

9. “Bren, I’m not planning anything.I haven’t planned anything for three years … I’m – I’m not a planner. I’m a liver. ”

“ I’m a pancreas, ”she said.“ I, ”and she kissed an absurd game. (Ph. R.)

10. “Someone at the door,” he said, blinking.

– Judging by the sound, about four, – said Fili. (AT) zeugma

Exercise IV. You will find mostly examples of verbal irony in the passages Explain what conditions made the opposite assessment possible.Note the part of speech used in irony, as well as its syntactic function:

2. When the war began, she took a signed photograph of the Kaiser and hung it with some solemnity in the servants’ dressing room; this was her only combat action. (EW)

3. “I had a conspiracy, a plan, a little quiet entertainment, the essence of which was that this old man and grandson should be poor, like frozen rats,” and Mr. Brass revealed the whole story, portraying himself rather holy holy character.(D.)

4. The elevator accommodated two people and slowly rose, groaning with uncertainty. (I.M.)

5. England has been in a terrible state for several weeks. Lord Koodle will leave. Sir Thomas Doodle did not come, and in Great Britain (not to mention others) there was no government (D.)

besides Koodle and Doodle.

6. From early childhood Gertrude was raised by an aunt. Her aunt carefully taught her Christian principles. She also taught her Islam to be sure. (L.)

7.She’s a charming middle-aged lady with a bucket of mud face, and if she washed her hair after Coolidge’s second term, I’ll eat my spare tire, rim and all. (R.Ch.)

8. With all the expressiveness of a stone Welshman, he looked at him for another twenty seconds, apparently hoping to see him shut up. (R.Ch.)

9. “Well. The evening turns into a wonderful one, isn’t it?” “Great,” he said.

“And so to speak, you do everything to complicate the task, honey.”(DP)

Exercise V. Analyze the following cases of antonomasia. Indicate the type of used and implied meaning; indicate what additional information is created when using antonomazia; Note the morphological and semantic characteristics of common nouns used as proper nouns :

5. “Her mother is absolutely unbearable. Never met a Gorgon like this.”In any case, she is a monster, not a myth. ” (O.W.)

6. Our secretary is Esther D’Eath. Vulgar relatives pronounce her name as Dirt, some of us pronounce it Dit. (S. Ch.)

7. When Omar P. Quill died, his attorneys always called him O.P.Q. Each link to the O.P.Q. made Roger think of his grandfather as the middle of the alphabet. (GM)

8. “Your Fur and its Caddy fit perfectly. I respect history: don’t you know that Detroit was founded by Sir Antoine de la Motte Cadillac, a French fur trader.”(J.O’H.)

9. Now let me introduce you – it’s Mr. What is his name, you remember him, don’t you? call it American. (EW)

10. Cats and canaries added a whole new dimension of defeat to an already obsolete home. him because she knew that he would do anything in the world if he was paid for it, or he was afraid not to do it.She had no illusions about him. Joe was essential in her business. (J. St.)

12. What choice do Mr. and Mrs. Average have in the year of the moon landing – a poverty alleviation program or an ambitious NASA project? (MS)

13. The next speaker was a tall, gloomy man. Sir Something Someone. (P.)

14. We sat down at a table with two girls in yellow and three men, each of whom introduced himself to us as Mr. Mumble. (Sc.F.)

15. She was in the bedroom with one of the young Italians, Count Sizing.(I.Sh.)

Exercise VI. Discuss the structure and semantics of epithets in the following examples. Determine the type and purpose of the epithets:

4. He is a proud, arrogant, stubborn, arrogant peacock. (D.)

10. Her painful shoes slipped off. (U.)

11. She was a faded white rabbit of a woman. (A.S.)

12. And she still has this look, this “don’t touch me” look that women who were beautiful carry with them to the grave (J.B.)

13. Ten thirty is a dark hour in the city, where respectable doors are locked at nine. (T.C.)

14. He liked the smell of her hair after bathing. (Jn.B.)

15. I had to secretly record, with a powerful camera lens for a long distance, the meeting of Ken and Jerry in a “battery walk in the sun” style. (D.U.)

16. “Thief!” – shouted Pilon. “You dirty pig of your unfaithful friend!” (J.St.)

17. After dinner, she spent the Hausfrau jumping in the steam room of her miniature kitchen.(T.C.)

18. He nodded in greeting to an early buyer. (D.U.)

19. He did not like this ever-tragic appearance of the Shakespearean actor at all. (H.)

20. “What a picture!” shouted the ladies. “O! Lambs! Oh, sweets! Oh, ducks! Oh, pets! ” (K.M.)

Exercise VII. In the following examples, focus on exaggeration and understatement, note their originality or relevance, other SDs that contribute to their effect, and the exact words that contain the underlying emotional meaning:

1.I was scared to death when he entered the room. (S.)

2. The girls were dressed to kill. (J.Br.)

3. Newspapers are the organs of individual men who are trying to become party leaders in countries where a new batch is born every hour over a glass of beer in the nearest cafe. (JR)

4. I, as always, very sympathetic. (Jn.B.)

5. Four loudspeakers attached to the flagpole emitted a devastating roar that Benjamin could hardly call music, as if it were being played by a collection of brass bands, several hundred fire engines, a thousand blacksmith’s hammers and amplified sound reproduction wind force twelve.(AS)

6. The car that picked me up that very guilty evening was a Cadillac limousine about seventy-three blocks long. (J.B.)

7. She has one aunt in her family for about a thousand years. (Sc.F.)

8. He did not look like the same person; then it was all milk and honey – now it was all starch and vinegar. (D.)

9. She was a giant woman. Her plump figure was encased in a green crepe dress and red shoes on her feet. She carried a giant red purse that protruded as if it were filled with stones.(Florida)

10. She was very upset by the catastrophe that befell the bishops, but she was exciting, and it tickled to death that she had someone fresh to whom she could tell everything. (SM)

11. Babbitt’s preparations to leave the office to himself during his hour and a half of his lunch break was somewhat less thoughtful than the plans for an all-out European war. (SM)

12. The little woman, because she was pocket-sized, solemnly crossed her arms over her chest.(G.)

13. We danced on a scarf, a large space between the tables for the bar. (RV)

14. She wore a pink hat the size of a button (J.R.)

15. She was a sparrow woman. (Ph. L.)

16. And if one of us bends towards the other, even a fraction of an inch, the balance will be upset. (OZ)

17. He smiled back, breathing in my memories of gin. (W.G.)

18. About a very small man in the navy: this new sailor in sea boots was not five feet tall.(Th.P.)

19. She committed suicide in her miniature kitchen. (T.C.)

20. The rain intensified, the fish could swim through the air. (T.C.) hyperbole

Exercise VIII. In the following sentences, note the structure and semantics of oxymorons. Also indicate which of their members conveys an individually viewed characteristic of the object, and which reflects its generally accepted characteristic:

1. He was driving home to a packed deserted barracks.(J.)

2. Running to the elevator, he was amazed at his own cowardly courage. (G.M.)

3. They were a damn pathetic lot – the most pathetic lot of people I have ever seen. But they treated me well. Pretty damn good. (J. St.)

4. He behaved rather vile towards Ian (DC)

.

5. He might have noticed that her hair was hanging in beautiful numbers in strands, some curled, and some seemed to have forgotten about it, with such careless care and art, so hiding the art that she thought she would put it in a pattern …(Ph. S.)

6. There were several cabinets with incredibly unreadable books. (E. W.)

7. We were absorbed in the pleasures of travel, and I, in my humble pride that I was the only examiner who caused excitement – we were over the old bridge. (W. G.)

8. “Heaven must be hell. There are only repentant sinners, aren’t they? ” (Sh. D.)

9. Harriet turned back through the dark garden. A dim light watched from the night sky. (I. M.)

10.Sarah was a threat and tonic, my best enemy; Rozzie was a disease, my worst friend. (J. Car.)

11. It was no secret that Ray ripped off his father-in-law. (DW)

12. The neon sign reads “Welcome to Reno, the largest town in the world.” (AM)

13. Huck Finn and Holden Caulfield are the good bad guys in American literature. (Q.)

14. Aren’t we a middle-aged young woman here who cannot compete with the paid models in a fashion magazine, but who still catches your eye? (John.H)

15. Their bittersweet union did not last long. (AS)

16. He was confident that whites would notice his adoring hatred for them. (Wr.)

17. You have two great bad examples for parents. (Sc. F.)

18. Opened a wooden garage. The doors creaked. There was nothing in the garage. (R. Ch.)

19. She was a damn good woman too. (H.)

20. A very handsome young man with a pleasantly ugly face. (A.S.)

Exercise II. From the following examples, you will get a better understanding of the functions of the different types of repetition, as well as concurrency and chiasm:

1. I wake up and I am alone, I walk around Worley and I am alone; and I talk to people, and I am alone, and I look at his face when I am at home, and it is dead. (J. Br.) parallelism

2. Babbitt was virtuous. He advocated the prohibition of alcohol, although he did not practice it; he praised, although he did not obey motor speeding laws.(S. L.) parallelism

3. “Think about it better,” replied the gallant Blandois, “neglecting a lady, neglecting a lady means losing chivalry in relation to gender, and chivalry in relation to gender is part of my character. … “(D.) chiasm

4. Halfway down the right side of the dark brown hallway was a dark brown door with a dark brown sofa next to it. After I put on my hat, gloves, scarf and coat onto the sofa, the three of us walked through the dark brown door into the dark without brown.(WG) chiasm

5. I might just as well face facts: goodbye Susan, goodbye, big car, goodbye, big house, goodbye, strength, goodbye, stupid pretty dreams. (J.Br.) parallelism

6. I really don’t see anything romantic about the proposal. Being in love is very romantic. But there is nothing romantic about a specific proposal. (O. W.) chiasm

7.wanted to knock the table over and hit him until my hand was no longer strong, then give him a shoe, give him a shoe, give him a shoe. I took a deep breath. (J. Br.) Parallelism

8. She was sure that her father was unfoundedly suspected. Of course. Of course. (D.) repetition at the end

9. Now he understands. He understood a lot. First of all, you can be human. First a man, then a black or white man.(PA)

10. She stopped and seemed to catch the distant sound of a knock. Throwing the traveler, she hurried into the living room, in the corridor she must have heard a knock, an angry and impatient knock, the knock of a man who thinks he knocked too long. (AB)

11. Obviously it is a streptococcal infection. Obviously. (VD)

12. And a great desire for peace, peace of any kind, seized her. (AB)

13. When he blinks, a parrot-like gaze appears, the gaze of some strongly blinking tropical bird.(AM)

14. And there were people everywhere. People enter the gate and leave the gate. People stagger and fall. People fight and swear. (PA)

15. Then there was something between them. There was. There was. (Doctor)

16. He fled from the battle. He was an ordinary person who did not want to kill or be killed. Therefore, he fled the battle. (St. H.)

Exercise III. Find and analyze cases of detachment, obscurity and inversion. Please comment on the structure and function of each:

1.She narrowed her eyes slightly, looking at me, and said that I looked exactly like the boy Celia Braganzas. Around the mouth. (S.)

2. He watches everything with a keen eye, not malevolent, and full of fun rather than judgment. (VV) unknown

3. She was crazy about you. At the beginning. (R.U.)

4. How many images of new travels in a pleasant country, places of rest under a free wide sky, walks in fields and forests, and paths that are not often walked – how many tones of this well-remembered voice, how many flashes of form , a fluttering dress, hair that fluttered so merrily in the wind – how many visions of what was and what he had hoped for had not yet appeared before him in the old, dull, silent church! (D.) detachment

5. These were not monotonous days, not constrained by variety and not accompanied by pleasant communication, these were not dark, dull evenings or long solitary nights, it was not the absence of all the light and light pleasures for which they fought high young hearts, or knowing nothing about childhood, except for its weakness and easily vulnerable spirit, which caused such tears in Nell. (D.) unknown

6. Of all my old connections, all my old aspirations and hopes, all the living and dead world, this poor soul alone is natural to me.(D.) obscurity

7. Corruption could not spread with such success, although it was reduced to a system, and although some ministers with the same impudence and recklessness themselves and their defenders recognized it as the main means of government; if a long and almost unobservable progression of causes and effects did not prepare the conjuncture. (Large) detachment

8. I was accused of bad taste. It worried me not so much for my own sake (as I am used to neglect and arrows of incredible fate), but for the sake of criticism in general.(SM) detachment

9. He wandered day and night under the scorching sun and cold pale moon; through the dry heat of noon and the damp chill of the night; in the gray light of the morning and the red light of the eve. (D.)

10. Benny Collan, dear fellow, Benny Collan wants to marry her. Can the agent ask for more? (. C.) suspension

11. Women are not made to attack. They have to wait. (J.C.) inversion

12.The chase went, the horses chased – the boys jumped on – they drove the travelers. (D.) inversion

13. Then he said, “Do you think this is so? Is she involved in this lousy business? ” (JB) unknown

14. And she saw that Gopher Prairie was just an extension of all the villages they passed. It was exceptional for Kennicott alone. (S. L.) detachment

Exercise I.Discuss the semantic centers and structural features of the antithesis:

1. Ms. Nork had a big house and a little husband (S.L.)

2. Don’t use big words. They mean so little. (OU)

3.1 love big parties. They are so intimate. There is no privacy at small parties. (Sc. F.)

4. There is Mr. Guppy, who was first opened like the sun at noon, but suddenly shut up almost before midnight. (D.)

5. Same scene as when Keith entered! Such a

confusion of languages ​​before the circumstances were cleared up,

and the evidence was revealed! Such a dead silence when everything was

said! (D.)

6. Roop would like to be quick, precise, compassionate

and stern, not awkward, vague and sentimental. (IM)

7. His sleeves are too long, and his

trousers were too short, in

he was uncomfortable.

his clothes. (D.)

8. There was something eerie in the apartment building,

unearthly silence, which was a combination of overlap

and lack of employment. (St. X.)

9.It is safer to be married to a man with whom you can be

satisfied than a man, without whom it is impossible to be happy.

(E.)

10. Then the gentleman ran down the stairs from

.

mustache, out of breath. (D.)

11. Those were the best times, there were the worst times,

it was the age of wisdom, it was the age of stupidity,

it was the age of faith, it was the age of distrust,

it was the season of Light, it was the season of Darkness,

it was a source of hope, it was a winter of despair; we had everything ahead of us, we had nothing in front of us, we were all going straight to Heaven, we were all going straight the other way – in short, the period was so far from the present that some of its noisiest authorities insisted on its received for good or for evil, only in the superlative degree of comparison.(D.)

Exercise II. Indicate the type of climax. Notice its structure and the semantics of its components:

1. He clearly saw that the best cover story was

or camouflage. While he was wondering what to do,

he first dismissed the stop as impossible, then as unlikely,

then pretty awful. (W. G.)

2. “Is it a shark?” Brody said. The likelihood that at

he was the last to confront the fish – the beast, the monster, the

nightmare – made Brady’s heart beat faster.(PB)

3. If he got into the governor’s primaries on his

own hook, he would look realistic. But this

was different. They called him. He was moved. He was summoned. (RW)

4. We were all to each other, it was morning

.

life, it was bliss, it was madness, it was everything else

of this kind in the highest degree. (D.)

5. Like a well, like a crypt, like a grave, there was

in the prison without knowing the brightness outside.(D.)

6. “I will be sorry, I will really be sorry to leave you, my friend.” (D.)

7. “Of course, this is important. Incredibly, urgent, desperately important. ” (DS)

8. “I never told you about the letter that Jane Croft received from her minister when she was sick. He wrote a letter to Jane, and the address on the envelope was: Jane Croft; the Croft farm; Gravers Corners; Sutton County; New Hampshire; United States of America “What’s so funny about that?” “But listen, this is not the end: United States of America;

Continent of North America; Western Hemisphere; Earth;

Solar system; Universe; The mind of God is what is written on the envelope. “(Th. W.)

9. “I see, sir, you’ve heard of Jefferson Brick,” said

.

Colonel with a smile. “England has heard of Jefferson

Brick. Europe has heard of Jefferson Brick.” (D.)

Exercise III. Discuss the following comparison cases. Pay attention to the semantics of the tenor and the vehicle, whether they are short or long term. Indicate the basis of the comparison, both explicit and implicit. Find examples of disguised comparisons, don’t miss the link word connecting the two parts of the structure:

1.The menu was not just a panorama, but repetitive, like snoring. (ON)

2. The theme of the younger generation spread throughout the company like a yawn. (E. W.)

3. The pennies in the slot machines stood there like many blank faces, their dials glowing and twinkling – for no one.

(BN)

4. Wet like a fish, dry like a bone;

Alive like a bird, dead like a stone;

Plump as a partridge, cunning as a rat; Strong as a horse – weak as a cat;

Hard as flint – soft as a mole;

White as a lily, black as coal;

Simple as a pike, rough as a bear;

Strong as a drum, free as air;

Heavier than lead – light as a feather;

Firm like time – unreliable like weather; Hot as an oven, cold as a frog;

Cheerful like a lark, sick like a dog;

Wild like a tiger and soft like a dove;

Tough as a poker, as weak-willed as a glove;

Blind as a bat, deaf as a pillar;

Cool like a cucumber, warm like toast; Flat like a flounder, round like a ball; Dull as a hammer, sharp as an awl;

Fragile like glass, hard like cartilage;

Clean as a pin, clean as a whistle;

Red like a rose, square like a box.(ON)

5. She was always alive like a bird. (R. Ch.)

6. She was stubborn like a mule, she was always with

.

children. (G.)

7. Children! Breakfast is as good as any other meal

and I won’t let you gobble up like wolves. (Th. W.)

8. Six o’clock still found him hesitant. He had

no appetite for lunch and his abdominal muscles were fluttering

as if a flock of sparrows were flapping their wings against

of his insides.(Wr.)

9. And the cat, released, jumped and sat on her

shoulder: its tail waving a club, conducting a rhapsody of

music. (..)

10. He felt that his presence must, like a drop

some kind of stain, a tincture of a crystalline liquid that was absolutely

itself. (R.U.)

Exercise IV. Analyze the structure, semantics and functions

liters:

1.“To be a good actress, she always has to work for the truth in what she plays,” the man said in a voice that was not devoid of self-love. (NM)

2. “Yes, what the hell,” Ann said, looking at me,

gave me an unkind smile. (RW)

3. It was not unnatural if Gilbert felt some confusion –

cop. (E. W.)

4. The idea was not completely wrong. I thought I did

don’t grieve me. (I.M.)

5. I was quiet, but not indifferent; reserved but

without retreat; energetic at times, but rarely enthusiastic.

(Jn. B.)

6. He had all the trust of the world and not

for no reason. (J. O’H.)

7. Kirsten said, not without dignity: “Too much chatter

is unreasonable” (ch.)

8. “No, I had a profession, and then a company that needs to be cherished.” ,

said Ravenstreet not without bitterness.(P.)

9. I felt that I would not say no to a cup of tea. (..)

10. I would not mind going to the cinema. (E. W.)

11. “I don’t think you were too unhappy, my dear.” (P.)

12. Yet two weeks of success is definitely nothing.

and phone calls came from agents within a week.

(Ph. R.)

Exercise V. Analyze the peripheral data in terms of their semantic type, structure, function and originality:

1.A Gargantuan soldier named Daoud chose Dodge

head and carefully examined the jumpsuit’s convulsions and despair

, whose legs darted a yard above the deck. (Th. P.)

2. His face was red, the back of his head was flooded with

his collar and the second edition

of his chin was recently published. (PGU)

3. His huge leather chairs were good for the thigh bone. (R.W.)

4. “But Pickwick, gentlemen, Pickwick, that ruthless destroyer

of this homely desert oasis on Goswell Street!” (D.)

5. He made some money and then came

came back and married his dream from Blackwood. (Doctor)

6. The villages were full of women who did nothing

, but fight dirt and hunger and eliminate the consequences of

rubbing on clothes.