The document discusses the anatomy, nerve supply, blood supply, and examination of the human tongue. It notes that the tongue has intrinsic and extrinsic muscles that control movement. Sensory supply comes from the lingual nerve (V3) and glossopharyngeal nerve (CN9), while motor supply is from the hypoglossal nerve (CN12). Examination of the tongue involves inspection of color, atrophy/hypertrophy, fasciculation, and deviation, as well as palpation, taste testing, and assessing tongue movement. Neurological lesions can be identified by features such as spasticity, flaccidity, and presence or absence of fasciculation.

1. TONGUE
PHYSICAL DIAGNOSIS BY GOLWALLA, DR.J. VIJAY ( FINAL YR M.D GEN.MEDICINE)
ADAMS AND VICTOR’S PRINCIPLES OF NEUROLOGY.
Extrinsic muscles
1. Superior longitudinal fibers:
shorten the tongue.
2. Inferior longitudinal fibers:
shorten the tongue.
3. Vertical fibers: flatten and widen
the tongue.
4. Transverse fibers: narrow and
elongate the tongue
Intrinsicmuscles
1. Genioglossus - protrudes the tongue
2. Styloglossus - retracts and elevates its
root
3. Hypoglossus - causes the upper
surface to become convex
4. Palatoglossus
The average length of the human tongue from the oropharynx to the tip is 10 cm
NERVE SUPPLY
Sensory supply:
Anterior 2/3
Taste - Chorda tympani (CN7)
General sensation - Lingual
nerve (V3)
Posterior 1/3
Taste & General sensation -
Glossopharyngeal nerve
:
Motor supply:
Palatoglossus
CN10 of the pharyngeal plexus
All other intrinsic and extrinsic
Hypoglossal nerve
BLOOD SUPPLY
1. Lingual artery, a branch of the external carotid artery.
2. Tonsillar branch of the facial artery
3. Ascending pharyngeal artery.
EXAMINATION OF TONGUe
INSPECTION
(OBSERVE WHEN RESTING INSIDE)
COLOUR
ATROPY/HYPERTROPHY
FASCICULATION
DEVIATION (PROTRUDED OUT)
PALPATION
(WITHIN THE MOUTH)
FEEL OF THE TONGUE – SPASTIC/FLABBY
(PROTRUDED STATE)
TASTE SENSATION TEST - SWEET,SALT,
SOUR,BITTER
MOVEMENT OF THE TONGUE
PROTRUSION,SIDE TO SIDE
POWER – PUSH AGAINST CHEEKS
PERCUSSION
TAPPING RESULTS IN DIMPLE
(PERSISTS FOR SECONDS
IN MYOTONIA)
lesions
UMN(PSEUDO BULBAR PALSY) LMN(BULBAR PALSY)
FASCICULATION ABSENT PRESENT
FEEL SPASTIC FLABBY
FEATURES EVIDENCE OF MOTOR DISABILITY
BULBAR MALFUNCTION SYMPTOMS
ABNORMAL EMOTIONAL EXPRESSION
BULBAR MALFUNCTION SYMPTOMS
CAUSES CEREBRALATHERESCLEROSIS,MND,SOL,DEGENERATIVE
DISEASES.
MND, BULBAR POLIO,GBS,BOTULISM,MYASTENIA GRAVIS.