anantomy , histology of tongue

2. Presented by :- Dr. Aditya Shinde
Guided by :- Dr. Lalitagauri Mandke
( 1 - 70 )

3.  Introduction
 Definition
 Functions
 External features of tongue
 Histology
 Medical Anomalies

4.  Tongue is the sense organ that gives satiety
 It also helps is articulation
 It is also a mirror reflecting various systemic
diseases

5. A fleshy movable muscular process of the floor of
the mouth of the most vertebrates that bears the
sense organ and small glands and functions in
talking and swallowing

6.  Mass of striated
muscles covered
with the mucous
membrane
 Divided into right
and left halves by a
median septum
 Three parts:
 Oral (anterior ⅔)
 Pharyngeal (posterior
⅓)
 Root (base)
 Two surfaces:
 Dorsal

7.  Divided into anterior two
third and posterior one
third by a V-shaped sulcus
terminalis.
 The apex of the sulcus
faces backward and is
marked by a pit called the
foramen cecum
 Foramen cecum, an
embryological remnant,
marks the site of the upper
end of the thyroglossal
duct

8.  Anterior two third:
mucosa is rough, shows
three types of papillae:
 Filiform
 Fungiform
 Vallate
 Posterior one third: No
papillae but shows
nodular surface because
of underlying lymphatic
nodules, the lingual
tonsils

9.  Smooth (no papillae)
 In the midline
anteriorly, a mucosal
fold, frenulum connects
the tongue with the
floor of the mouth
 Lateral to frenulum,
deep lingual vein can be
seen through the
mucosa
 Lateral to lingual vein, a
fold of mucosa forms
the plica fimbriata

10.  Root:
 It is attached to the
mandible and soft palate
above and the hyoid
bone below. Because of
these attachments, we
are not able to swallow
the tongue itself.
 In between the two
bones, it is related to
geniohyoid and
mylohyoid muscles.

14.  TASTE
 Salt
 Sweet
 Sour
 Bitter
 umami

16.  Chewing
 Swallowing
 cleansing

17.  The tongue is the most important
articulator for speech production
 The primary function of the
tongue is to
provide a mechanism for taste.
Taste buds are located on different
areas of the tongue, but are
generally found around the edges.
They are sensitive to
four main tastes: Bitter,
Sour,
Salty & Sweet
 The tongue is needed for sucking,
chewing, swallowing, eating,
drinking, , sweeping the mouth for
food debris and other particles.
 Trumpeters and horn & flute
players have very well developed
FUNCTIONS in brief :FUNCTIONS in brief :

18. Extrinsic Muscles Intrinsic Muscles
 Genioglossus superior longitudinal
 Hyoglossus inferior longitudinal
 Styloglossus tansverse
 Chondroglossus vertical
 Palatoglossus

19. It is triangular in sagittal section,
lying near and parallel to the
midline.
It arises from a short tendon
attached to the superior genial
tubercle behind the mandibular
symphysis, above the origin of
geniohyoid. From this point, it
fans out backwards and upwards.

20.  BLOOD SUPPLY:
 Sublingual branch of the Lingual artery.
 Submental branch of the Facial artery.
 NERVE SUPPY
 Hypoglossal nerve.

21. Acting bilaterally, they depress
the central part of the tongue,
making it concave from side to
side.
Acting unilaterally, the tongue
diverges to opposite side
Protrude the apex

22. It is thin and
quadrilateral.
It arises from the
whole length of the
greater cornu and
the front of the
body of the hyoid
bone.
It passes vertically
up to enter the side
of the tongue
between
Styloglossus
laterally and the
inferior longitudinal
muscle medially.

23.  Vascular Supply
Sublingual branch of the Lingual artery.
Submental branch of the Facial artery.
 Innervation
Hypoglossal nerve.
 Actions
It depresses the tongue.

24.  It is sometimes described as a
part of Hyoglossus and is
separated from it by some fibers
of Genioglossus.
 It is 2 cm long, arising from the
medial side and base of the
lesser cornu and the adjoining
part of the body of the hyoid.
 It ascends to merge into the
intrinsic musculature between
Hyoglossus and Genioglossus
muscle.

25.  It is the shortest and
smallest of three styloid
muscles.
 It arises from the
anterolateral aspect of the
styloid process near its
apex and from the styloid
end of the
stylomandibular ligament.
 it passes downwards and
forwards and divides at
the side of the tongue into
a longitudinal part, which
enters the tongue
dorsolaterally to blend
with the inferior
longitudinal muscle in
front of Hyoglossus and an
oblique part, which
overlap Hyoglossus and
decussate with it.

26.  Vascular Supply
 Sublingual branch of the Lingual artery.
 Innervation
 Hypoglossal nerve.
 Action
 It draws the tongue up and backward.

27.  It is narrower at its middle
than at its end.
 It is closely associated with
soft palate in function and
innervation.
 Together with its overlying
mucosa, it forms the
palatoglossal arch.
 It arises from the oral
surface of the palatine
aponeurosis where it is
continuous with its fellow.
 It extends forwards,
downwards and laterally in
front of the palatine tonsil
to the side of the tongue.

28.  Vascular Supply
 Ascending palatine branch of Facial artery.
 Ascending pharyngeal artery.
 Innervation
 Cranial part of the accessory nerve via the pharyngeal plexus.
 Actions
 Elevates the root of the tongue and approximates the palatoglossal
arch to its contralateral,shutting off the oral cavity from the
oropharynx.

29. Superior longitudinal
It constitutes a thin stratum of oblique and longitudinal
fibers lying beneath the mucosa of the dorsum of the
tongue.
It extends forwards from the submucous fibrous tissue
near the epiglottis and from the median lingual septum to
the lingual margins

30. Inferior longitudinal
It is a narrow band of muscle close to the inferior lingual
surface between Genioglossus and Hyoglossus.
It extends from the root of the tongue to apex.
Some of its posterior fibers are connected to the body of
the hyoid bone.

31. Transverse
They pass laterally from the median fibrous septum to
the submucous fibrous tissue at the lingual margin,
blending with palatopharyngeus.
They extend from the dorsal to the ventral aspect of the
tongue in the anterior borders.

32.  Vascular Supply – Lingual artery.
 Innervation – Hypoglossal nerve.

33.  The intrinsic muscles alter the shape of the tongue.
 Contraction of superior and inferior longitudinal muscles tends to
shorten the tongue.
 The transverse muscle narrows and elongates the tongue.
 The vertical muscle flattens and widens the tongue

34.  Anterior ⅔:
 General sensations:
Lingual nerve
 Special sensations : chorda
tympani
 Posterior ⅓:
 General & special
sensations:
glossopharyngeal nerve
 Base:
 General & special
sensations: internal
laryngeal nerve

35.  Intrinsic muscles:
 Hypoglossal nerve
 Extrinsic muscles:
 All supplied by the
hypoglossal nerve,
except the
palatoglossus
 The palatoglossus
supplied by the
pharyngeal plexus

36.  Arteries:
 Lingual artery
 Tonsillar branch of
facial artery
 Ascending pharyngeal
artery
 Veins:
 Lingual vein,
ultimately drains into
the internal jugular
vein
Hypoglossal
nerve
Lingual
artery & vein
Deep lingual
vein
Dorsal lingual
artery & vein

37.  Tip:
 Sub mental nodes
bilaterally & then deep
cervical nodes
 Anterior two third:
 Submandibular
unilaterally & then deep
cervical nodes
 Posterior third:
 Deep cervical nodes
(jugulodigastric mainly)

38.  skeletal muscle supported by connective tissue.
 The mucous membrane differs in its structure.
Dorsal Lingual Mucosa
 Thicker, no sub mucosa covered by numerous papillae.
 stratified squamous epithelium
 Non-keratinized posteriorly / fully keratinized overlying the
filliform papillae anteriorly.

39.  4 principal types –
 Filiform papillae
 Fungiform papillae
 Foliate papillae
 Circumvallate
papillae

40. 1.1. Filiform papilla:Filiform papilla: Makes up majority of the papillae and covers the anterior part
of the tongue. They appear as slender, threadlike keratinized projections
(~ 2 to 3 mm) of the surface epithelial cells. These papillae facilitate mastication
(by compressing and breaking food when tongue is apposed to the hard palate)
and movement of the food on the surface of the tongue. The papillae is directed
towards the throat and assist in movement of food towards that direction.
NO TASTE BUDS.
FILLIFORM PAPILLA

41. 41
2.2. Fungiform papillaFungiform papilla: (Fungus-like) These are interspersed between the filiform papilla.
More numerous near the tip of the tongue. Smooth, round structures that appear
red because of their highly vascular connective tissue core, seen through a thin,
nonkeratinized stratified squamous epithelium. Taste buds are usually seen within
the epithelium.
Filiform papilla
FUNGIFORM PAPILLA

42. 3.3. Foliate PapillaFoliate Papilla: (Leaf-like). Present on the lateral margins of the posterior tongue.
Consist of 4 to 11 parallel ridges that alternate with deep grooves in the mucosa,
and a few taste buds are present in the epithelium. They contain serous glands
underlying the taste buds which cleanse the grooves.
FOLIATE PAPILLAEFOLIATE PAPILLAE

43. 4.4. Circumvallate papillaCircumvallate papilla: (Walled papilla). 10 to 14 in number these are seen along
the V-shaped sulcus between the base and the body of the tongue. Large, ~ 3 mm
in diameter with a deep surrounding groove. Ducts of von Ebner glands (serous
salivary glands) open into the grooves. Taste buds are seen lining the walls of
the papillae.
CIRCUMVALLATE PAPILLACIRCUMVALLATE PAPILLA

44. 44
Unique sense organs that contain the chemical sense for taste Microscopically visible
barrel-shaped bodies found in the oral epithelium . Usually associated with papillae of
the tongue (circumvallate, foliate and fungiform). Also seen in soft palate, epiglottis,
larynx, and pharynx . Referred to as NEUROEPITHELIAL STRUCTURES. But most
correctly referred
as epithelial cells closely associated with clib-shaped sensory nerve endings. These
nerves arise from the chorda tympani in anterior tongue and glossopharyngeal in
posterior tongue and come to lie among the taste cells. Each taste bud has ~ 10 to
14 cells. Majority are taste cells with elongated microvilli that project into the
taste pore. (Epiglottis and larynx – Vagus nerve)
ype 1 dark cell (60% of cells)
ype 2, light cells (30%)
ype 3 (7%) and Type 4 (basal cells ~ 3%)
TASTE BUDSTASTE BUDS

45.  all that can be seen
from the surface,
even with a
scanning electron
microscope, is a
small hole, the taste
pore, through
which the sapid
substance must
pass

46.  Supporting cells - contain microvilli, appear to
secrete substances into lumen of taste bud.
 Sensory receptor cell - has peg-like extensions
projecting into lumen. These contain the sites
of sensory transduction.
 Basal cells - these differentiate into new
receptor cells. They are derived from
surrounding epithelium. The cells are
continuously renewed every 10 days or so.

47.  composed of elongated
sensory cells arranged with
other nonsensory cells like
the segments of an orange
 The apical portions of the
sensory cells have microvilli
that project into the region
of the taste pore. These
microvilli are 2 to 5 µm long
and 0.05 to 0.2 µm wide,
and function perhaps to
increase the surface area of
the cell membrane

48. The surface of the taste buds is composed of cell membrane with lipid
bilayer. When taste substances are adsorbed with the membrane, the
electric characteristics such as electric potential change. It is thought
that the changes of membrane potential are obtained from various taste
buds and neural network calculates them by pattern recognition.

49.  Cranial nerves carry
taste information into
the brain to a part of the
brain stem called the
nucleus of the solitary
tract.
 From the nucleus of the
solitary tract, taste
information goes to the
thalamus and then to
the cerebral cortex.
 Like information for
smell, taste information
also goes to the limbic
system(hypothalamus
and amygdala).

50.  New taste buds are produced every three
to ten days to replace the ones worn out
by scalding or frozen foods

52. Location of Taste Buds Innervation
Anterior part of tongue
excluding vallate papillae
Chorda tympani via lingual
nerve
Inferior surface of the soft
palate
Facial nerve, greater petrosal
nerve, pterygopalatine
ganglion and lesser palatine
nerve.
Circumvallate papillae,
Postsulcal part of tongue,
palatoglossal arches and
oropharynx.
Glossopharyngeal nerve.
Extreme pharyngeal part of
the tongue
Internal laryngeal branch of
vagus nerve.

53.  The complete inability to taste is called ageusia,
the reduced ability to taste is called
hypogeusia, and the enhanced ability to taste is
called hypergeusia. Ageusia is a rare disorder

54. MICROGLOSSIA
 This is a condition where the size
of the tongue is abnormally small.
Cases of complete absence of the
tongue have been reported.
Fortunately, it is a rare condition.
Obviously, a tiny tongue will
pose many difficulties related to
speech and swallowing. There is
no treatment for this condition,
and the affected person will have
to train their tongue to the best of
their abilities.

55.  This is a much more common condition
than microglossia, where the tongue is
highly enlarged. An enlarged tongue may
be congenital, when it is associated with
generalized muscular hypertrophy or
hemi hypertrophy.
 As a rule, macroglossia causes
disturbances in the teeth as well. Due to
the continuous pressure exerted by the
heavy tongue, teeth begin to move away
and the tongue occupies these spaces
between the teeth, giving it a scalloped
appearance.
 The treatment of macroglossia involves
the removal of the cause that gives rise to
this condition. At times, surgical
stripping of the tongue to reduce the
heavy musculature is also warranted.

56.  This condition is also
referred to as scrotal tongue
since the tongue often
resembles the scrotum in
this state. Here a transverse
groove is present on the
tongue from which
numerous smaller grooves
radiate all over the surface
of the tongue. The
condition is usually
painless and the only
problem is with the food
debris gets stuck in the
grooves. These have to be
cleaned by gauze or a
toothbrush.

57. Ankyloglossia occurs as a result of
the fusion of the lingual frenum to
the floor of the mouth. However,
complete fusion rarely occurs; a
partial ankyloglossia or "tongue-tie"
is a much more common condition.
This leads to a myriad of speech
problems such as lisping and
stuttering. The treatment is to
surgically sever the connection
between the frenum and the floor of
the mouth.

58. This condition is a classic developmental disorder
of the tongue. It is a failure of the developmental
apparatus during the organogenesis of the fetus.
A structure called "tuberculum impar" is
supposed to withdraw when the two halves of
the tongue come close to each other during
development. When this does not happen, the
structure gets trapped in between the two halves
of the tongue, thereby creating an area, which
looks like a bald patch on it. Median Rhomboid
Glossitis has also been strongly linked with the
fungal infection caused by Candida albicans,
where the tongue has an ovoid patch just before
the entry into the esophagus. This condition is
reportedly thrice as common in men as in
women. The exact cause for this occurrence is
not known, although hormonal links have been
suggested.
There is no known treatment for MRG, though
doctors have tried to administer anti-fungal
agents with mixed results

59.  Cleft tongue is a condition where the
tongue has a cleft running right across
it horizontally or vertically, although
reported cases have had vertical clefts.
Complete clefting is extremely rare,
and occurs as a result of lack of
developmental forces to push both
halves of the tongue towards each
other. Partial clefting presents as a
deep groove in the middle of the
tongue and is a common feature in the
oro-facial-digital syndrome. Cleft
tongue is of little importance other
than causing difficulty in eating as
food gets stuck in the cleft.

60.  This condition is also called a Geographic
Tongue due to the behavior of the lesions,
which tend to "migrate" from one area of
the tongue to another. The exact cause for
the condition remains unknown,
although it tends to occur with more
intensity in cases of emotional stress.
Females are twice as affected as males,
but no racial differences have been
observed. The lesions here are yellowish-
white or deep red in color depending on
the papillae that are affected. Patients
with this condition are usually
asymptomatic and the lesions themselves
are an incidental finding during routine
check-up. Again there is no known
treatment for the disease, but some
doctors have reported moderate success
with vitamins and mineral supplements.

61.  This is a condition characterized by the
hypertrophy of the filiform papillae of
the tongue as well as desquamation of
the area where this occurs. If the papillae
become stained with tobacco, they
appear black in color and look like hair
on the tongue. The tongue could also
appear yellowish-white if foodstuff is
trapped within these papillae. Anemia
and gastric troubles are said to have a
significant bearing on the development
of this condition. Antibiotics like
penicillin and Aureomycin are also
responsible for the staining of the
papillae. Sometimes, head and neck
irradiation after cancer may also produce
this condition. The only treatment of the
condition is to keep the tongue as clean
as possible by using a toothbrush.

62. A common HIV-related infection is called candidiasis. Symptoms
include inflammation of and a white film on the tongue. Another viral
infection that affects the mouth is oral hairy leukoplakia, which
causes white lesions on the tongue.

63. A tongue piercing is a body piercing usually
done directly through the centre of the tongue.
Standard tongue piercing or one hole in the
centre of the tongue is the most common and
safest way to have your pierced .
According to Canadian Dental Association
infection are the most common generalized
complication of tongue piercing with an
estimate 20% infection rate of intraoral
piercing.
It can cause: bleeding , drooling , nerve
damage,pain, swelling , allergic reaction.
The tongue jewellery knocks into the teeth
and gum tissue, causing teeth to crack, chip or
break , damage to the fillings and other
restoration and damage to gum tissue.

64.  Tongue is a strong muscle that is anchored to the floor
of the mouth and it has the organs of taste reception.
 It is associated with the functions of taste , speech ,
mastication and deglutition.
 Papillae are the projections of mucous membrane or
corium which gives the anterior two-third of the
tongue its characteristic roughness.
(filiform,fungiform,vallate).
 Tongue appears very mobile still it cannot be
swallowed like food because tongue is anchored to
hyoid bone , mandible and soft palate with attachment
of three extrinsic and four intrinsic muscle.
 Thanks to the taste buds that the multiple hotels,
restaurants, fast food outlets, chat-pakori shops etc. are
flourishing.

65. 1. Gray’s Anatomy For Students: -Richard LD Rake, Wayne Vogl 1st Ed,
chapter 8 Conceptual overview of head and neck, Regional anatomy,
oral cavity- tongue page 989- 996.
2. Shafer’s Text Book Of Oral Pathology – 5th Ed ; Shafer, Hine, Levy,
Section-1, Disturbance of development and growth, R. Rajenrda,
page35-44.
3. B.D. Chauraisa’s human anatomy; Regional And Applied Dissection
and Clinical 4th Ed Vol-3 section-1 chapter-17 “The Tongue” page
249-254.
4. Ten Cate’ oral histology

66. 7. Color atlas of dental medicine – Periodontology ; Herbert. F. Wolf,
Edith. M, Klaus H. Rate’s; 3rd Ed; chapter- Therapy, Phase-I therapy
page237.
8. De Moor RJG, De Witte AMJC, De Bruyne MAA. “Tongue piercing and
associated oral and dental complications” Endod Dent Traumatol 2000;
16: 232–23