The tongue develops from the first, second, third and fourth branchial arches. It has intrinsic and extrinsic muscles that allow it to move and perform functions like speech, taste and swallowing. The tongue's surface has various papillae that contain taste buds. The tongue has implications in areas like speech pathology, surgery, oncology and more. Conditions and lesions of the tongue can provide clinical insights.

1. Anatomy of tongue & its
applied aspects
Anchal Mehra
II MDS

2. Contents
1. Introduction
2. Development
3. Anatomy
Parts and surfaces of the tongue
Muscles of the tongue
Vascular supply of the tongue
Innervation of the tongue
Lymphatic drainage of the tongue
4. Applied aspect
5. Bibliography

3. INTRODUCTION
 The tongue is a muscular structure
that forms part of the floor of the
oral cavity and part of the anterior
wall of the oropharynx.
 Primary organ of taste (gustation)
 It has an oral part that lies in the
mouth, and a pharyngeal part that
lies in the oropharynx.
 The oral and pharyngeal parts are
separated by a V-shaped sulcus,
the sulcus terminalis.

4. t.impa
r
Embryonic origin is derived from 1st,2nd,3rd & 4th branchial
arch, by the end of the 4th developmental week..

5. • The anterior 2/3rd of the tongue is
formed from the two lateral
swellings that develop on both
sides of the tuberculum impar.
 Immediately behind the
tuberculum impar, Foramen
Caecum.
 Lateral swellings grow rapidly
by proliferation of the first
pharyngeal arch mesenchyme,
until they fuse with one another
and form the median sulcus of
the tongue.

6.  Swellings from the floor of the
3rd and 1st pharyngeal arches
overgrow the 2nd arch .
 The posterior1/3rd of the tongue
arises from the hypobranchial
eminence.
 Hypobranchial eminence divided
into
i. Cranial part(Copula)-2nd &3rd
arch
ii.Caudal part-4th arch
(forms the Epiglottis )

7. MUSCLES
 Muscles of tongue are derived from occipital myotomes,
which at first are closely related to developing cranium
and later migrate inferiorly and anteriorly around the
pharynx and enter tongue.
 They carry along with them the fibers of hypoglossal
Nerve.

8. Parts & functions
 It has a fixed root, and a mobile body &
tip that can take on a variety of shapes
& positions.
 TIP-
◦ anterior end of the body.
◦ Rest on upper incisors.
 BODY-
◦ anterior two thirds of the tongue.
◦ Upper and lower surface.
 ROOT-
It is attached to styloid process , soft
palate above and to mandible ,hyoid
bone below.

9. External surface
 Tongue has dorsal surface & ventral surface.
 Ventral - The sublingual surface of the tongue is
covered with thin, transparent mucosa,which shows a
median fold called the ‘ frenulum linguae’ .
 On either side of frenulum , there is a prominence
produced by deep lingual veins.
 More laterally there is a fold called plica fimbricata.

10.  Dorsal surface- convex in all directions.
a.Oral Part : anterior 2/3
b.Pharyngeal part : posterior 1/3

11. Dorsal surface-Anterior 2/3rd
 The dorsal mucosa covered by filiform, fungiform
,foliate and circumvallate papillae.

12. Circumvallate papillae
Vallate papillae:
 Large and flat topped
 They are large in size 1-2 mm in diameter 8-12 in number
 Lie directly anterior to the terminal sulcus
 Walls are studded with taste buds
 Each papilla is a cylindrical projection surrounded by a
circular sulcus.

13. Filiform Papilla
 Most numerous and cover most of the
Presulcal area of dorsum of tongue.
 Pinpoint cone-shaped projections of the
mucosa that ends in one or more points.
 Gives velvety appearance to the tongue.
 They are smallest papillae.
 Covered with keratin.
 Increase the friction between the tongue and
food.

14. Fungiform papilla
 These are mushroom shaped.
 More numerous near tip & margins of tongue but some of
them scattered over the dorsum.

15. Foliate papillae
 Bilaterally at the sides of the
tongue near sulcus terminalis.
 Bounded by narrow fold of
mucous membrane .
 Has numerous taste buds.

16. Taste buds
• Present in relation to cirumvallate
papilla, fungiform papillae and
foliate papilla.
• The taste buds are located in the
walls and grooves of the papillae.
• Opens on surface as taste pores.
• Taste buds contain the taste receptor
cells, which are also known as
gustatory cells.
• On average, the human tongue has
2,000–8,000 taste buds.

17. TASTE SENSATION
 Gustatory receptors detect
following types of taste sensation.
 Sweet: tip
 Umami : middle
 Bitter: base
 Sour: lateral margin
 Salty: anterolateral

18. Dorsal surface -Posterior Third
 The mucosa of the posterior third of the
tongue is devoid of small papillae.
 Its surface is irregular and has many large
nodules, composed of lymphoid tissue.
 Collectively, the lymphoid nodules are
called the lingual tonsil which gives it the
cobblestone appearance.
 The anterior wall of the oropharynx is
formed by the upper part of the posterior
one-third or pharyngeal part of the tongue.

19.  A pair of mucosal
pouches (valleculae) ,
one on each side of
the midline, between
the base of the tongue
and epiglottis.

20. Minor salivary glands
Glands of blandin-nuhn –
 Anterior lingual glands (also called apical glands) are
deeply placed glands .
 Located near the tip of the tongue on each side of the
frenulum linguae.
 Each opens by three or four ducts on the under
surface of the tongue's apex.

21. Glands of Weber
 They lie along the lateral border of the tongue
,posterior to vallate papillae.
 These open into the crypts of the lingual tonsils on
the posterior tongue.
 These glands are pure mucous secreting glands.
 Abscess formed due to accumulation of pus and
fluids in this gland is called Peritonsillar Abscess.

22. Glands of von ebner
Located below the circumvallate &
folate papillae, opening of their ducts
into the troughs of the vallate papillae.

23. Functions
1. Speech
2. Taste
3. Mastication
4. Deglutition

24. Muscles of tongue
 Each half contains 4 intrinsic muscles
4 extrinsic muscles

25. INTRINSIC MUSCLES
 Intrinsic
◦ Superior longitudinal
◦ Inferior longitudinal
◦ Transverse
◦ Vertical
 The intrinsic muscles of the tongue originate and insert
within the substance of the tongue.

26. Superior
longitudinal
Inferior
longitudinal
Vertical
Transverse
They alter the shape of the tongue by lengthening and shortening it,
curling and uncurling its apex and edges, and flattening and rounding
its surface.

27. Superior longitudinal
 The superior longitudinal muscle lie
beneath the mucosa of the dorsum
of the tongue.
 Some fibres are inserted into the
mucous membrane.
Action-
 shortens the tongue,makes dorsum
concave

28. Inferior longitudinal
 Lie close to the inferior lingual surface
between genioglossus and hyoglossus.
 It extends from the root of the tongue to
the apex. Some of its posterior fibres
are connected to the body of the hyoid
bone.
 Anteriorly it blends with styloglossus
 Action shortens the tongue & makes
dorsum concave

29. Transverse & Vertical
 The transverse muscles pass
laterally from the median
fibrous septum to the
submucous fibrous tissue at
the lingual margin.
 ACTION- makes tongue
narrow & elongated
 The vertical muscles extend
from the dorsal to the ventral
aspects of the tongue in the
anterior borders.
 ACTION- makes tongue broad
& flattened.
Ttransverse linguae

30. Extrinsic muscles- attached to soft
palate & styloid process above
Mandible & hyoid bone -below

31. Genioglossus
 The thick fan-shaped genioglossus muscles make
a contribution to the structure of the tongue.
 ORIGIN - from superior genial tubercle
 INSERTION- Upper fibers: tip of the tongue
Middle fibers: dorsum
Lower fibers: hyoid bone
Genioglossus
muscle

32. Action
Upper fibers: retract the tip
Middle fibers: depress the tongue
Lower fibers: pull the posterior part forward
(thus protrusion of the tongue from the
mouth)
 muscles are innervated by the hypoglossal
nerves.

33. Hyoglossus muscle
The hyoglossus muscles are thin quadrangular muscles
lateral to the genioglossus muscles.

34.  Origin: Greater cornu, and the adjacent part of
the body of the hyoid bone
 Insertion: Side of the tongue .
ACTIONS
 Depresses the tongue.
 Innervated by the hypoglossal nerve [XII] .

35. Styloglossus
 Origin : Styloid process near its apex.
 Insertion : Lateral surface of tongue.
 Action: Draws the tongue
elevates & retracts the tongue

36. Palatoglossus
 Origin: Palatine aponeurosis of soft palate
 Insertion: Side of the tongue
ACTION
• Elevate the posterior part of the tongue,
• Depress the soft palate.
INNERVATION
 innervated by the vagus nerves.

37. Arterial supply
 Lingual artery- Mainly by lingual artery which is a
branch of external carotid artery.
 Divides into :
 Dorsal lingual arteries: supply posterior part
 Deep lingual artery : supplies the anterior part
 The root of the tongue is supplied by the tonsillar
and ascending pharyngeal arteries.

38. Innervation
Anterior two-thirds (oral)
• General sensation
lingual nerve
• Special sensation (taste)
chorda tympani
Sensory
Posterior one-third
(pharyngeal)
• General and special
(taste) sensation via
nerve
Palatoglossus -
vagus nerve
Intrinsic
muscle
Genioglossus
Hypoglossal nerve
Motor

40. Veins
1. Dorsal lingual vein: drains the dorsum and sides of the
tongue
2. Deep lingual veins: drains the tip of the tongue
3. All these veins terminate directly or indirectly
into Internal jugular veins

41. LYMPHATIC DRAINAGE
1. Tip: drains bilaterally to submental
nodes
2. Right & left anterior 2/3rd of
tongue drain unilaterally to
submandibular nodes.
3. Posterior most part & posterior
1/3rd of tongue drain bilaterally
into jugulodiagastric nodes .
4. The whole lymph finally drains
into “jugulo omohyoid nodes”

42. Applied Aspects

43. Inspection
Inspect the dorsum of the tongue at rest for variation in
size,color, and texture.
Wrap a piece of gauze around the tip of the protruded tongue to
hold
Observe and note
1. The distribution of papillae,
2. Margins of the tongue.
3. Depapillated areas,
4. Fissures, ulcers, and keratotic areas.
5. Frenal attachment
6. Any deviations as the patient protrudes tongue and attempts
to move it to the right and left.
7. Tongue thrust on swallowing.

44. Developmental disturbances
 Aglossia & microglossia-Manifested as microglossia
with glossoptosis.
 Macroglossia – tongue hypertrophy, pseudomacroglossia
 Ankyloglossia or tongue tie
 Cleft tongue/bifid tongue
 Fissured tongue-scortal tongue,lingual plicata-
It is characterized by grooves that vary in depth and are
noted along the dorsal and lateral aspect of the tongue.

45.  Median rhomboid glossitis- the central
papillary atrophy of the tongue,anterior to
circumvallate
 Geographic tongue- is serpiginous white lines
surrounding areas of smooth, depapillated
mucosa.
 Hairy tongue-(lingua nigra,black hairy
tongue,lingua villosa)- hypertrophy of filliform
papillae due to lack of mechanical debridement.
 Lingual varices- a dilated, tortuous vein, deep
lingual vein.
 Lingual thyroid nodule- follicles of thyroid
tissue are found in the substance of the tongue

46. MALIGNANT TUMOURS OF TONGUE
• Squamous Cell Carcinoma
o Malignant lymphoma
o Malignant melanoma
o Metastatic tumors
o Sarcoma

47. BENIGN TUMORS OF TONGUE
 Papilloma
 Pyogenic granuloma
 Rhabdomyoma
 Fibroma
 Glomus tumor
 Granular cell tumor
 Keratoacanthoma
 Leiomyoma
 Lipoma

48. Contd. Applied aspects
 Paralysis of the Genioglossus
◦ tendency of tongue to fall posteriorly,
obstructing the airway.
 Injury to the Hypoglossal Nerve
◦ paralysis and eventual atrophy of affected
side of the tongue.
 Sublingual Absorption of Drugs
◦ quick absorption of a drug through deep
lingual veins
Bilateral parasymphysis fracture- as genioglossus muscle is attached to the
superior genial tubercle, when bilateral parasymphysis fracture, tongue might
fall back

49.  Thyroglossal Duct Cyst
A cystic remnant of the thyroglossal duct may
be found in the root of the tongue .
 Aberrant Thyroid Gland
found anywhere along the path of the
embryonic thyroglossal duct.
 Glossopharyngeal neuralgia- sharp
shooting pain in post. 1/3rd of tongue.
 Frey’s syndrome- gustatory sweating.

50. Surface lesions
 Frictional keratosis
 Tobacco keratosis
 Leukoplakia of tongue
 Lichen planus
 Patches of radiation injury

51. Vesiculo-bullous disease of tongue
 Erythema multiforme
 Pemphigus vulgaris
 Pemphigoid
 Amyloidosis
 Dermatitis herpetiformis

52. Ulcers of the tongue
Major causes-
 recurrent apthous
 Malignant ulcers
 Neutropenia
 Nutritional disorders
 STDs

53. Glossitis
 Conditions Associated-
 Chemical irritants
 Drug reaction
 Sarcoidosis
 Sjögren syndrome
 Systemic infections (e.g., syphilis)

54. Infections
Viral-
 herpes simplex
 Herpes varicella zoster
 Coxsackie B infections.

55. Bacterial-
 Tuberculosis
 Histoplasmosis
 Actinomycosis

56. Fungal –
 Gives white patches due to growth of C.
albicans.
 Pseudomembranous thrush
 Atrophic candidiasis
 Chronic hyperplastic candidiasis

57. COLOR CHANGES
1. Pale Yellow Anemia, Jaundice.
2. Orange – obstructive jaundice.
3. Blue Cyanosis, Congenital heart disease, Polycythemia
4. Strawberry red Scarlet fever,antibiotics
5. Beefy red Vitamin B deficiency, pernicious anemia
6. Magenta Aribinoflavinosis,megaloblastic anaemia
7. Black(hairy) Poor oral hygiene, Smoking, Metal
poisoning.
8. Pigmentation Addisons disease, malignant melanoma.

58. Systemic diseases
 Blood dyscrasias
 Metabolic disorders
 Dermatologic disorders
 Characteristic feature-Atrophy /depapillation

59. IRON DEFICIENCY
ANAEMIA-
 Manifest in the orofacial region as atrophic
Glossitis.
 Smooth, glazed tongue –pale yellow to red in colour

60. Pernicious anaemia
 Hunters Or beefy red tongue.
 Tongue : Glossopyrosis, Glossodynia, Glossitis
 Tongue - inflamed, beefy red, atrophy -
 Loss of taste

61. PLUMMER-VINSON SYNDROME
(PATERSON-KELLY SYNDROME;
 Marked atrophy of the lingual papillae,
which produces a smooth, red appearance
of the dorsal tongue.
Megaloblastic anaemia
‘’Magenta tongue’’
 tongue becomes fiery red, swollen, and shows atrophy
of both the filliform and fungiform papillae

62. Vit B deficiency
 only niacin and folic acid deficiencies are
encountered clinically.
 First, the tip and margins of the tongue
become red and swollen.
 advanced cases, the papillae are lost, and
the red colour becomes even more intense.

63. CONCLUSION

64. Bibliography
 Henry Gray(2004),Gray's Anatomy .
 Frank H.Netter,MD. Atlas of human anatomy
 SHAFER’S 6TH EDITION Textbook of oral
pathology
 B.D Chaurasia(2006) Human Anatomy,Regional
and Applied,Dissection.
 Sinnatamby C S. Last’s anatomy regional and
applied. 11th edition
 D.W. Beaven , S.E. Brooks A colour atlas of The
tongue in clinical diagnosis
 Internet sources.