The document provides an overview of the anatomy and applied aspects of the tongue. It discusses the tongue's structure, muscles, blood supply, innervation, and development. Key points include that the tongue has extrinsic and intrinsic muscles innervated by the hypoglossal nerve and is supplied by the lingual artery. The tongue contains various papillae and serves roles in taste, swallowing, and speech. Applied aspects discussed include injuries, tumors, infections, and developmental abnormalities that can affect the tongue's function and structure.

1. Anatomy of tongue
& its applied
aspects
L. VASAVI REDDY
IMDS

2. 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.

3. Epithelium:
• Anterior 2/3rd – 1st branchial arch
• Posterior 1/3rd - 3rd branchial arch
• Posterior most part- 4th arch
Muscles:
• Occipital myotomes
Connective tissues:
From the local mesenchyme

4. External features:
• 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- ◦ curved upper dorsal surface
◦ an inferior surface
• ROOT: It is attached to styloid
process , soft palate above and to
mandible ,hyoid bone below.

5. Dorsal surface Ventral surface
• Oral part
• Pharyngeal part

6. Papillae of tongue: • Circum vallate papillae: large
in size, situated immediately in
front of sulcus terminalis
• Fungiform papillae: numerous
near tip and margins of
tongue, they are bright red in
colour
• Filiform papillae: cover the
presulcular area of dorsum of
tongue giving a characteristic
velvety appearance
• Foliate papillae: few are
present

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. Extrinsic muscles:

9. Blood supply of tongue:
• Arterial supply:
• Lingual artery
• Tonsillar- branch of facial
artery; ascending pharyngeal
branch
• Venouus drainage:
• Deep lingual vein is largest
and principal vein of tongue

10. Lymphatic
drainage:

11. Nerve supply:

12. Taste
pathway:

13. Taste sensation:
• Gustatory receptors detect following types of taste
sensation.
• Sweet: tip
• Bitter: base
• Sour: lateral margin
• Salty: anterolateral

14. Inspection:
• 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

15. Applied aspects:
• Paralysis of the Genioglossus(safety muscle of tongue) ◦ 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
• Referred pain is felt in the ear in diseases of posterior tongue.
• Glossitis: Chemical irritants , drug reaction, sarcoidosis, sjögren syndrome
Systemic infections (e.g., syphilis)

16. 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.
• 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

17. Malignant tumours:
• Squamous Cell Carcinoma
• Malignant lymphoma
• Malignant melanoma
• Metastatic tumors
• Sarcoma
Premalignant lesions:
Leukoplakia
erythroplakia
Bening tumours:
• Papilloma
• Rhabdomyoma
• Fibroma
• Glomus tumor
• Granular cell tumor
• Keratoacanthoma
• Leiomyoma
• Lipoma

18. Color changes in tongue:
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.

19. Tongue coating evaluation in halitosis:
Miyazaki tongue coating
index