1. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2) Policy Development Division 1 Identification and Removal of Lingual and Palatine Tonsils as SRMs in Beef Market Heads and Tongues USDA-FSIS-OPPD

2. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)2Policy Development Division FSIS Policy on Beef Tonsils Beef tonsils are identified as “specified risk materials” (SRMs) in cattle of all ages per 9 CFR 310.22(a)(2). Beef tonsils are identified as “specified risk materials” (SRMs) in cattle of all ages per 9 CFR 310.22(a)(2).9 CFR 310.22(a)(2).9 CFR 310.22(a)(2). FSIS policy has focused on removal of palatine and lingual tonsils in beef and is outlined in Chapter II, Part V. of FSIS Directive 6100.4. FSIS policy has focused on removal of palatine and lingual tonsils in beef and is outlined in Chapter II, Part V. of FSIS Directive 6100.4.FSIS Directive 6100.4FSIS Directive 6100.4

3. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)3Policy Development Division Beef Market Heads Beef Market Heads are typically sold as “whole” beef heads with tongue. Beef Market Heads are typically sold as “whole” beef heads with tongue. Beef Market Heads can only be saved from cattle less than 30 months of age after removal of grossly identifiable (i.e. visible to the unaided eye). Beef Market Heads can only be saved from cattle less than 30 months of age after removal of grossly identifiable (i.e. visible to the unaided eye) palatine and lingual tonsil tissue (SRM) within specified landmarks.

4. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)4Policy Development Division Beef Market Heads Whole beef market heads cannot be saved from cattle 30 months and older as the entire skull and associated non-meat components are considered SRM material per 9 CFR 310.22(a)(1). Whole beef market heads cannot be saved from cattle 30 months and older as the entire skull and associated non-meat components are considered SRM material per 9 CFR 310.22(a)(1).

5. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)5Policy Development Division FSIS Policy on Beef Palatine and Lingual Tonsils Palatine and lingual tonsil in the oropharynx are the designated tonsils (SRM) that must be removed during head boning including preparation of beef market heads and tongues. Other tonsils need not be removed as SRM unless found to be unwholesome. Palatine and lingual tonsil in the oropharynx are the designated tonsils (SRM) that must be removed during head boning including preparation of beef market heads and tongues. Other tonsils need not be removed as SRM unless found to be unwholesome.

6. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)6Policy Development Division FSIS Policy on Beef Pharyngeal and Tubal Tonsils Based on a lack of scientific evidence, the pharyngeal and tubal tonsils of the nasopharynx, are not considered SRM and need not be removed unless found to be unwholesome. Based on a lack of scientific evidence, the pharyngeal and tubal tonsils of the nasopharynx, are not considered SRM and need not be removed unless found to be unwholesome.

7. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)7Policy Development Division FSIS Verification Procedures for Removal of Tonsils in Beef Market Heads  FSIS Inspection personnel should follow verification procedures outlined in FSIS Directive 6100.4 regarding SRM removal procedures in the plant’s HACCP, SSOP, or pre-requisite program procedures to remove the designated tonsil tissue (SRM) of concern from beef market heads and tongues. FSIS Directive 6100.4 FSIS Directive 6100.4

8. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)8Policy Development Division Why the concern over Beef Market Heads? 1.Nationwide Data Analysis of SRM related NRs and a recent recall suggest not all specified tonsil tissue is being adequately removed from beef market heads and tongues.

9. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)9Policy Development Division Why the concern over Beef Market Heads? 2.Due to differences in processing of beef market heads compared to regular boning of beef heads, the verification of adequate removal of from beef market heads requires more in-depth knowledge of head anatomy and location of tonsils. 2.Due to differences in processing of beef market heads compared to regular boning of beef heads, the verification of adequate removal of palatine and lingual tonsil from beef market heads requires more in-depth knowledge of head anatomy and location of tonsils.

10. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)10Policy Development Division FSIS Verification Procedures for Beef Tonsils From FSIS Directive 6100.4:FSIS Directive 6100.4 1. Inspection program personnel are to verify that the establishment’s procedures for the removal, segregation, and disposition of tonsils [using] … accepted head dressing procedures [that include] removal of [tonsils on] the tongue…

11. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)11Policy Development Division FSIS Verification Procedures for Beef Tonsils (2) 2. If an establishment harvests tongue for human food, inspection program personnel are to verify that the establishment’s harvesting procedure includes making a transverse cut, or effectively skinning caudal (just behind) to the last vallate papillae on the tongue, to ensure complete removal of lingual tonsils.

12. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)12Policy Development Division Objectives Review the basic anatomy of the beef head observed during head inspection. Review the basic anatomy of the beef head observed during head inspection. Identify location and gross appearances of bovine palatine and lingual tonsils on: Identify location and gross appearances of bovine palatine and lingual tonsils on: 1. Beef market head 2. Beef tongues

13. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)13Policy Development Division Approach to Objectives Beef head inspection entails incision of the four (4) sets of lymph nodes and cheek muscles of the head. Beef head inspection entails incision of the four (4) sets of lymph nodes and cheek muscles of the head. Occasionally, tonsils may be observed during head inspection; therefore, we will demonstrate tonsils in a manner familiar to FSIS inspectors. Occasionally, tonsils may be observed during head inspection; therefore, we will demonstrate tonsils in a manner familiar to FSIS inspectors.

14. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)14Policy Development Division Approach to Objectives (2) This presentation will be accessible with other SRM guidance material on the FSIS PDD (Technical Service Center) website at: http://www.fsis.usda.gov/Regulations_&_Policies/P olicy_Points/index.asp#SRM http://www.fsis.usda.gov/Regulations_&_Policies/P olicy_Points/index.asp#SRM

15. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)15Policy Development Division Review of Head Inspection Anatomy Before locating and identifying the specified tonsils in a beef market head, it is beneficial to review the anatomical landmarks on the beef head observed during head inspection. Before locating and identifying the specified tonsils in a beef market head, it is beneficial to review the anatomical landmarks on the beef head observed during head inspection.

16. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)16Policy Development Division Review of Head Inspection Anatomy (2) This presentation will identify the specified palatine and lingual tonsils (SRMs) as they may be exposed while performing head inspection using a tongue-in head inspection procedure. This presentation will identify the specified palatine and lingual tonsils (SRMs) as they may be exposed while performing head inspection using a tongue-in head inspection procedure.

17. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)17 Here is the caudal view of a beef head seen during a tongue-in head presentation. Here is the caudal view of a beef head seen during a tongue-in head presentation. Policy Development Division

18. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)18 4 Major Head Lymph Nodes: 1.Parotid lymph nodes (lnn.) 2.Lateral retropharyngeal lymph nodes 3.Mandibular lnn. 4.Medial retropharyngeal lnn. ( below #2; not shown; see slide #20) Policy Development Division

19. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)19Policy Development Division Another view of three (3) of four (4) lymph nodes incised during head inspection

20. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)20 Medial Retropharyngeal Lymph nodes. Notice they are located just below the muscle (sternothyro- hyoideus mm.) tissue. Policy Development Division

21. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)21 Note the opening to nasopharynx as indicated by presence of pharyngeal septum as indicated by presence of pharyngeal septum (arrow) after incision of medial retropharyn- geal lnn. Policy Development Division

22. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)22Policy Development Division Beef Pharyngeal and Palatine Tonsils The palatine and lingual tonsils are the tonsils designated as the intended SRM to be removed and are accessible through the oropharynx. The palatine and lingual tonsils are the tonsils designated as the intended SRM to be removed and are accessible through the oropharynx.

23. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)23 Tonsil Location The figure eight (8) represents the location of tonsils relative to the nasopharynx (above) and oropharnyx (below). The figure eight (8) represents the location of tonsils relative to the nasopharynx (above) and oropharnyx (below). Policy Development Division

24. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)24 Tonsil Location Tonsil Location Palatine tonsils are at the 4 and 8 o’clock positions of the oropharnyx. Palatine tonsils are at the 4 and 8 o’clock positions of the oropharnyx. Lingual tonsils are located at the base of the tongue. Lingual tonsils are located at the base of the tongue. Policy Development Division

25. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)25Policy Development Division Other tonsils including the pharyngeal and tubal tonsils can be found in the nasopharynx and need not be removed as SRM. Other tonsils including the pharyngeal and tubal tonsils can be found in the nasopharynx and need not be removed as SRM.

26. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)26Policy Development Division Size of Tonsils The size of beef tonsils vary from animal to animal depending on two (2) major factors: The size of beef tonsils vary from animal to animal depending on two (2) major factors: 1. age (younger>>larger tonsils) and 2. reactivity to antigenic stimulation (reactive>>larger tonsils).

27. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)27Policy Development Division Pharyngeal Tonsils Pharyngeal tonsils are mentioned here only for anatomical reference. Pharyngeal tonsils are mentioned here only for anatomical reference. Pharyngeal tonsils, located at the roof of the nasopharynx, tend to be larger and less inflamed (congested) than other tonsils. Pharyngeal tonsils, located at the roof of the nasopharynx, tend to be larger and less inflamed (congested) than other tonsils. Pharyngeal tonsils have a soft folded appearance Pharyngeal tonsils have a soft folded appearance

28. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)28 Here is the pharyngeal tonsil reflected downward after opening of the nasopharynx. Note its soft folded appearance. Policy Development Division

29. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)29 1.Nasopharynx 2.Medial retropharyngeal lymph node (incised) 3.Epiglottis 4.Edge of the soft palate or the palatopharyngeal arch 5. Pharyngeal tonsil Policy Development Division

30. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)30Policy Development Division Palatine Tonsils Located adjacent to soft palate below the mucosal surface and the opening of sinus of palatine tonsil. Located adjacent to soft palate below the mucosal surface and the opening of sinus of palatine tonsil. Note: Palatine tonsils tend to be larger, more congested, and inflamed at post mortem. As the length of post mortem increases, these tonsils tend to be less congested. Note: Palatine tonsils tend to be larger, more congested, and inflamed at post mortem. As the length of post mortem increases, these tonsils tend to be less congested.

31. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)31Policy Development Division 1.Palatine tonsil3. Pharyngeal tonsil 2. Nasopharynx4. Tongue

32. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)32 Note the congested appearance below the mucosal surface. The arrow points to the palatine tonsil and congestion around it. Policy Development Division

33. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)33Policy Development Division

34. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)34Policy Development Division

35. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)35Policy Development Division

36. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)36Policy Development Division Note: The probe is directed at the palatine tonsil (1) into the opening to the sinus of the palatine tonsil lateral to base of the tongue (4). The pharyngeal tonsil (3) has sagged into the nasopharynx (2).

37. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)37Policy Development Division

38. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)38 Note: The opening to sinus of the palatine tonsil (arrows) is a useful landmark for locating the palatine tonsil. Policy Development Division

39. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)39Policy Development Division

40. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)40Policy Development Division Beef Tongue and Palatine Tonsils Depending on how the tongue is removed from the head, the palatine tonsil may be found attached to remnants of the beef tongue. Depending on how the tongue is removed from the head, the palatine tonsil may be found attached to remnants of the beef tongue.

41. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)41Policy Development Division

42. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)42Policy Development Division Note: Lingual tonsil to be removed is located below the yellow cut line.

43. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)43Policy Development Division Lingual Tonsils Located at the base of the tongue Located at the base of the tongue Lingual tonsils are removed by removing the epithelium and underlining muscle to a sufficient depth (~>5mm) just caudal to the last vallate papillae by knife trimming or skinning. Lingual tonsils are removed by removing the epithelium and underlining muscle to a sufficient depth (~>5mm) just caudal to the last vallate papillae by knife trimming or skinning.

44. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)44 Lingual Tonsils Policy Development Division

45. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)45 Can you identify the vallate papillae and location of lingual tonsils in this picture? Can you identify the vallate papillae and location of lingual tonsils in this picture? Answer: See the next slide. Answer: See the next slide. Lingual Tonsils Policy Development Division

46. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)46Policy Development Division Beef tongues are adequately trimmed when the surface layers are removed to a sufficient depth (~>5mm) caudal to the last vallate papillae.

47. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)47 Removal of lingual tonsils in a beef market head. Policy Development Division

48. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)48 Removal of lingual tonsils in a beef market head. Note: Less radical removal leaving more tongue meat is also acceptable. Policy Development Division

49. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)49Policy Development Division Beef Market Head sans Lingual and Palatine Tonsils Removal of the palatine and associated lingual tonsils of a beef market head meet the requirements of 9 CFR 310.22 regarding removal of SRM tissue. Removal of the palatine and associated lingual tonsils of a beef market head meet the requirements of 9 CFR 310.22 regarding removal of SRM tissue.

50. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)50 Here is a beef market head with all tonsil related SRM removed. The arrow points to the short cut tongue in situ. Policy Development Division

51. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)51 A beef market head with all tonsil related SRM removed is eligible for the mark of inspection and can enter commerce. Policy Development Division

52. UNITED STATES DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE October 10, 2008 (v2)52Policy Development Division Questions? Please submit your tonsil or SRM questions to one of the following: 1. AskFSIS at http://askfsis.custhelp.com http://askfsis.custhelp.com OR 2. Contact the Policy Development Division (PDD) (formerly the TSC) at 1-800-233-3935.