Anatomy of Tongue

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basic anatomy of tongue,muscles of tongue,nerve and blood supply of tongue and clinical features

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Anatomy of Tongue

  1. 1. `
  2. 2. Presented by; Humayun Afridi Saqib Habib Taif Ahmad Faisal Mansoor. Khyber College of Dentistry Peshawar
  3. 3. Contents  Introduction  General Features  Papillae , Types  Taste Buds  Extrinsic & Intrinsic Muscles  Movements  Vasculature  Innervation  Functions  Clinical Aspects
  4. 4. INTRODUCTION & GENERALFEATURES SAQIB HABIB CLASS NO: 40
  5. 5. INTRODUCTION Mass of striated muscles covered with mucous membrane Voluntary muscular structure Length: 3 inches Location: floor of the mouth Shape: triangular Attachement: With mandible and hyoid bone  Has an apex , body and root
  6. 6. GENERAL FEATURES SURFACES :  Two surfaces • Superior surface • Inferior surface  Superior surface is divided into three parts • Anterior 2/3 part called as Oral part • Posterior 1/3 part called as Pharyngeal part • Base(root) of tongue
  7. 7. General Features  TERMINAL SULCUS V-shaped sulcus divides tongue into anterior & posterior parts  Apex of sulcus marked by a pit - FORAMEN CECUM
  8. 8. General Features  Foramen cecum ,an embryological remnant, marks the upper end of thyroglossal duct  Sometime a thyroglossal duct persists and connects the foramen cecum with the thyroid gland in neck(thyroglossal cyst)
  9. 9. Superior Surface Oral Part(anterior 2/3): • Comprises of a median furrow • Rough surface due to presence of papillae • Surrounded by anterior and lateral teeth • Mobile part of tongue
  10. 10. Superior Surface Pharyngeal Part(Posterior 1/3) • Lies behind the sulcus terminalis • No papillae, shows nodular surface, presence of lymphatic nodules and lingual tonsils • Contributes to the anterior wall of oropharynx
  11. 11. Pharnygeal Part
  12. 12. Base of Tongue  Base of tongue is far back and is bottom of tongue  Contributes to the front wall of pharynx  Movement can affect the diameter of pharynx i.e • When it push forwards, thereby expanding the pharynx • When it pull backwards, thereby constricting the pharynx • Lacks papillae
  13. 13. INFERIOR SURFACE Covered by smooth mucous membrane In the midline , a mucosal fold called Frenulum connects the tongue with the floor of the mouth Lateral to frenulum, deep lingual vein can be seen through the mucosa Lateral to the lingual vein , mucosal fold called as plica fimbriata is present
  14. 14. Frenulum Lingual veins Plica fimbriata
  15. 15. PAPILLAE
  16. 16. PAPPILAE  Indentation of any structure in the overlying epithelium is called papillae  Superior surface of tongue , covered by numerous papillae  Have taste buds on their surfaces  Types of of papillae; • Vallate/circumvallate • Filiform • Fungiform • Foliate
  17. 17. Vallate Papillae  Largest among papillae  SHAPE: Blunt-ended cylindrical  NUMBER: 8 to 12 LOCATION: infront of sulcus terminalis ARRANGEMENT: Occur in V shape line
  18. 18. VALLATE PAPILLAE
  19. 19. Filiform Papillae  SHAPE: Thin, long papillae having pointed ends ‘V’ shaped cones  Only papillae having no taste buds NUMBER: numerous These papillae are mechanical and not involved in gustation Identified by increased keratinization LOCATION: Present at pre-sulcal area of the tongue
  20. 20. LHISTOLOGICAL VEIW
  21. 21. Fungiform Pappilae SHAPE: slightly mushroom-shaped if looked at in longitudinal section  Taste buds on their surfaces LOCATION: apex of the tongue as well as the margins Larger than filiform papillae
  22. 22. FUNGIFORM PAPILLAE
  23. 23. Foliate Pappilae  SHAPE: Short vertical folds LOCATION: Present lateral to terminal sulcus and at margins
  24. 24. FOLLIATE PAPILLAE
  25. 25. Taste Buds  Sensory receptors for taste The sensation of taste is called gustation Taste buds are located on the surfaces of papillae except filiform papillae
  26. 26. Electron microscopic structure of taste buds
  27. 27. Taste Buds  Four taste sensations, recently a fifth basic taste has been added: sour, sweet, salty, bitter and the recently added umami UMAMI
  28. 28. Umami Taste  Umami is from japanese word which means ‘pleasant savory taste’  Human tongue has glutamate receptors, which is the source of umami flavour  Kikunae ikeda, japanese scientist proposed its existence in 1908  This taste is mostly found in fish, cured meats, mushrooms, cheese, spinach etc.
  29. 29. Interesting Facts  Women have shorter tongue than men.  Blue whale has the largest tongue in animal kingdom and weighs 5400 lbs  About half of all bacteria in your mouth live on your tongue  Tongue heals faster than any part of the body  Your tongue is germ free only if it is pink. If it is white there is a thin film of bacteria on it.
  30. 30.  Chinese believe that tongue is representative of organs of body
  31. 31. Muscles of Tongue BY TAIF AHMAD Class No; 74
  32. 32. MUSCLES OF TONGUE EXTRINSIC MUSCLES INTRINSIC MUSCLES
  33. 33. The tongue is divided into two halves by a median septum and the muscles of each half consist of Intrinsic And Extrinsic Muscles  Therefore each muscle occur in Pair.
  34. 34. INTRINSIC MUSCLES  These muscles are confined to the tongue,  They originate and inserts within the tongue,  No bony attachments,  FUNCTION: They alter the shape of tongue
  35. 35. Types of Intrinsic Muscles There are four types Superior Longitudinal, Inferior Longitudinal, Vertical muscles, And Transverse muscles.
  36. 36. Superior Longitudinal Muscle It lies just beneath the dorsum of the tongue. ACTION: It curls the tip upward and rolls it posteriorly
  37. 37. Action of Superior Longitudinal Muscle
  38. 38. Inferior Longitudinal Muscles  Lies on each side lateral to the Genioglossus muscles,  ACTION: They curl the tip of tongue inferiorly.
  39. 39. Transverse Muscles  Lies inferior to the superior longitudinal muscle and run from the septum to margins  ACTION: They narrow the tongue and increase its height.
  40. 40. Vertical muscles  It runs inferolaterally from the dorsum,  ACTION: Flattens the dorsum.
  41. 41. EXTRINSIC MUSCLES  These muscles take origin from parts outside the  1 2 3 4 tongue, therefore move the tongue as well as alter the shape. Divided into four types namely; ) GENIOGLOSSUS ) HYOGLOSSUS ) STYLOGLOSSUS ) PALATOGLOSSUS
  42. 42. STYLOGLOSSUS and PALATOGLOSSUS attach the tongue superiorly, while GENIOGLOSSUS and HYOGLOSSUS attach the tongue inferiorly.
  43. 43. GENIOGLOSSUS  ORIGIN: From superior mental spines,  INSERTION: Into the mucous membrane of the tongue.  Action: Protrudes the tongue, depress central part of tongue and increase the volume of mouth as in sucking. GENIOGLOSSUS
  44. 44. HYOGLOSSUS  ORIGIN: Arises from greater horn and body of hyoid bone,  INSERTION: Side of tongue.  ACTION: It depresses side of tongue assisting GENIOGLOSSUS to enlarge oral cavity. HYOGLOSSUS
  45. 45. STYLOGLOSSUS  ORIGIN: Lower part of Styloid process and upper part of stylohyoid ligament,  INSERTION: Side of tongue.  ACTION: Elevates and retracts the tongue. STYLOGLOSSUS
  46. 46. PALATOGLOSSUS  ORIGIN: From soft palate.  INSERTION: Lateral margin of tongue.  ACTION: Elevates back of tongue and depresses soft palate.
  47. 47. • Protrusion: • Genioglossus on both sides acting together • Retraction: • Styloglossus and hyoglossus on both sides acting together • Depression: • Hyoglossus and genioglossus on both sides acting together • Elevation: • Styloglossus and palatoglossus on both sides acting together
  48. 48. INNERVATION  Both extrinsic and intrinsic muscles are supplied by HYPOGLOSSAL NERVE except PALATOGLOSSUS muscle which is in turn supplied by VAGUS NERVE.
  49. 49. FACTS 1). The tongue is the strongest muscle in the body and the only muscle that is connected only at one end. 2). Using a tongue scraper to clean your tongue is proven to prevent heart attacks, pneumonia, premature births, diabetes. 3). Your tongue never stops working. Even when you sleep it is pushing saliva into your throat.
  50. 50. VASCULATURE & INNERVATION OF TONGUE HUMAYUN AFRIDI CLASS No. 55
  51. 51. BLOOD SUPPLY Arterial Supply  Lingual artery - supplies tongue and floor of the mouth.  Originates from external carotid artery in neck  Passes between hyoglossus and genioglossus muscles of tongue ILingual artery
  52. 52. Arterial Supply • Lingual artery mainly gives three branches within the tongue namely • Dorsal lingual artery • Deep lingual artery • Sub lingual artery
  53. 53. Arterial Supply  Also secondary supply to the tongue by:  Tonsillar branch of facial artery  Ascending pharyngeal artery (branch of external carotid artery)
  54. 54. Venous Drainage  Drained by dorsal lingual vein and deep lingual veins Dorsal lingual vein  Deep Lingual Veins:  Begins near tip of tongue and run beneath the mucous membrane  Visible on the inferior surface of tongue  Anterior to lingual artery  Ultimately drains into internal jugular vein Deep lingual vein
  55. 55. Deep lingual vein
  56. 56. Venous Drainage  Dorsal Lingual Veins  Drain the dorsum and sides of tongue  Runs along the lingual artery  Drains into internal jugular vein Dorsal lingual vein
  57. 57. Lymphatics Apical Vessels: Drains into Submental nodes & deep cervical nodes Marginal Vessels: Drains into Submandibular nodes & deep cervical nodes Basal Vessels: Drains into Deep cervical nodes (jugulodigastric mainly)
  58. 58. LYMPH VESSELS 1. APICAL 2. MARGINAL AFFERENT(RECEIVING) i. TIP ii. FRENULUM SIDE OF TONGUE IN FRONT OF SULCUS TERMINALIS POSTERIOR 1/3RD or Base 3. BASAL EFFERENT(DRAINING) - SUBMENTAL ( MAJOR LYMPH NODE ) - SUBMANDIBULAR NODE - JUGULODIGASTRIC JUGULO- DIGASTRIC (deep cervical nodes)
  59. 59. Innervation  Innervation is complex and consists of three different supplies  Motor supply  General sensory supply  Special sensory supply
  60. 60. Motor Supply  All extrinsic and intrinsic muscles are supplied by HYPOGLOSSAL NERVE except PALATOGLOSSUS muscle which is supplied by VAGUS NERVE.
  61. 61. Sensory supply  General sensory sensation is by three nerves  Lingual nerve – anterior 2/3rd of tongue  Glossopharyngeal nerve – posterior 1/3rd of tongue  Vagus nerve – posterior most part of tongue
  62. 62. Special sensory supply  Supplied by three nerves  Chorda tympani (facial) – taste sensation of anterior 2/3rd of tongue  Glossopharyngeal (ix) – taste sensation of posterior 1/3rd of tongue  Vagus nerve (x) – taste sensation of posterior most part
  63. 63. Functions  Deglutition  Taste sensation  Speech production  Breast feeding  Self cleansing system  Mastication
  64. 64. CLINICAL ASPECTS FAISAL MANSOOR
  65. 65.  GLOSSITIS is usually a part of generalized ulceration of mouth cavity . In certain anaemias due to atrophy of filiform papillae tongue becomes smooth.  The presence of a rich network of lymphatics and loose areolar tissue in the substance of tongue is responsible for the enormous swelling of the tongue in acute glossitis. Clinical aspects
  66. 66.  The under-surface of the tongue is good site for observation of jaundice. In unconscious patients, the tongue may fall back and obstruct the air passage. This can be prevented either by lying the patient on one side with head down or by keeping the tongue out mechanically.  Referred pain is felt in the ear in diseases of posterior part of tongue, as ninth nerve commonly supply to both the regions Clinical aspects
  67. 67.  Carcinoma of tongue is quite common. The affected side is removed surgically. Carcinoma of posterior one third is more dangerous. Clinical aspects
  68. 68. Now, Lets find how attentive were you… 
  69. 69. Q1) WHICH PAPILLAE ARE RIGHT ANTERIOR TO SULCUS TERMINALIS? A. Foliate B. Vallate C. Fungiform D. Filiform
  70. 70. Q2) WHICH OF THE ONLY MUSCLES OF THE TONGUE IS INNERVATED BY THE VAGUS NERVE[X]? A. Styloglossus B. Genioglossus C. Palatoglossus D. Hyoglossus
  71. 71. Q3) DEEP LINGUAL VEINS DRAIN INTO: A. External Jugular Vein B. Internal Jugular Vein
  72. 72. Q4) CHORDA TYMPANI IS BRANCH OF WHICH CRANIAL NERVE? A. Vestibulocochlear B. Facial C. Glossopharyngeal D. Hypoglossal
  73. 73. Q5) CHORDA TYMPANI IS THE NERVE OF TASTE FOR ALL EXCEPT WHICH PAPILLAE? A. Filiform B. Fungiform C. Foliate D. Vallate
  74. 74. Q6) WHICH OF THE PAPILLAE ARE NUMEROUS OF ALL IN NUMBER? A. Filliform B. Fungiform C. Foliate D. Vallate
  75. 75. Think About This In Medical School we have a hundred classes that teach us how to fight off death…And not one lesson on how to go on living.” “

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