27.

Tongue (including clinical significance)

Functions
1. Taste.
2. Speech.
3. Mastication.
4. Deglutition.

Shape - conical in shape being elongated posteroanteriorly & flattened dorsoventrally.

External Features

1. A root - attached to the mandible and hyoid bone by muscles. It is because of these
attachments that the tongue is not swallowed during deglutition. The nerve and vessels of
the tongue enter through its root.
2. A tip. - It is the anterior free end of the tongue, which comes into contact with the central
incisors.
3. A body. The bulk of tongue between the root and tip is called body. It has dorsal and ventral
surfaces and right and left lateral margins.

 Dorsal surface
 The dorsal surface = convex on all the sides.
 It is divided by a V-shaped sulcus, the sulcus terminalis into two parts:
1. Anterior 2/3 or oral part - lies on the floor of the mouth.
2. Posterior 1/3/ or pharyngeal part - is in contact with the palate.

 At the tip of the sulcus terminalis  foramen cecum (thyroid precursor is derived from
here).
 Its tip with the incisors and its margin with the premolars.
  The posterior part (Postsulcal, posterior 1/3) forms the anterior wall of the oropharynx.
 At the base of the tongue we have lingual follicles which collectively form the lingual tonsil.
 The tongue is vascularized by the lingual artery.
 Innervation of the tongue is a little complex and should be differentiated between general
sensation and taste sensation/ special visceral innervation (SVA).
 Somatosensory innervation (thermal and tectile stimuli) of:
 the presulcal part - provided by the lingual n.
 the postsulcal part - provided by the glossopharyngeal n., with the exception of the
epiglottic valleculae that is innervated by the vagus n..
 Taste sensation differs a little and can be seen in the picture below.

 There are 4 types of papillae on the tongue, made of irregular connective tissue, that form
the dorsum part of the tongue.
 They are positioned above the connective tissue, which separates them from the intrinsic
muscles.
 These papillae also have function of making the tongue rougher, which make it easier to “lick
ice cream” or to move the
food.
 All except filiform are
associated with taste buds.
 #C.S.  Depapilation or
hypertrophy of papillae is 2
abnormal conditions that can
occur.

Types of pappillae:
 Filiform, most numerous specially
ant 2/3, no taste buds,
responsible for touch
 Fungiform, mushroom shaped, on tip of the tongue, can distinguish 5 tastes.
 Foliate, leaf shaped, presented on side of posterior side of tongue.
 Circumvallate, lie anterior to the sulcus terminalis, has taste buds.

Muscles of the tongue

- The tongue has:

 4 extrinsic muscles
o Genioglossus
o Hyoglossus
o Styloglossus
o Palatoglossus (also a muscle of the soft palate, innervated by the
pharyngeal branch of Vagus n.)

 4 intrinsic muscles.
o Superior & Inferior longitudinal
o Transverse
o Vertical

 With the exception of the palatoglossus, they are all innervated by the hypoglossal
nerve.

#C.S.  Referred pain of tongue cancer: The patients with toungue cancer often complain of pain
in ear, temporomandibular joint, temporal fossa, and/or lower teeth.