Tongue-Gross Anatomy & Applied Aspects. Dr.N.Mugunthan.M.S Associate Professor, MGMC&RI, Sri Balaji Vidyapeeth, Pondicherry

1. TONGUE
Gross Anatomy & Applied Aspects
Lecture by
Dr.N.Mugunthan.MBBS.,MS.,DNB.,MNAMS.,PhD.,
Associate Professor,
MGMC&RI.

2. Learning Objectives
Tongue
 Development
 Parts and surfaces
 Muscles
 Blood supply
 Innervation
 Lymphatic drainage
 Applied aspects
 Summary
© Dr.N.Mugunthan

3. Development
At the end of fourth week
I. Epithelium:
Anterior 2/3:
 2 lingual swellings and
tuberculum impar ( first
branchial arch)
Supplied by lingual nerve (post-
trematic) and chorda tympani
(pre-trematic) nerve
Posterior 1/3:
Upper half of hypobranchial
eminence ( third arch)
Supplied by glossopharyngeal
nerve
© Dr.N.Mugunthan

4. II. Muscles:
 From the occipital
myotomes
Supplied by hypoglossal
nerve
III. Connective tissue:
 From local mesenchyme
Development cont…
© Dr.N.Mugunthan

5. Parts & surfaces
1. Oral part (ant.2/3)
V shaped sulcus terminalis
2. Pharyngeal part (post.1/3)
 Apex (tip)
 Body
 Root
 2 lateral borders
 2 surfaces (ventral & dorsal)
© Dr.N.Mugunthan

6. Relations
 Apex – related to lower
incisors
 Body – floor of oral cavity
 Root -attached to the
mandible and the hyoid
bone
 Lateral borders – related to
gum & tooth of inf.alveolar
process.
© Dr.N.Mugunthan

7. Ventral surface
 Lingual frenulum - runs
vertically from the floor of
the mouth to the
undersurface of the tongue.
(limit the movement of the
tongue)
 Deep lingual veins - on
either side of frenulum.
 Plica fimbriata (mucosal
fold)- on either side of deep
lingual veins
© Dr.N.Mugunthan

8. Dorsal surface
Sulcus terminalis -oral and
pharyngeal surfaces are separated
by a V-shaped sulcus
 Foramen cecum - Apex of the V-
shaped sulcus a small depression
Thyroglossal duct - if persists
connects the foramen cecum with
the thyroid gland in the neck.
Papillae – tiny finger like
projections (ant.2/3)
Lymphatic aggregations
(post.1/3) © Dr.N.Mugunthan

9. Papillae
 They are 4 varieties
1. Filiform
2. Fungiform
3. Foliate
4. Circumvallate
© Dr.N.Mugunthan

10. Filiform papillae
 Small cone-shaped with
one or multi ends.
 Present over ant.2/3 of
tongue
 Act as an abrasive coating
( cleaning and grasping
action)
 Does not contain taste
buds
© Dr.N.Mugunthan

11. Fungiform papillae
 Round shaped (mushroom)
and larger than filiform
 Present on the tip & margins
of tongue
 Taste buds embedded in
their surfaces.
 They respond to both sweet
and sour tastes.
© Dr.N.Mugunthan

12. Foliate papilla
 Red leaf-like mucosal ridges
 present at the sides, near
sulcus terminalis
 Has numerous taste buds
© Dr.N.Mugunthan

13. Circumvallate papilla
 Large cylindrical
structures
 8 to 12 in number
 Form a ‘V’ shaped row in
front of sulcus terminalis
© Dr.N.Mugunthan

14. Tongue Muscles
 The tongue is divided into a
left and right half by a
median sagittal septum.
 All tongue muscles are
paired.
 It has two types:
 Extrinsic muscles.
 Intrinsic muscles.
© Dr.N.Mugunthan

15. Extrinsic muscles (alter
the position of tongue)
1. Genioglossus
2. Hyoglossus
3. Chondroglossus
4. Styloglossus
5. Palatoglossus
Intrinsic muscles(alter
the shape of tongue)
1. Superior longitudinal
2. Inferior longitudinal
3. Transverse
4. Vertical
Tongue Muscles cont…
© Dr.N.Mugunthan

16. Genioglossus
(safety muscle of tongue)
Origin:
 Superior genial tubercle (mandible)
above the origin of geniohyoid
Insertion:
 Fan shaped radiated fibers insert
into mucous membrane of the tongue.
 Lowest fibres passing down to the
hyoid body
Action:
 Protrusion (safety muscle)
 Bilaterally –Central part depression
 Unilaterally – Diverges to the
 opposite side © Dr.N.Mugunthan

17. Hyoglossus
Origin:
Greater cornu &
body of hyoid bone
Insertion:
Side of the tongue
between styloglossus
and inferior longitudinal
Actions:
 Depresses the tongue
© Dr.N.Mugunthan

18. Chondroglossus
 A part of hyoglossus -
separated from it by
genioglossus
Origin:
Medial side and base of lesser
cornua of hyoid
Insertion:
Intrinsic musculature between
hyoglossus and genioglossus
© Dr.N.Mugunthan

19. Styloglossus
 Origin :
 Styloid process near its
apex
Insertion :
 Longitudinal part into the
inferior longitudinal muscles
 Oblique part into
hyoglossus
Action:
 Draws the tongue upwards
and backward
© Dr.N.Mugunthan

20. Palatoglossus
Mostly a part of soft palate than
the tongue
Origin:
 Palatine aponeurosis of soft
palate
Insertion:
Side of the tongue
Action:
 Elevates the posterior part of
tongue
 Bilaterally- approximates the
palatoglossal folds to constrict
the oropharyngeal isthmus
© Dr.N.Mugunthan

21. Intrinsic muscles
Originate and insert within the substance of the
tongue.
Types:
1. Superior longitudinal muscle
2. Inferior longitudinal muscle
3. Transverse muscle
4. Vertical muscle
Function: Altering the tongue shape:
a) Lengthening and shortening the tongue.
b) Curling and uncurling its apex and edges.
c) Flattening and rounding its surface.
Working in pairs or one side at a time.
© Dr.N.Mugunthan

22. Superior longitudinal muscle
Origin:
 Submucous fibrous layer
below the dorsum of the
tongue and lingual septum
Insertion:
 Extends to the lingual margin
Action:
 Turns the apex and sides of
the tongue upward to make
the dorsum concave
© Dr.N.Mugunthan

23. Inferior longitudinal
 Narrow band close to the
inferior surface of the tongue
Origin:
Root of tongue and body of
hyoid bone
Insertion:
Apex of tongue
Action:
 Curls the tip inferiorly and
shortens the tongue
© Dr.N.Mugunthan

24. Transverse muscles
Origin:
 Median fibrous septum
Insertion:
 Fibrous tissue at the
margins of tongue
Action:
 Narrows and elongates the
tongue
© Dr.N.Mugunthan

25. Vertical muscles
Origin:
 Dorsum surface of the
borders of the tongue
Insertion:
 Ventral surface of the
borders of the tongue
Action:
 Flattens and broadens the
tongue
© Dr.N.Mugunthan

26. Arterial supply of the tongue
 Lingual artery
 A branch of external carotid
artery
1. Dorsal lingual arteries
supply posterior part
2. Deep lingual artery
supplies the anterior part
3. Sublingual artery
supplies the sublingual
gland and floor of the
mouth
© Dr.N.Mugunthan

27. Venous drainage
 Dorsal lingual vein-
drains the dorsum and
sides of the tongue
 Deep lingual veins -
drains the tip of the
tongue and join
sublingual veins
 All these veins terminate
directly or indirectly into
internal jugular veins
© Dr.N.Mugunthan

28. Lymphatic drainage
 Tip - drain to submental nodes
 Sides -submandibular 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
© Dr.N.Mugunthan

29. Nerve supply
I. Motor supply:
 All muscles of the tongue
(intrinsic and extrinsic) are
supplied by hypoglossal
nerve,
 Except palatoglossus
which is supplied by cranial
part of accessory
nerve(pharyngeal plexus)
© Dr.N.Mugunthan

30. II. Sensory supply:
A. General sensation
B. Taste sensation
Anterior 2/3 of the tongue:
A. General sensation: lingual nerve
B. Taste sensation : chorda tympani
Posterior 1/3 of the tongue:
A&B.Both general and taste
sensation:
Glossopharyngeal nerve
Posterior most part of the tongue:
Vagus nerve
Nerve supply cont…
© Dr.N.Mugunthan

31. Taste discrimination
4 main types of taste
sensation:
1. Sweet: tip
2. Sour: middle
3. Salty: anterolateral
4. Bitter: base
 However all areas of tongue
are responsive to all taste
stimuli
© Dr.N.Mugunthan

32. Applied Aspects
Congenital anomalies:
(developmental)
 Aglossia
(Absence of tongue – failure of
formation of lingual swellings)
 Hemiglossia
(failure of formation of one side
lingual swelling)
 Bifid tongue (failure of fusion of two
lingual swellings)
 Double tongue
© Dr.N.Mugunthan

33. Applied Aspects cont…
Congenital anomalies:
(developmental)
 Aglossia
(Absence of tongue – failure of
formation of lingual swellings)
 Hemiglossia
(failure of formation of one side
lingual swelling)
 Bifid tongue (failure of fusion of two
lingual swellings)
 Double tongue
© Dr.N.Mugunthan

34. Applied Aspects cont…
Congenital anomalies:
(developmental)
 Aglossia
(Absence of tongue – failure of
formation of lingual swellings)
 Hemiglossia
(failure of formation of one side
lingual swelling)
 Bifid tongue (failure of fusion of two
lingual swellings)
 Double tongue
© Dr.N.Mugunthan

35. Applied Aspects cont…
Congenital anomalies:
(developmental)
 Aglossia
(Absence of tongue – failure of
formation of lingual swellings)
 Hemiglossia
(failure of formation of one side
lingual swelling)
 Bifid tongue (failure of fusion of two
lingual swellings)
 Double tongue
(formation of double pair of lingual
swellings)
© Dr.N.Mugunthan

36.  Ankyloglossia (tongue-tie)-
failure of deepening of
alveolo-lingual sulcus
 Lingual thyroid
 Macroglossia
 Microglossia
 Fissured, plicated or
scrotal tongue
 Leukoplakia
 Carcinoma of the tongue
 Tongue and sleep Apnea
Applied Aspects cont…
© Dr.N.Mugunthan

37.  Ankyloglossia (tongue-tie)-
failur of deepening of
alveololingual sulcus
 Lingual thyroid
(failure of migration of
median thyroid rudiment)
 Macroglossia
 Microglossia
 Fissured, plicated or
scrotal tongue
 Leukoplakia
 Carcinoma of the tongue
 Tongue and sleep Apnea
Applied Aspects cont…
© Dr.N.Mugunthan

38.  Ankyloglossia (tongue-tie)-
failur of deepening of
alveololingual sulcus
 Lingual thyroid
 Macroglossia
 Microglossia
 Fissured, plicated or
scrotal tongue
 Leukoplakia
 Carcinoma of the tongue
 Tongue and sleep Apnea
Applied Aspects cont…
© Dr.N.Mugunthan

39.  Ankyloglossia (tongue-tie)-
failur of deepening of
alveololingual sulcus
 Lingual thyroid
 Macroglossia
 Microglossia
 Fissured, plicated or
scrotal tongue
 Leukoplakia
 Carcinoma of the tongue
 Tongue and sleep Apnea
Applied Aspects cont…
© Dr.N.Mugunthan

40.  Ankyloglossia (tongue-tie)-
failur of deepening of
alveololingual sulcus
 Lingual thyroid
 Macroglossia
 Microglossia
 Fissured, plicated or
scrotal tongue
 Leukoplakia
 Carcinoma of the tongue
 Tongue and sleep Apnea
Applied Aspects cont…
© Dr.N.Mugunthan

41.  Ankyloglossia (tongue-tie)-
failur of deepening of
alveololingual sulcus
 Lingual thyroid
 Macroglossia
 Microglossia
 Fissured, plicated or
scrotal tongue
 Leukoplakia (premalignant
condition)
 Carcinoma of the tongue
 Tongue and sleep Apnea
Applied Aspects cont…
© Dr.N.Mugunthan

42.  Ankyloglossia (tongue-tie)-
failur of deepening of
alveololingual sulcus
 Lingual thyroid
 Macroglossia
 Microglossia
 Fissured, plicated or
scrotal tongue
 Leukoplakia
 Carcinoma of the tongue
 Tongue and sleep Apnea
Applied Aspects cont…
© Dr.N.Mugunthan

43.  Ankyloglossia (tongue-tie)-
failur of deepening of
alveololingual sulcus
 Lingual thyroid
 Macroglossia
 Microglossia
 Fissured, plicated or
scrotal tongue
 Leukoplakia
 Carcinoma of the tongue
 Tongue and sleep apnea
Applied Aspects cont…
© Dr.N.Mugunthan

44. Summary
 Development
 Parts and surfaces
 Muscles
 Blood supply
 Innervation
 Lymphatic drainage
 Applied aspects
© Dr.N.Mugunthan

45. If any questions click @dr.mugunth111@gmail.com