• TONGUE

INTRODUCTION

It is a solid conical muscular organ partially covered by mucous

membrane & lies partly in the oral cavity and partly in pharynx.
 FUNCTION

Act as a organ of taste, helps in mastication and speech.

Sometime utilized in gestures and facial expression.
Helps in moistening the lip.
In lower animals it is used for thermoregulation.
Tongue print may be useful for medico-legal cases.
 PRESENTING PARTS

It has :-

a) Tip

b) Base

c) Dorsal surface

d) Inferior surface

e) Two lateral margin

f) Root
  Tip is directed forward and is in the contact of incisors teeth

BASE:- It is directed toward the oropharynx and is

formed by the posterior one-third of tongue.

It is connected to the epiglottis by a median and a

pair of lateral glosso-epiglottic fold.

On each side of the median fold there is

depression known as epiglottic vallecula.

 DORSAL SURFACE
 Convex on all side.

 Covered with mucous membrane.

 Lined by stratified squamous non-keratinised epithelium.

 Divided by “V” shape sulcus sulcus terminalis into anterior

(pre-
sulcal) and posterior part ( Post-
sulcal).
In the anterior part the mucus membrane is adherent to the
underlying muscle and contain numerous papillae which is the
projection of lamina propria covered by mucus membrane.
Papilla are:- Circumvallate, Filliform, fungiform and foliate.
In posterior one third of the tongue no papillae are present and the mucus membrane is
also not attached to the underlying muscles.

The underlying muscle in the posterior part contain numerous serous gland and
lymphatic follicles known as lingual tonsils.
 INFERIOR SURFACE

a) Frenulum linguae:- It is a median fold

connecting the tongue to the floor of
mouth. The sublingual papillae is present
on each side of the base of frenulum
through which the submandibular duct
opens.

b) On each side of frenulum the plica

fimbriata passes upward and medially, the
profunda linguae vein intervenes between
the fimbriata fold and frenulum.
 LATERAL MARGIN

Each margin is covered with

mucous membrane and
palatoglossal arch is attached
to the margin at the junction
of anterior 2/3rd and
posterior 1/3rd.
 ROOT

 It is the part of tongue attached to the floor of mouth and extends

from the symphysis menti to hyoid bone.

 Root is formed by the lower fibres of genioglossus muscle.

 MUSCLES OF THE TONGUE

Tongue contain two type of muscles:- Extrinsic and intrinsic

muscle.

Extrinsic muscle alter the position of tongue whereas

intrinsic muscle alter the shape of tongue.
 EXTRINSIC MUSCLE

1. GENIOGLOSSUS

2. HYOGLOSSUS

3. CHONDROGLOSSUS

4. STYLOGLOSSUS

5. PALATOGLOSSUS
 GENIOGLOSSUS

It is a fan shape muscle and form the bulk of

tongue.

Origin:- Superior genial tubercle of mandible.

Insertion:-
a) Lower fibres are attached to the body of hyoid
bone.

b) Intermediate fibres passes deep to hyoglossus

and are continuous with middle constrictor of
pharynx.

c) Upper fibres run forward and upward and are

inserted into tongue extending from the root
to its apex
 ACTION

a) Protrude the tongue and make the dorsal surface concave.

b) It prevents the backward fall of tongue hence prevent the closure of oropharynx
and prevent the blockage of respiratory passage. That is why this muscle is also
called as the “safety muscle” of tongue.
 HYOGLOSSUS
It is a quadrangular muscle and arise partly from the upper surface of greater
cornu and partly from the hyoid bone.

The muscle passes upward and forward under the cover of mylohyoid and is
inserted into the side of tongue.

Action:- It depresses the side of tongue and make the dorsal surface convex.
 CHONDROGLOSSUS

It is detached part of hyoglossus separated by genioglossus muscle. It arise from

lesser cornu and pat of body of hyoid bone.

It is inserted into the side of tongue.

Action:- It depresses the side of tongue.

 STYLOGLOSSUS

It arise from the tip of styloid process and stylomandibular ligament.

It passes downward and forward and is inserted into the side of tongue.

Action:- It retracts the tongue backward and upward and is antagonist to

genioglossus.
 PALATOGLOSSUS

ORIGIN:- Under surface of palatine aponeurosis.

INSERTION:- Side of tongue in front of sulcus terminalis .

ACTION:- It elevates the base of the tongue and narrows the oro-pharyngeal isthmus.
 INTRINSIC MUSCLES

There are 4 intrinsic muscles of the tongue –

a) Superior longitudinal muscle

b) Inferior longitudinal

c) Transverse linguae

d) Verticalis linguae
 SUPERIOR LONGITUDINAL MUSCLE

It lies beneath the mucus membrane of the dorsal surface of the tongue.

It arise from the posterior part of median raphe, diverges forward and laterally and are
inserted into the sides of tongue.

Action:- They reduces the length of the tongue and make the dorsal surface concave from
side to side.
 INFERIOR LONGITUDINAL

It lies beneath the mucus membrane of the under

surface of the tongue, deep to the insertion of the
hyoglossus.

The muscle arise from the posterior part of the side

of tongue and converges forward for insertion into
anterior part of septum.

Action:- They shorten the tongue and make the

dorsal surface convex.
 TRANSVERSUS LINGUAE

They arise from the median fibrous septum ,pass laterally through the
genioglossus and are inserted into the side of tongue.

Action:- It reduces the width and increases the length of tongue.

 VERTICALIS LINGUAE

Each muscle arise from the lamina propria of the dorsum of the tongue, passes
downward through the fibres of genioglossus and then curve laterally for insertion into
side of tongue.

Action:- It increases the width

of tongue and make the dorsal
surface concave from side to side.
 MUSCLE ALTERING THE SHAPE OF TONGUE

Making the dorsum concave Genioglossus, Superior longitudinal,

Verticalis linguae. Styloglossus

Making the dorsum convex Hypoglossal and inferior longitudinal

Muscle shortening the tongue Superior and inferior longitudinal and

verticalis linguae

Muscle elongating the tongue Transversus linguae

 NERVE SUPPLY

1. MOTOR SUPPLY

a) Somato-motor

b) Secreto-motor

c) Vasomotor

2. SENSORY SUPPLY
a) Somatomotor supply:- All muscles of tongue are supplied by hypoglossal nerve

except palatoglossus which is supplied by cranial part of accessory nerve via pharyngeal

plexus.
a) Secretomotor:- Pre ganglionic fibres arise from the superior salivatory

nucleus and pass through the facial, chorda tympani and lingual nerve and are

relayed into the submandibular ganglion. Post ganglionic fibres reach the lingual

gland via the lingual nerve.

a) Vasomotor:- These are derived from the sympathetic nerves which surrounds

the lingual artery and convey post ganglionic fibres from the superior cervical

ganglion of the sympathetic trunk.

 SENSORY SUPPLY

1. From anterior 2/3rd :-General

sensation by lingual nerve and special
sense of taste by chorda tympani.

2. From posterior 1/3rd of tongue :-

Glossopharyngeal (both general and
special)

3. From vallecula:- By internal laryngeal

branch of superior laryngeal nerve.

4. Muscle sense is conveyed by

hypoglossal,lingual,trigeminal
ganglion.
 ARTERIAL SUPPLY

1. Chief supply by lingual artery.

2. Ascending palatine and tonsillar branch

of facial artery.

3. Ascending pharyngeal branch of ECA.

 LYMPHATIC DRAINAGE

Lymphatics of tongue is arranged in four sets:-

a) Apical

b) Marginal

c) Central

d) Dorsal
 APICAL

It drains the tip and frenulum linguae.

a) Some vessels may pierce mylohyoid and drains

into submental and few passes downward in
front of hyoid bone and drains into juglo-
omohyoid lymph node.

b) Some drains into submandibular lymph node

after piercing mylohyoid.

c) A few may pass deep to mylohyoid and drains

into deep cervical lymph nodes.
 MARGINAL SET

It drains the side of tongue in front of sulcus

terminalis and terminate as follows:-

a) Some drains into submandibular lymph

nodes after piercing mylohyoid.

b) Some passes deep to mylohyoid and

drains into deep cervical lymph nodes.
 CENTRAL SET

It drains the dorsal surface of anterior 2/3rd

of tongue in front of vallate papillae.
It descends between the two genioglossus
with or without decussation and terminate
as follows:-

a) Most of the vessels drains into juglo-

diagastric or juglo-omohyoid without
piercing mylohyoid.

b) A few may pierce mylohyoid and drains

into submandibular lymph node.
 DORSAL SET

It drains the posterior 1/3rd of the tongue

including vallate papillae.

a) Most of the vessels drains bilaterally into

juglo-diagastric after piercing pharyngeal
wall.

b) One vessel passes downward behind the

tongue and hyoid bone ,pierces the
thyrohyoid membrane and drains directly
into juglo-omohyoid.
 PECULIARITY OF TONGUE LYMPHATICS

1. Lymphatics do not go with the blood vessels.

2. In the midline of tongue a free decussation take place and lymphatics passes
bilaterally.

3. Tip of the tongue has the richest lymphatic drainage.

4. A group of lymph node situated at the bifurcation of CCA is known as the

“Principle lymph node of tongue”.
 DEVELOPMENT OF TONGUE

Tongue develop in the floor of mouth with respect to pharynx during 4 th month of IU life.

The medial most part of first arch proliferates to form two swellings called as “Lingual
swellings”.

The two lingual swellings are soon separated by another midline swelling called as
“Tuberculum Impar”.

Immediately behind the Tuberculum Impar the epithelium dips down for the thyroglossal duct
which is marked by a depression called as “Foramen Caecum”.

Another midline swelling appear in relation to 2nd , 3rd & 4th arch called as “Hypobranchial
eminence”.
The hypobranchial eminence divides into cranial (with respect to 2nd & 3rd arch) and caudal
part ( 4th arch).

The caudal part forms the epiglottis.

The anterior 2/3rd of the tongue is formed by the fusion of :-

a) Tuberculum Impar
b) Two lingual swellings

Thus the anterior 2/3rd is derived from the 1st arch.

The posterior 1/3rd of the tongue is formed from the cranial part of hypobranchial eminence
and in this the second arch mesoderm get buried below the surface hence posterior 1/3 rd
of tongue is formed from 3rd arch.

The posterior most part of the tongue is derived from 4 th arch.

According to the derivative hence the
anterior 2/3rd since is derived from the first
arch Hence is supplied by the chorda
tympani and mandibular nerve.

Posterior 1/3rd is supplied by

glossopharyngeal which is the nerve of 3rd
arch.

Posterior most part is supplied by superior

laryngeal nerve which is the nerve of 4th
arch.
 CLINICAL

1. Sometime thyroid tissue may be found embedded in the substance of tongue.

2. Gag reflex:- when posterior part of tongue is touched it causes gag due to supply of 9 th
and 10th cranial nerve which causes the contraction of muscle.

3. Due to genioglossus muscle paralysis ,the tongue has the tendency to fall back,
obstructing the airways .

4. Trauma such as a fractured mandible may injure the hypoglossal nerve resulting in
paralysis and atrophy of one side of tongue. The tongue deviates to the paralysed side
while protrusion because of the action of unaffected genioglossus muscle.
 CLINICAL RELATED TO TONGUE.

1. Macroglossia
2. Microglossia
3. Tongue tie/Ankyloglossia
4. Bifid tongue
5. Presence of thyroid tissue in the tongue.
6. Persistence of thyroglossal duct as a cyst at the base of tongue.
7. Fissured tongue.