The tongue develops from the fusion of swellings in the embryo and is composed of extrinsic and intrinsic muscles. It has a dorsal and ventral surface covered in papillae and taste buds. The tongue receives its blood supply from the lingual artery and drains lymphatically into submandibular and deep cervical nodes. It is innervated by cranial nerves including the hypoglossal nerve for motor function and the lingual, glossopharyngeal, and vagus nerves for sensory function. Abnormalities of the tongue can impact speech, swallowing, and other functions.

1. ANATOMY OF TONGUE
Presenter Moderator
DR CHAITRA N DR DECHU

2. Contents
 Development
 Anatomy – surfaces
muscles
arterial supply
lymphatic drainage
nerve supply
 Applied anatomy

3. DEVELOPMENT

4. Development of tongue
 It develops during 4th week of gestation

5. Anterior 2/3
 The anterior two thirds of the tongue is formed by fusion of the
tuberculum impar and the two lingual swellings.
 supplied by the lingual branch of the mandibular nerve
Posterior 1/3
 The posterior one-third of the tongue is formed from the cranial part of the
hypobranchial eminence (copula)
 supplied by the glossopharyngeal nerve,

6.  The posterior most part of the tongue is derived from the fourth arch
 supplied by the superior laryngeal nerve

7.  The musculature of the tongue is
derived from the occipital
myotomes

8.  The mucosa of tongue is derived from endoderm of foregut
 The fibroareolar stroma is derived from the neural crest
 The circumvallate papillae of tongue develop from the cranial part
of hypobranchial eminence and migrate to the anterior aspect of
sulcus terminalis. They are supplied by glossopharyngeal nerve

9. Development of sensory nerves
 Lingual nerve
 Chorda tympani nerve
 Glossopharyngeal nerve

10. ANATOMY

11. Anatomy
 Dorsal surface
 Ventral surface
 Root
 Apex

12. Dorsal surface
 Oral part
 Pharyngeal part

13. Dorsal surface
 Anterior 2/3rd
 Mucosa is rough

14. Papillae of the tongue
 Projections of mucous membrane which
gives the anterior 2/3rd of tongue its
characteristic roughness

15. Circumvallete papillae
 Largest among papillae
 Shape: dome shaped
 Size: 1-2mm in diameter
 Number: 8 to 12
 Location: in front of sulcus terminalis
 Arranged in V shaped

16. Filiform papillae
 Hair like or thread like in appearance
 Function: facilitate mastication
 No taste buds
 Histologically
cone shaped appearance
lined by stratified squamous epithelium.

17. Fungiform papillae
 Mushroom shaped
 Deep red colour
 Taste buds seen within the epithelium

18. Foliate papillae
 Red leaf like
 Bilaterally at the sides of tongue

19. Papillae of tongue

20. Taste buds
 The receptors for taste
 Located on the surface of the tongue, soft
palate and epiglottis.
 Each taste bud contains approximately 50–
100 cells and has a life span of 10–14 days

22. Pharyngeal 1/3 of the tongue
 Lies behind sulcus terminalis
 Forms anterior wall of oropharynx
 No papillae
 Consist of lingual tonsil

23. Ventral surface
 Covered by smooth mucous membrane
 Lingual frenulum
 Plica fimbriata

25. Ankyloglossia
 Congenital anamoly characterized by abnormal short lingual frenulum
 Resists mobility of tongue
Clinical features
 Tongue has heart shaped protrusion
 Protrusion is limited

26.  Type 1  Type 2

27.  Type 3  Type 4

28.  Apex
forms the anterior free end which at rest lies behind the upper
incisor

29.  Root
attached to mandible and soft palate above
hyoid bone below

30. MUSCLES

31. Muscles
Extrinsic
 Genioglossus
 Hyoglossus
 Styloglossus
 palatoglossus
Intrinsic
 superior longitudinal
 inferior longitudinal
 transverse
 vertical

32. genioglossus
Origin
 from the superior genial tubercle
Insertion:
 hyoid body near the midline.
 posterior part of the tongue
 ventral surface of the tongue

33.  Action
 Protrusion
 Bilaterally: Central part depression
 Unilaterally: Diverges to opposite side
 Clinical importance
 If paralysed, the tongue falls posteriorly
 Total relaxation occurs during general anaesthesia

34. HYOGLOSSUS
Origin
 greater cornu and from the front of the
body of the hyoid bone
Insertion
 Lateral border of the tongue
 Nerve: hypoglossal nerve
 Action: Depression

35. STYLOGLOSSUS
Origin
 Tip and anterior surface of styloid process
Insertion
 Lateral border of the tongue
Nerve supply
 hypoglossal nerve
Action
 pull the tongue upwards and backwards

36. Palatoglossus
 Origin: inferior surface of palatine aponeurosis
 Insertion: lateral margins of tongue
 Action: elevates the posterior part of the tongue

37. Superior longitudinal
 Origin:dorsum of tongue
 Insertion lingual margin
 Action: makes dorsum concave
shortens the tongue

38. Inferior longitudinal
 Origin: root of the tongue
 Insertion: apex of the tongue
 Action: shortens the tongue
makes the dorsum convex

39. Transverse
 Origin: median fibrous septum
 Insertion: fibrous tissue at margins of the tongue
 Action: narrows and elongates the tongue

40. Vertical
 Origin: borders of anterior part of the tongue
 Insertion: ventral surface of the tongue
 Action: flattens and broadens the tongue

41. Vascular supply

42. Lingual artery
 Branch of external carotid artery
 Near the tip of the tongue, the lingual artery anastomoses with its fellow from the
opposite side.
Branches
 dorsal lingual artery
 sublingual artery
 deep lingual artery

43. Dorsal lingual artery
Supply
 mucous membrane of the
dorsum of the tongue,
 the palatoglossal arch,
 soft palate,
 tonsil
 epiglottis.

44. sublingual artery
Supplies
 sublingual gland
 floor of mouth

45.  deep lingual artery
 Supplies anterior part of the tongue

46. Clinical importance
 Injury to the lingual artery during surgery can lead to life-threatening hemorrhage
 If both lingual arteries are damaged, leads to necrosis of the tongue
 lingual artery stenosis is seen in patients with radiotherapy

47. Venous drainage
 deep lingual vein: drains the tip of the tongue
 Dorsal lingual veins: drain the dorsum and sides of the tongue and join the lingual
veins accompanying the lingual artery.

48. Lymphatic drainage
The lymphatics from the tongue drain to three main regions:
 Marginal
 Central
 dorsal

49. Lymphatic drainage
 Tip- drain to submental nodes
 Anterior 2/3rd – submandibular
 Posterior part – deep cervical nodes
 The deep cervical nodes involve jugulo
omohyoid and jugulo digastric nodes

51. Clinical importance
 Presence of rich network of lymphatics is responsible for swelling of tongue in
acute glossitis
 CA of posterior 1/3rd of the tongue is more dangerous due to bilateral lymphatic
spread

52. NERVE SUPPLY

53. Motor
 All muscles of the tongue are innervated by the hypoglossal
nerve [XII] except for the palatoglossus muscle, which is
innervated by the vagus nerve [X].

54. Sensory
 Anterior two-thirds (oral)
 General sensation: mandibular nerve [V3] via lingual nerve
 Special sensation (taste): facial nerve [VII] via chorda tympani
Posterior one-third (pharyngeal)
 General and special (taste) sensation via glossopharyngeal nerve
[IX

55.  Posterior one-third (pharyngeal)
 General and special (taste) sensation via glossopharyngeal nerve [IX]
 Posterior most part
 Innervated by vagus nerve through internal laryngeal nerve

56. Clinical importance
Injury to hypoglossal nerve
 Trauma like fractures mandible
 Paralysis of one side of tongue
 Tongue deviates to paralysed side during protrusion
 Injury to both sides causes tongue to be motionless

57. Functions of tongue
Mastication
 Tongue is a important accessory organ in digestive system
 Crushes food against hard palate, during mastication and manipulation of food for
softening prior to swallowing
 During mastication food is converted into bolus and is placed on tongue and
travelled posteriorly along the tongue, passes the food over epiglottis into the
oesophagus

58. Speech
 Tongue is the principle articulator
 Intrinsic muscles of tongue enable shaping of tongue which facilitates speech
 Voice is produced by larynx and modified by tongue by constantly altering its
shape, position by contracting lips, teeth, alveolar process, hard palate and soft
palate

59. CLINICAL IMPORTANCE

60. Microglossia
 Abnormal small tongue
Clinical features:
 Difficulty in speech and mastication
 High arched palate
 Airway obstruction

61. Macroglossia
 Congenital: idiopathic muscle hypertrophy
hemangioma
lymphangioma
 Acquired: metabolic
inflammatory
trauma

62. Fissured tongue
 Characteristic grooves that vary in depth
Clinical features
 Elderly
 Deep furrows

63. Bifid tongue
 Due to lack of fusion of lingual swellings

64. Median rhomboid glossitis
 Asymptomatic elongated erythematous patch
 Etiology: Congenital
Candida albicans
 Clinical features: lesions are ovoid, diamond reddish
patch

65. Geographic tongue
 Benign migratory glossitis
 Constantly changing serpiginous lines
 Surrounds areas of smooth depapillated mucosa

66. Black hairy tongue
 Defective desquamation of filiform papillae
 Due to hypertrophy of papillae
 Poor oral hygiene

67. Bald tongue
 Absence of filiform and fungiform
 Primary
 Secondary
 Tertiary

68. References
 Scott browns otorhinolaryngeology 8th edition
 Cummings
 Inderbir singh human embryology
 https://www.ncbi.nlm.nih.gov/books/NBK547697/#:~:text=The%20muscles%20of%
20the%20tongue,include%20extrinsic%20and%20intrinsic%20muscles.
 https://www.ncbi.nlm.nih.gov/books/NBK554513/#:~:text=The%20submandibular
%20lymph%20nodes%20are,portion%20up%20to%20the%20tip