SlideShare a Scribd company logo
1 of 36
Fuad Ridha Mahabot
•
•
•
•

A mass of skeletal muscle covered by mucous membrane
Midline septum separating two muscular halves
Has dorsum, tip, inferior surface and root
Anterior 2/3 (oral part) - faces upwards towards the hard
palate
• Posterior 1/3 (pharyngeal part) - faces backwards towards the
oropharynx
• Stratified squamous epithelium:
 keratinised on the oral part
 non-keratinised on the pharyngeal part
• Tip - is the most anterior - merges into the inferior surface
• Mucous membrane of the inferior surface - thin and smooth
(similar to FOM and cheek)
Oral anterior 2/3 of the dorsum of the tongue:
•
•

covered by mucous membrane into which underlying muscles are inserted
surface is roughened by the presence of 3 types of papillae: filiform,
fungiform and vallate papillae
 Filiform papillae:
• conical projections that give rise to velvety appearance of the
tongue
• located along the entire dorsum of the tongue, but they are not
involved in taste sensation
 Foliate papillae:
• small folds of mucosa located along the lateral surface of the
tongue
 Fungiform papillae:
• visible as discrete pink pinheads
• more numerous towards the edge of the tongue
• each bears a few taste buds
 Vallate papillae:
• are about a dozen in number
• arranged in the form of a V with apex pointing backwards
• each is a cylindrical projection surrounded a circular sulcus and a
raised outer wall
• there are many taste buds and serous glands in the sulcus that
surrounds each vallate papillae (as there are no other glands on
the dorsum of anterior 2/3 of the tongue)
Vallate Papillae

Filiform Papillae

Fungiform Papillae
• sulcus terminalis: ill defined shallow groove which marks the
junction of the oral and the pharyngeal part of the tongue
• vallate papillae are far back on the oral surface - not in contact
with the food being chewed; but the food juices and saliva reach
them - so flavours are transmitted to them
•
•
•
•

There are scattered mucous and serous glands under the tip and sides
On the undersurface behind the tip there is a rather large mixed gland on
the each side of midline - anterior lingual gland
From each gland small ducts open on the undersurface of the tongue
Ranula - retention cyst of this gland
Posterior 1/3 of the dorsum of the tongue:
•
•
•

•
•

is the anterior wall of the oropharynx
extends from sulcus terminalis and epiglottis
Foramen caecum: is a small depression at the apex of the sulcus - the
remains of the upper end of the thyroglossal duct
 there are no papillae behind this sulcus
Smooth mucous membrane has a nodular appearance - constitute the
lingual tonsil, part of Waldeyer’s ring.
Between tongue and epiglottis - midline flange of mucous membrane
(median glossoepiglottic fold).
 Each side of which is depression (valleculae), bounded laterally by
similar mucosal fold (lateral glossoepiglottic fold), extending from the
side of the epiglottis to the wall of the pharynx
Inferior surface of the tongue:
•
•
•
•

Lingual frenulum - a small midline septum of mucous membrane - unites it
to the floor of the mouth
Lateral to this - deep lingual vein (visible through the mucosa); lingual
artery and nerve (not visible)
Farther laterally is another fold of mucosa - fimbriated fold
Foliate papillae - a series of parallel folds of mucous membrane on the
sides of the posterior part of the tongue
• Palatoglossal arches (anterior pillars of the pauces) - ridge of
mucous membrane raised up by palatoglossus muscles
 extends from the undersurface of the front of the soft palate to the
sides of tongue in line with the vallate papillae
 the whole constitutes oropharyngeal isthmus
• closed by depression of the palate and elevation of dorsum of
tongue
• narrowed by contraction of palatoglossus muscle
• Divided into:
 intrinsic (wholly within the tongue and not attached to the bone)
•
•
•
•

superior longitudinal
inferior longitudinal
transverse
vertical

 extrinsic (attached to the bone)
•
•
•
•

genioglossus
hyoglossus
styloglossus
palatoglossus
Intrinsic Muscles
• Superior longitudinal muscle:
 lies beneath mucous membrane
 shortens the tongue, make its dorsum concave

• Inferior longitudinal muscle:
 lying close to the inferior surface of the tongue
 between genioglossus and hyoglossus
 shortens the tongue, make its dorsum convex
• Transverse muscle:
 extends from median septum to the margins
 makes the tongue narrow and elongated

• Vertical muscle:
 found at the borders of the anterior part of the tongue
 makes the tongue broad and flattened
Extrinsic Muscles
• Genioglossus:
 origin: Upper genial tubercle of mandible
 insertion: the fibres radiate widely to be inserted into the mucous
membrane of the tongue; the lowest fibres passing down to the hyoid
body

• Hyoglossus:
 origin: from the length of the greater horn of the hyoid bone and from
lateral part of its body
 insertion: the fibres extend upward and its upper border
interdigitating at right angles with the fibres of styloglossus, and is
attached to the side of the tongue
 Superficial to muscle from the above downwards:
• lingual nerve
• submandibular duct
• hypoglossal nerve with its accompanying veins
 Passing deep to its posterior border from above downwards:
• glossopharyngeal nerve
• styloid ligament
• lingual artery

• Styloglossus:
 origin: from the front of the lower part of the styloid process and the
upper part of the stylohyoid ligament
 insertion: passes forwards below the superior constrictor to be
inserted into the side of the tongue, interdigitating with upper fibres
of hyoglossus

• Palatoglossus:
 origin: arises from the undersurface of the palatine aponeurosis
 insertion: side of the tongue (junction of oral and pharygeal part)
Muscles

Origin

Genioglossus

Upper genial tubercle
of mandible

Hyoglossus

Greater cornu, front
of lateral part of body
of hyoid bone

Styloglossus

Tip, anterior surface
of styloid process

Palatoglossus

Oral surface of
palatine aponeurosis

Inserton

Action(s)

Upper fibres: tip of
the tongue
Middle fibres: dorsum
Lower fibres: hyoid
bone

Upper fibres: retract the
tip
Middle fibres: depress the
tongue
Lower fibres: pull the
posterior part forward
(thus protrusion of the
tongue from the mouth)

Side of tongue

Depress the tongue
Retracting the protruded
tongue

Side of tongue

Pulls the tongue upwards
and backwards during
swallowing

Side of tongue
(junction of oral and
pharygeal part)

Pulls up root of tongue,
approximates
palatoglossal arches,
closes oropharyngeal
isthmus
• Tongue is supplied by the lingual artery
 run above the greater horn of the hyoid bone deep to hyoglossus
 passes forwards to the tip
 beneath hyoglossus it gives off dorsal lingual branches into the
posterior part
 at the anterior border of hyoglossus it gives a branch to the sublingual
gland and the floor of the mouth
 fibrous septum dividing the two halves of the tongue prevents any
significant anastomosis of blood vessels across the midline
• Venous tributaries
 accompanying the lingual artery
 its dorsal branches form the lingual vein
 from the tip by deep lingual vein
 it runs back superficial to hyoglossus and is joined at the anterior
border of the muscle by the sublingual vein (from the sublingual
gland) to form the vena comitans of the hyprglossal nerve
 it continues backwards close to the nerve and joining either the
lingual, facial or internal jugular vein
 lingual vein usually joins the internal jugular near the greater horn of
the hyoid bone
• Lymph from one side (esp. of the posterior side), may reach
the nodes of the both sides of the neck (in contrast to the
blood supply which remains unilateral)
• Tip - drain to submental nodes or directly to deep cervical
nodes
• Marginal lymphatics from the anterior part tend to drain to
ipsilateral submandibular nodes or directly to deep cervical
nodes
• Central lymphatics - drain to deep cervical nodes of either
side
• Posterior part - drains directly and bilaterally to deep cervical
nodes
• The deep cervical nodes usually involved: jugulodigastric and
jugulo-omohyoid nodes
• All lymph from the tongue is believed to eventually drain
through the jugulo-omohyoid node before reaching the
thoracic duct or right lymphatic duct
• Motor: all muscles of the tongue (intrinsic and extrinsic) are
supplied by hypoglossal nerve except palatoglossus which is
supplied by pharyngeal plexus
• Sensory:
 anterior 2/3 of the tongue:
• general sensation: lingual nerve - branch of the mandibular nerve
(with cell bodies in the trigeminal ganglion)
• taste: chorda tympani (with cell bodies in the geniculate ganglion
of facial nerve)
• parasympathetic secretomotor fibres to the anterior lingual gland
run in the chorda tympani from the superior salivary nucleus, and
relay in the submandibular genglion
 posterior 1/3 of the tongue: innervated by the glossopharyngeal
nerve (both general sensation and taste), with cell bodies in the
glossopharyngeal ganglia in the jugular foramen
 posterior most part of the tongue: innervated by the vagus nerve
through the internal laryngeal branch (with cell bodies in the inferior
vagal ganglion)
• Starts to develop near the end of the fourth week
• Epithelium:
 Anterior 2/3:
• from 2 lingual swellings and one tuberculum impar, i.e., from first
branchial arch
• supplied by lingual nerve (post-trematic) and chorda tympani (pretrematic)
 Posterior 1/3:
• from the cranial half of the hypobranchial eminence, i.e., from the
third arch
• supplied by glossopharyngeal nerve
 Posterior most:
• from the fourth arch
• supplied by vagus nerve

• Muscles develop from the occipital myotomes which are
supplied by hypoglossal nerve
• Connective tissue develops from local mesenchyme
• Injury to hypoglossal nerve produces paralysis of the muscles
of the tongue on the side of lesion
 infranuclear lesion (i.e., in motor neuron disease and in
syringobulbia): gradual atrophy and muscular twitchings of the
affected half of the tongue observed
 supranuclear lesion (i.e., in pesudobulbar palsy): produce paralysis
without palsy (tongue is stiff, small and moves sluggishly)

• The presence of rich networkof lymphatics and loose areolar
tissue in the substance of tongue is responsible for enormous
swelling of tongue in acute glossitis
• The undersurface of the tongue is a good site for observation
of jaundice
• In unconscious patients, the tongue may fall back and
obstruct the air passages. This can be prevented by lying the
patient on one side with head down or by keeping the tongue
pulled out mechanically
• In the carcinoma of tongue, the affected site of tongue is
removed surgically. All deep cervical nodes are also removed
(block dissection)
• Carcinoma of posterior 1/3 of the tongue is more dangerous
due to bilateral lymphatic spread
Anatomy of the tongue

More Related Content

What's hot

Anatomy of Submandibular Gland
Anatomy of Submandibular GlandAnatomy of Submandibular Gland
Anatomy of Submandibular Gland
Fuad Ridha Mahabot
 
Deep cervical fascia (fascia colli)
Deep cervical fascia (fascia colli)Deep cervical fascia (fascia colli)
Deep cervical fascia (fascia colli)
surajitkundu
 

What's hot (20)

Anatomy of the Oral cavity Proper
Anatomy of the Oral cavity ProperAnatomy of the Oral cavity Proper
Anatomy of the Oral cavity Proper
 
Anatomy of Submandibular Gland
Anatomy of Submandibular GlandAnatomy of Submandibular Gland
Anatomy of Submandibular Gland
 
Salivary glands ppt
Salivary glands pptSalivary glands ppt
Salivary glands ppt
 
Tongue-Gross Anatomy & Applied Aspects. Dr.N.Mugunthan.M.S
Tongue-Gross Anatomy & Applied Aspects. Dr.N.Mugunthan.M.STongue-Gross Anatomy & Applied Aspects. Dr.N.Mugunthan.M.S
Tongue-Gross Anatomy & Applied Aspects. Dr.N.Mugunthan.M.S
 
TONGUE ppt
TONGUE pptTONGUE ppt
TONGUE ppt
 
Anterior triangle of the neck
Anterior triangle of the neckAnterior triangle of the neck
Anterior triangle of the neck
 
Pharynx
PharynxPharynx
Pharynx
 
Hard and soft palate
Hard and soft palateHard and soft palate
Hard and soft palate
 
Salivary glands anatomy & applied aspects
Salivary glands anatomy & applied aspectsSalivary glands anatomy & applied aspects
Salivary glands anatomy & applied aspects
 
Anatomy of Pharynx
Anatomy of PharynxAnatomy of Pharynx
Anatomy of Pharynx
 
Posterior triangle of neck - Powerpoint lecture notes by Dr.N.Mugunthan.
Posterior triangle of neck - Powerpoint lecture notes by Dr.N.Mugunthan.Posterior triangle of neck - Powerpoint lecture notes by Dr.N.Mugunthan.
Posterior triangle of neck - Powerpoint lecture notes by Dr.N.Mugunthan.
 
Anatomy of Tongue
Anatomy of TongueAnatomy of Tongue
Anatomy of Tongue
 
Anatomy- Muscles of Facial expression
Anatomy-  Muscles of Facial expression  Anatomy-  Muscles of Facial expression
Anatomy- Muscles of Facial expression
 
Anatomy of oral cavity
Anatomy of oral cavityAnatomy of oral cavity
Anatomy of oral cavity
 
Salivary gland ppt - Kanato Assumi
Salivary gland ppt  - Kanato AssumiSalivary gland ppt  - Kanato Assumi
Salivary gland ppt - Kanato Assumi
 
Palatine Tonsils
Palatine TonsilsPalatine Tonsils
Palatine Tonsils
 
Scalp
Scalp Scalp
Scalp
 
Anatomy of parotid gland
Anatomy of parotid glandAnatomy of parotid gland
Anatomy of parotid gland
 
Parotid gland
 Parotid gland  Parotid gland
Parotid gland
 
Deep cervical fascia (fascia colli)
Deep cervical fascia (fascia colli)Deep cervical fascia (fascia colli)
Deep cervical fascia (fascia colli)
 

Viewers also liked

Anatomy of the ear
Anatomy of the earAnatomy of the ear
Anatomy of the ear
NancyDecker
 

Viewers also liked (16)

Parts of eyes
Parts of eyesParts of eyes
Parts of eyes
 
The blind spot
The blind spotThe blind spot
The blind spot
 
Anatomy of the ear
Anatomy of the earAnatomy of the ear
Anatomy of the ear
 
Bocca Fisio
Bocca FisioBocca Fisio
Bocca Fisio
 
The human tongue
The human tongueThe human tongue
The human tongue
 
Tongue Anatomy
Tongue AnatomyTongue Anatomy
Tongue Anatomy
 
Bocca Esperimento
Bocca EsperimentoBocca Esperimento
Bocca Esperimento
 
Atlante di anatomia umana per PC/Mac
Atlante di anatomia umana per PC/MacAtlante di anatomia umana per PC/Mac
Atlante di anatomia umana per PC/Mac
 
Tongue my ppt
Tongue my pptTongue my ppt
Tongue my ppt
 
Tongue by Dr. Analhaq Shaikh
Tongue by Dr. Analhaq ShaikhTongue by Dr. Analhaq Shaikh
Tongue by Dr. Analhaq Shaikh
 
Tongue
TongueTongue
Tongue
 
Muscles of tongue
Muscles of tongueMuscles of tongue
Muscles of tongue
 
Ear Anatomy
Ear AnatomyEar Anatomy
Ear Anatomy
 
Anatomy and physiology of the ear
Anatomy and physiology of the earAnatomy and physiology of the ear
Anatomy and physiology of the ear
 
Platelets
PlateletsPlatelets
Platelets
 
The human ear
The human earThe human ear
The human ear
 

Similar to Anatomy of the tongue

Anatomy Of Oral Cavity And Oropharynx.pptx
Anatomy Of Oral Cavity And Oropharynx.pptxAnatomy Of Oral Cavity And Oropharynx.pptx
Anatomy Of Oral Cavity And Oropharynx.pptx
Htet Ko
 
Anatomy of Oral Region and Pharynx
Anatomy of Oral Region and PharynxAnatomy of Oral Region and Pharynx
Anatomy of Oral Region and Pharynx
PSPDG-UNUD
 

Similar to Anatomy of the tongue (20)

14-ORAL CAVITY.ppt
14-ORAL CAVITY.ppt14-ORAL CAVITY.ppt
14-ORAL CAVITY.ppt
 
14-ORAL CAVITY.ppt
14-ORAL CAVITY.ppt14-ORAL CAVITY.ppt
14-ORAL CAVITY.ppt
 
The tongue, its development and anatomy
The tongue, its development and anatomyThe tongue, its development and anatomy
The tongue, its development and anatomy
 
Tongue, palatine .pdf
Tongue, palatine .pdfTongue, palatine .pdf
Tongue, palatine .pdf
 
Oral cavity 2.pdf
Oral cavity 2.pdfOral cavity 2.pdf
Oral cavity 2.pdf
 
Anatomy of the oral cavity
Anatomy of the oral cavityAnatomy of the oral cavity
Anatomy of the oral cavity
 
14-ORAL CAVITY
14-ORAL CAVITY14-ORAL CAVITY
14-ORAL CAVITY
 
Tongue
TongueTongue
Tongue
 
Tongue and its applied aspects
Tongue and its applied aspectsTongue and its applied aspects
Tongue and its applied aspects
 
Anatomy Of Oral Cavity And Oropharynx.pptx
Anatomy Of Oral Cavity And Oropharynx.pptxAnatomy Of Oral Cavity And Oropharynx.pptx
Anatomy Of Oral Cavity And Oropharynx.pptx
 
Anatomy of tongue & its applied aspects
Anatomy of tongue & its applied aspectsAnatomy of tongue & its applied aspects
Anatomy of tongue & its applied aspects
 
development & growth of tongue
development & growth of tonguedevelopment & growth of tongue
development & growth of tongue
 
Oral cavity and pharynx short
Oral cavity and pharynx shortOral cavity and pharynx short
Oral cavity and pharynx short
 
Anatomy of the gastrointestinal system by Dawood Alatefi
Anatomy of the gastrointestinal system by Dawood AlatefiAnatomy of the gastrointestinal system by Dawood Alatefi
Anatomy of the gastrointestinal system by Dawood Alatefi
 
Seminar on tongue /prosthodontic courses
Seminar on tongue /prosthodontic coursesSeminar on tongue /prosthodontic courses
Seminar on tongue /prosthodontic courses
 
Anatomy of Oral Region and Pharynx
Anatomy of Oral Region and PharynxAnatomy of Oral Region and Pharynx
Anatomy of Oral Region and Pharynx
 
Tongue /prosthodontic courses
Tongue /prosthodontic coursesTongue /prosthodontic courses
Tongue /prosthodontic courses
 
Tongue
TongueTongue
Tongue
 
Surgical anatomy of tongue
Surgical anatomy of tongueSurgical anatomy of tongue
Surgical anatomy of tongue
 
Tongue
TongueTongue
Tongue
 

More from Fuad Ridha Mahabot (9)

Facial Nerve and Its Clinical Importance
Facial Nerve and Its Clinical ImportanceFacial Nerve and Its Clinical Importance
Facial Nerve and Its Clinical Importance
 
Hoarseness
HoarsenessHoarseness
Hoarseness
 
Allergic skin testing - a 4 year experience in Hospital Ampang
Allergic skin testing -  a 4 year experience in Hospital AmpangAllergic skin testing -  a 4 year experience in Hospital Ampang
Allergic skin testing - a 4 year experience in Hospital Ampang
 
Approach to dysphagia
Approach to dysphagiaApproach to dysphagia
Approach to dysphagia
 
Functions of larynx
Functions of larynxFunctions of larynx
Functions of larynx
 
Nasopharyngeal carcinoma
Nasopharyngeal carcinomaNasopharyngeal carcinoma
Nasopharyngeal carcinoma
 
Physiology of the nose
Physiology of the nosePhysiology of the nose
Physiology of the nose
 
Surgical anatomy of the neck
Surgical anatomy of the neckSurgical anatomy of the neck
Surgical anatomy of the neck
 
Principles of incision and wound closure
Principles of incision and wound closurePrinciples of incision and wound closure
Principles of incision and wound closure
 

Recently uploaded

Gardella_Mateo_IntellectualProperty.pdf.
Gardella_Mateo_IntellectualProperty.pdf.Gardella_Mateo_IntellectualProperty.pdf.
Gardella_Mateo_IntellectualProperty.pdf.
MateoGardella
 
1029 - Danh muc Sach Giao Khoa 10 . pdf
1029 -  Danh muc Sach Giao Khoa 10 . pdf1029 -  Danh muc Sach Giao Khoa 10 . pdf
1029 - Danh muc Sach Giao Khoa 10 . pdf
QucHHunhnh
 
An Overview of Mutual Funds Bcom Project.pdf
An Overview of Mutual Funds Bcom Project.pdfAn Overview of Mutual Funds Bcom Project.pdf
An Overview of Mutual Funds Bcom Project.pdf
SanaAli374401
 

Recently uploaded (20)

psychiatric nursing HISTORY COLLECTION .docx
psychiatric  nursing HISTORY  COLLECTION  .docxpsychiatric  nursing HISTORY  COLLECTION  .docx
psychiatric nursing HISTORY COLLECTION .docx
 
Measures of Central Tendency: Mean, Median and Mode
Measures of Central Tendency: Mean, Median and ModeMeasures of Central Tendency: Mean, Median and Mode
Measures of Central Tendency: Mean, Median and Mode
 
How to Give a Domain for a Field in Odoo 17
How to Give a Domain for a Field in Odoo 17How to Give a Domain for a Field in Odoo 17
How to Give a Domain for a Field in Odoo 17
 
Gardella_Mateo_IntellectualProperty.pdf.
Gardella_Mateo_IntellectualProperty.pdf.Gardella_Mateo_IntellectualProperty.pdf.
Gardella_Mateo_IntellectualProperty.pdf.
 
SOCIAL AND HISTORICAL CONTEXT - LFTVD.pptx
SOCIAL AND HISTORICAL CONTEXT - LFTVD.pptxSOCIAL AND HISTORICAL CONTEXT - LFTVD.pptx
SOCIAL AND HISTORICAL CONTEXT - LFTVD.pptx
 
Application orientated numerical on hev.ppt
Application orientated numerical on hev.pptApplication orientated numerical on hev.ppt
Application orientated numerical on hev.ppt
 
Unit-IV; Professional Sales Representative (PSR).pptx
Unit-IV; Professional Sales Representative (PSR).pptxUnit-IV; Professional Sales Representative (PSR).pptx
Unit-IV; Professional Sales Representative (PSR).pptx
 
ICT Role in 21st Century Education & its Challenges.pptx
ICT Role in 21st Century Education & its Challenges.pptxICT Role in 21st Century Education & its Challenges.pptx
ICT Role in 21st Century Education & its Challenges.pptx
 
This PowerPoint helps students to consider the concept of infinity.
This PowerPoint helps students to consider the concept of infinity.This PowerPoint helps students to consider the concept of infinity.
This PowerPoint helps students to consider the concept of infinity.
 
Mattingly "AI & Prompt Design: Structured Data, Assistants, & RAG"
Mattingly "AI & Prompt Design: Structured Data, Assistants, & RAG"Mattingly "AI & Prompt Design: Structured Data, Assistants, & RAG"
Mattingly "AI & Prompt Design: Structured Data, Assistants, & RAG"
 
Presentation by Andreas Schleicher Tackling the School Absenteeism Crisis 30 ...
Presentation by Andreas Schleicher Tackling the School Absenteeism Crisis 30 ...Presentation by Andreas Schleicher Tackling the School Absenteeism Crisis 30 ...
Presentation by Andreas Schleicher Tackling the School Absenteeism Crisis 30 ...
 
PROCESS RECORDING FORMAT.docx
PROCESS      RECORDING        FORMAT.docxPROCESS      RECORDING        FORMAT.docx
PROCESS RECORDING FORMAT.docx
 
1029 - Danh muc Sach Giao Khoa 10 . pdf
1029 -  Danh muc Sach Giao Khoa 10 . pdf1029 -  Danh muc Sach Giao Khoa 10 . pdf
1029 - Danh muc Sach Giao Khoa 10 . pdf
 
Introduction to Nonprofit Accounting: The Basics
Introduction to Nonprofit Accounting: The BasicsIntroduction to Nonprofit Accounting: The Basics
Introduction to Nonprofit Accounting: The Basics
 
An Overview of Mutual Funds Bcom Project.pdf
An Overview of Mutual Funds Bcom Project.pdfAn Overview of Mutual Funds Bcom Project.pdf
An Overview of Mutual Funds Bcom Project.pdf
 
Nutritional Needs Presentation - HLTH 104
Nutritional Needs Presentation - HLTH 104Nutritional Needs Presentation - HLTH 104
Nutritional Needs Presentation - HLTH 104
 
Accessible design: Minimum effort, maximum impact
Accessible design: Minimum effort, maximum impactAccessible design: Minimum effort, maximum impact
Accessible design: Minimum effort, maximum impact
 
Class 11th Physics NEET formula sheet pdf
Class 11th Physics NEET formula sheet pdfClass 11th Physics NEET formula sheet pdf
Class 11th Physics NEET formula sheet pdf
 
SECOND SEMESTER TOPIC COVERAGE SY 2023-2024 Trends, Networks, and Critical Th...
SECOND SEMESTER TOPIC COVERAGE SY 2023-2024 Trends, Networks, and Critical Th...SECOND SEMESTER TOPIC COVERAGE SY 2023-2024 Trends, Networks, and Critical Th...
SECOND SEMESTER TOPIC COVERAGE SY 2023-2024 Trends, Networks, and Critical Th...
 
Basic Civil Engineering first year Notes- Chapter 4 Building.pptx
Basic Civil Engineering first year Notes- Chapter 4 Building.pptxBasic Civil Engineering first year Notes- Chapter 4 Building.pptx
Basic Civil Engineering first year Notes- Chapter 4 Building.pptx
 

Anatomy of the tongue

  • 2. • • • • A mass of skeletal muscle covered by mucous membrane Midline septum separating two muscular halves Has dorsum, tip, inferior surface and root Anterior 2/3 (oral part) - faces upwards towards the hard palate • Posterior 1/3 (pharyngeal part) - faces backwards towards the oropharynx • Stratified squamous epithelium:  keratinised on the oral part  non-keratinised on the pharyngeal part
  • 3.
  • 4. • Tip - is the most anterior - merges into the inferior surface • Mucous membrane of the inferior surface - thin and smooth (similar to FOM and cheek) Oral anterior 2/3 of the dorsum of the tongue: • • covered by mucous membrane into which underlying muscles are inserted surface is roughened by the presence of 3 types of papillae: filiform, fungiform and vallate papillae  Filiform papillae: • conical projections that give rise to velvety appearance of the tongue • located along the entire dorsum of the tongue, but they are not involved in taste sensation
  • 5.  Foliate papillae: • small folds of mucosa located along the lateral surface of the tongue  Fungiform papillae: • visible as discrete pink pinheads • more numerous towards the edge of the tongue • each bears a few taste buds  Vallate papillae: • are about a dozen in number • arranged in the form of a V with apex pointing backwards • each is a cylindrical projection surrounded a circular sulcus and a raised outer wall • there are many taste buds and serous glands in the sulcus that surrounds each vallate papillae (as there are no other glands on the dorsum of anterior 2/3 of the tongue)
  • 7. • sulcus terminalis: ill defined shallow groove which marks the junction of the oral and the pharyngeal part of the tongue • vallate papillae are far back on the oral surface - not in contact with the food being chewed; but the food juices and saliva reach them - so flavours are transmitted to them • • • • There are scattered mucous and serous glands under the tip and sides On the undersurface behind the tip there is a rather large mixed gland on the each side of midline - anterior lingual gland From each gland small ducts open on the undersurface of the tongue Ranula - retention cyst of this gland
  • 8.
  • 9. Posterior 1/3 of the dorsum of the tongue: • • • • • is the anterior wall of the oropharynx extends from sulcus terminalis and epiglottis Foramen caecum: is a small depression at the apex of the sulcus - the remains of the upper end of the thyroglossal duct  there are no papillae behind this sulcus Smooth mucous membrane has a nodular appearance - constitute the lingual tonsil, part of Waldeyer’s ring. Between tongue and epiglottis - midline flange of mucous membrane (median glossoepiglottic fold).  Each side of which is depression (valleculae), bounded laterally by similar mucosal fold (lateral glossoepiglottic fold), extending from the side of the epiglottis to the wall of the pharynx
  • 10. Inferior surface of the tongue: • • • • Lingual frenulum - a small midline septum of mucous membrane - unites it to the floor of the mouth Lateral to this - deep lingual vein (visible through the mucosa); lingual artery and nerve (not visible) Farther laterally is another fold of mucosa - fimbriated fold Foliate papillae - a series of parallel folds of mucous membrane on the sides of the posterior part of the tongue
  • 11. • Palatoglossal arches (anterior pillars of the pauces) - ridge of mucous membrane raised up by palatoglossus muscles  extends from the undersurface of the front of the soft palate to the sides of tongue in line with the vallate papillae  the whole constitutes oropharyngeal isthmus • closed by depression of the palate and elevation of dorsum of tongue • narrowed by contraction of palatoglossus muscle
  • 12. • Divided into:  intrinsic (wholly within the tongue and not attached to the bone) • • • • superior longitudinal inferior longitudinal transverse vertical  extrinsic (attached to the bone) • • • • genioglossus hyoglossus styloglossus palatoglossus
  • 13. Intrinsic Muscles • Superior longitudinal muscle:  lies beneath mucous membrane  shortens the tongue, make its dorsum concave • Inferior longitudinal muscle:  lying close to the inferior surface of the tongue  between genioglossus and hyoglossus  shortens the tongue, make its dorsum convex
  • 14. • Transverse muscle:  extends from median septum to the margins  makes the tongue narrow and elongated • Vertical muscle:  found at the borders of the anterior part of the tongue  makes the tongue broad and flattened
  • 15. Extrinsic Muscles • Genioglossus:  origin: Upper genial tubercle of mandible  insertion: the fibres radiate widely to be inserted into the mucous membrane of the tongue; the lowest fibres passing down to the hyoid body • Hyoglossus:  origin: from the length of the greater horn of the hyoid bone and from lateral part of its body  insertion: the fibres extend upward and its upper border interdigitating at right angles with the fibres of styloglossus, and is attached to the side of the tongue
  • 16.
  • 17.  Superficial to muscle from the above downwards: • lingual nerve • submandibular duct • hypoglossal nerve with its accompanying veins  Passing deep to its posterior border from above downwards: • glossopharyngeal nerve • styloid ligament • lingual artery • Styloglossus:  origin: from the front of the lower part of the styloid process and the upper part of the stylohyoid ligament
  • 18.
  • 19.  insertion: passes forwards below the superior constrictor to be inserted into the side of the tongue, interdigitating with upper fibres of hyoglossus • Palatoglossus:  origin: arises from the undersurface of the palatine aponeurosis  insertion: side of the tongue (junction of oral and pharygeal part)
  • 20. Muscles Origin Genioglossus Upper genial tubercle of mandible Hyoglossus Greater cornu, front of lateral part of body of hyoid bone Styloglossus Tip, anterior surface of styloid process Palatoglossus Oral surface of palatine aponeurosis Inserton Action(s) Upper fibres: tip of the tongue Middle fibres: dorsum Lower fibres: hyoid bone Upper fibres: retract the tip Middle fibres: depress the tongue Lower fibres: pull the posterior part forward (thus protrusion of the tongue from the mouth) Side of tongue Depress the tongue Retracting the protruded tongue Side of tongue Pulls the tongue upwards and backwards during swallowing Side of tongue (junction of oral and pharygeal part) Pulls up root of tongue, approximates palatoglossal arches, closes oropharyngeal isthmus
  • 21. • Tongue is supplied by the lingual artery  run above the greater horn of the hyoid bone deep to hyoglossus  passes forwards to the tip  beneath hyoglossus it gives off dorsal lingual branches into the posterior part  at the anterior border of hyoglossus it gives a branch to the sublingual gland and the floor of the mouth  fibrous septum dividing the two halves of the tongue prevents any significant anastomosis of blood vessels across the midline
  • 22.
  • 23. • Venous tributaries  accompanying the lingual artery  its dorsal branches form the lingual vein  from the tip by deep lingual vein  it runs back superficial to hyoglossus and is joined at the anterior border of the muscle by the sublingual vein (from the sublingual gland) to form the vena comitans of the hyprglossal nerve  it continues backwards close to the nerve and joining either the lingual, facial or internal jugular vein  lingual vein usually joins the internal jugular near the greater horn of the hyoid bone
  • 24.
  • 25. • Lymph from one side (esp. of the posterior side), may reach the nodes of the both sides of the neck (in contrast to the blood supply which remains unilateral) • Tip - drain to submental nodes or directly to deep cervical nodes • Marginal lymphatics from the anterior part tend to drain to ipsilateral submandibular nodes or directly to deep cervical nodes • Central lymphatics - drain to deep cervical nodes of either side • Posterior part - drains directly and bilaterally to deep cervical nodes
  • 26. • The deep cervical nodes usually involved: jugulodigastric and jugulo-omohyoid nodes • All lymph from the tongue is believed to eventually drain through the jugulo-omohyoid node before reaching the thoracic duct or right lymphatic duct
  • 27.
  • 28. • Motor: all muscles of the tongue (intrinsic and extrinsic) are supplied by hypoglossal nerve except palatoglossus which is supplied by pharyngeal plexus • Sensory:  anterior 2/3 of the tongue: • general sensation: lingual nerve - branch of the mandibular nerve (with cell bodies in the trigeminal ganglion) • taste: chorda tympani (with cell bodies in the geniculate ganglion of facial nerve) • parasympathetic secretomotor fibres to the anterior lingual gland run in the chorda tympani from the superior salivary nucleus, and relay in the submandibular genglion
  • 29.
  • 30.  posterior 1/3 of the tongue: innervated by the glossopharyngeal nerve (both general sensation and taste), with cell bodies in the glossopharyngeal ganglia in the jugular foramen  posterior most part of the tongue: innervated by the vagus nerve through the internal laryngeal branch (with cell bodies in the inferior vagal ganglion)
  • 31. • Starts to develop near the end of the fourth week • Epithelium:  Anterior 2/3: • from 2 lingual swellings and one tuberculum impar, i.e., from first branchial arch • supplied by lingual nerve (post-trematic) and chorda tympani (pretrematic)  Posterior 1/3: • from the cranial half of the hypobranchial eminence, i.e., from the third arch • supplied by glossopharyngeal nerve
  • 32.
  • 33.  Posterior most: • from the fourth arch • supplied by vagus nerve • Muscles develop from the occipital myotomes which are supplied by hypoglossal nerve • Connective tissue develops from local mesenchyme
  • 34. • Injury to hypoglossal nerve produces paralysis of the muscles of the tongue on the side of lesion  infranuclear lesion (i.e., in motor neuron disease and in syringobulbia): gradual atrophy and muscular twitchings of the affected half of the tongue observed  supranuclear lesion (i.e., in pesudobulbar palsy): produce paralysis without palsy (tongue is stiff, small and moves sluggishly) • The presence of rich networkof lymphatics and loose areolar tissue in the substance of tongue is responsible for enormous swelling of tongue in acute glossitis • The undersurface of the tongue is a good site for observation of jaundice
  • 35. • In unconscious patients, the tongue may fall back and obstruct the air passages. This can be prevented by lying the patient on one side with head down or by keeping the tongue pulled out mechanically • In the carcinoma of tongue, the affected site of tongue is removed surgically. All deep cervical nodes are also removed (block dissection) • Carcinoma of posterior 1/3 of the tongue is more dangerous due to bilateral lymphatic spread

Editor's Notes

  1. Lingual nerve: Joined by chorda tympani 2cm below BOS, deep to lower border of medial pterygoid Curves down on the medial pterygoid i/f of inferior alveolar nerve Passes under free lower border of sup. constrictor and goes forward above myelohyoid muscle Lies laterally to submandibular duct, then runs medially below the duct Ascends on hyoglossusto the anterior 2/3rd of the tongue with supplies common sensation and taste Submandibular duct emerges from superf part of the gland near posterior border of mylohyoid Runs forwards and upwards between mylohyoid and hyoglossus then sublinglual gland and genioglossus Open into FOM on the sublingual papillae besides frenulum Crosses laterally by lingual n. Hypoglossal n. Emerges from the surface of medulla between pyramid and olive Enters hypoglossal canal in the occipital bone Passes downwards btw IJV and ICA Crossed laterally by occipital artery Swings forward crossing both carotid arteries at the commancement of ligual artery Passes superficial then deep to hyoglossus Supplies all muscles of the tongue expect palatoglossus Glossopharyngeal nerve Emerges from the surface of medulla between and inferior cerebellar peduncle Enters anterior compartment of jugular foramen Lies lateral to inferior petrosal sinus Has a small superior ganglion and large inferior ganglion below IAM Tympanic branch passes into middle ear through tympanic canaliculus, to form tympanic plexus Passes laterally between IJV and ICA, then btw ECA to innervate stylopharyngeus Carotid branch – innervate carotid sinus and body Pharyngeal branch – forms pharyngeal plexus Enters pharynx btw superior and middle constrictor, gives off tonsillar branch for afferent fibres for tonsillar mucosa, and lingual branch for common sensation and taste from the posterior part of the tongue as well as secretomotor fibres for lingual glands
  2. The pharyngeal plexus is a plexus of nerves formed by: • The pharyngeal branch of the vagus, which includes the cranial root of the accessory. This provides the motor supply to the muscles except for the tensor palati which is supplied by the mandibular division of the trigeminal. • The glossopharyngeal nerve, which provides the sensory supply to the pharynx. • Branches from the sympathetic trunk.