Your tongue is very stretchy and you use it with your teeth to make lots of different

sounds that make up words. The front of your tongue is also used when you eat it
helps to move the food around your mouth and back towards your throat so your
back teeth can really break it up. The top of your tongue is not smooth like the
underneath it has lots of humps and bumps called papillae (stick out your tongue
and have a look in the mirror!). These papillae are like the end of your boots they
help to crab the food and stop it slipping while you chew.

Papillae: Papillae contains taste bud (chemo-receptors), which helps us identify

between different tastes of food. When we chew food, a portion of it dissolves in
the saliva. This dissolved part of food comes in contact with the taste buds and
generates nerve impulses. These nerve fibres are known as microvilli. These
nerve fibres carry messages to the taste center in the brain. Then brain perceives
the taste.
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Foliate, Vallate and Fungiform have taste buds which helps in identifying
the taste
Filiform helps in holding the food ( to grip the food in place)

Tonsils: Both the types of tonsils helps in filtering germs.

Adenoids: They help in fighting infections.

Frenulum linguae: It secures or holds the tongue in place inside the mouth.

Very small fibre-like or hair-like projections are present on the upper side of the
tongue which connect with nerve fibres at the lower end of the tongue which lead
to the brain.

There are about 3000 taste buds on the tongue of an adult person. There are four main
tastes - sweet, salty, sour and bitter. These four main tastes are felt by different portion
of the tongue. The tip of our tongue senses salt and sweet. The taste buds at the sides
detect sour taste. The rear portion of the tongue detect bitter taste
When the food has been really well chewed and mixed with saliva, your back muscles in
your tongue help you swallow. You dont however swallow your tongue! It is tied to the
bottom of your mouth by a thin piece of tissue called thefrenulum. You can see this if you
look in the mirror and lift up your tongue to see underneath.
The papillae on your tongue are where you find your taste buds. When you were born, you
had about 10,000 taste buds, but as you get older, this number will become less and less.
When you are old enough to retire, you may only have 5,000 taste buds, which is why some
foods taste stronger to you than they would to your parents or grandparents!

Taste buds can pick our sweet, sour, bitter and salty flavours on different parts of your
tongue have a look at where this is on the diagram.
Each bud has lots of tiny hairs that can sense flavours and send messages to your brain.
Sometimes these are good but sometimes these are bad maybe you dont like a flavour or
it is something dangerous to eat or drink. When you are cold, your taste buds dont work as
well so you may be able to eat or drink a flavour you dont normally like!
Pain is the bodys way of telling us there is something wrong that needs to be addressed.
Visceral senses are encased within the visceral organs. Visceral organs pertain to organs which are
internally located, particularly of the torso or abdomen, such as the lungs, heart, liver, spleen, and so
forth. Somatic sensory receptors are those which are located within the body wall, such as the sense of
touch with receptors located on the skin.
Visceral senses and somatic sense can be used in some cases interchangeably. The sense of hearing,
for example, or pain within a visceral organ. The pain is a general sense which is typically considered to
be general and somatic, however, pain within a visceral organ refers to a general sense that is now in a
visceral location.

How Somatic Pain Feels

Somatic pain is generally described as musculoskeletal pain. Because many nerves
supply the muscles, bones and other soft tissues, somatic pain is usually easier to
locate than visceral pain. It also tends to be more intense. Some chronic pain
conditions caused by somatic pain include:

How Visceral Pain Feels

Visceral pain is internal pain. It comes from the organs or the blood vessels, which
are not as extensively innervated, or supplied by, sensory nerves. Unlike somatic
pain, visceral pain may feel dull and vague, and may be harder to pinpoint. Some
common types of visceral pain include:

Somatic Pain
Somatic pain is caused by the activation of pain receptors in either the body
surface or musculoskeletal tissues. A common cause of somatic pain in SCI persons is
postsurgical pain from the surgical incision. It is usually described as dull or aching.
Somatic pain, that is a complication of SCI, occurs with increased frequency in the
shoulder, hip, and hand, although it also occurs in the lower back and buttocks.
Somatic pain is probably caused by a combination of factors, such as abnormalities
that may have always been there, inflammation, repetitive trauma, excessive activity,

vigorous stretching, and contractions due to paralysis, spasticity, flabbiness, disuse

and misuse. Generally speaking, somatic pain is usually aggravated by activity and
relieved by rest.
Visceral Pain
Visceral pain is the pain we feel when our internal organs are damaged or injured
and is by far the most common form of pain. Viscera refers to the internal areas of the
body that are enclosed in a cavity. Visceral pain is caused by the activation of pain
receptors in the chest, abdomen or pelvic areas. Visceral pain is vague and not well
localized and is usually described as pressure-like, deep squeezing, dull or diffuse.
Visceral pain is caused by problems with internal organs, such as the stomach, kidney,
gallbladder, urinary bladder, and intestines. These problems include distension,
perforation, inflammation, and impaction or constipation, which can cause associated
symptoms, such as nausea, fever, and malaise, and pain. Visceral pain is also caused
by problems with abdominal muscles and the abdominal wall, such as spasm.
Somatic Pain

Source - tissues such as skin, muscle, joints, bones, and ligaments - often
known as musculo-skeletal pain.

Receptors activated - specific receptors (nociceptors) for heat, cold, vibration,

stretch (muscles), inflammation (e.g. cuts and sprains which cause tissue
disruption), and oxygen starvation (ischaemic muscle cramps).

Characteristics - often sharp and well localised, and can often be reproduced by
touching or moving the area or tissue involved.

Useful Medications - may respond to combinations of Paracetamol, Weak

Opioids ORStrong Opioids, and NSAIDs (see Analgesic Flow Chart).

Visceral Pain

Source - internal organs of the main body cavities. There are three main cavities
- thorax (heart and lungs), abdomen (liver, kidneys, spleen and bowels), pelvis
(bladder, womb, and ovaries).

Receptors activated - specific receptors (nociceptors) for stretch, inflammation,

and oxygen starvation (ischaemia).

Characteristics - often poorly localised, and may feel like a vague deep ache,
sometimes being cramping or colicky in nature. It frequently produces referred
pain to the back, with pelvic pain referring pain to the lower back, abdominal pain
referring pain to the mid-back, and thoracic pain referring pain to the upper back.

Useful medications - usually very responsive to Weak Opioids and Strong

Opioids.