basic anatomy of tongue,muscles of tongue,nerve and blood supply of tongue and clinical features

1. `

3. Presented by;
Humayun Afridi
Saqib Habib
Taif Ahmad
Faisal Mansoor.
Khyber College of Dentistry
Peshawar

4. Contents
 Introduction
 General Features
 Papillae , Types
 Taste Buds
 Extrinsic & Intrinsic Muscles
 Movements
 Vasculature
 Innervation
 Functions
 Clinical Aspects

5. INTRODUCTION & GENERALFEATURES
SAQIB HABIB
CLASS NO: 40

6. INTRODUCTION
Mass of striated muscles covered with mucous
membrane
Voluntary muscular structure
Length: 3 inches
Location: floor of the mouth
Shape: triangular
Attachement: With mandible and hyoid bone
 Has an apex , body and root

7. GENERAL FEATURES
SURFACES :
 Two surfaces
• Superior surface
• Inferior surface
 Superior surface is
divided into three parts
• Anterior 2/3 part
called as Oral part
• Posterior 1/3 part
called as Pharyngeal
part
• Base(root) of tongue

8. General Features
 TERMINAL SULCUS
V-shaped sulcus
divides tongue into
anterior & posterior
parts
 Apex of sulcus marked
by a pit - FORAMEN
CECUM

9. General Features
 Foramen cecum ,an
embryological
remnant, marks the upper
end of thyroglossal duct
 Sometime a thyroglossal
duct persists and connects
the foramen cecum with
the thyroid gland in
neck(thyroglossal cyst)

10. Superior Surface
Oral Part(anterior 2/3):
• Comprises of a
median furrow
• Rough surface due to
presence of papillae
• Surrounded by
anterior and lateral
teeth
• Mobile part of
tongue

11. Superior Surface
Pharyngeal
Part(Posterior 1/3)
• Lies behind the
sulcus terminalis
• No papillae, shows
nodular
surface, presence of
lymphatic nodules
and lingual tonsils
• Contributes to the
anterior wall of
oropharynx

12. Pharnygeal Part

13. Base of Tongue
 Base of tongue is far back
and is bottom of tongue
 Contributes to the front
wall of pharynx
 Movement can affect the
diameter of pharynx i.e
• When it push
forwards, thereby
expanding the pharynx
• When it pull
backwards, thereby
constricting the
pharynx
• Lacks papillae

14. INFERIOR SURFACE
Covered by smooth mucous membrane
In the midline , a mucosal fold called Frenulum
connects the tongue with the floor of the mouth
Lateral to frenulum, deep lingual vein can be seen
through the mucosa
Lateral to the lingual vein , mucosal fold called as
plica fimbriata is present

15. Frenulum
Lingual veins
Plica
fimbriata

16. PAPILLAE

17. PAPPILAE
 Indentation of any structure
in the overlying epithelium
is called papillae
 Superior surface of tongue
, covered by numerous
papillae
 Have taste buds on their
surfaces
 Types of of papillae;
• Vallate/circumvallate
• Filiform
• Fungiform
• Foliate

19. Vallate Papillae
 Largest among papillae
 SHAPE: Blunt-ended cylindrical
 NUMBER: 8 to 12
LOCATION: infront of sulcus terminalis
ARRANGEMENT: Occur in V shape line

20. VALLATE
PAPILLAE

21. Filiform Papillae
 SHAPE: Thin, long papillae having pointed ends
‘V’ shaped cones
 Only papillae having no taste buds
NUMBER: numerous
These papillae are mechanical and not involved in
gustation
Identified by increased keratinization
LOCATION: Present at pre-sulcal area of the tongue

22. LHISTOLOGICAL VEIW

23. Fungiform Pappilae
SHAPE: slightly mushroom-shaped if looked at in
longitudinal section
 Taste buds on their surfaces
LOCATION: apex of the tongue as well as the margins
Larger than filiform papillae

24. FUNGIFORM PAPILLAE

25. Foliate Pappilae
 SHAPE: Short vertical folds
LOCATION: Present lateral to terminal sulcus and at
margins

26. FOLLIATE
PAPILLAE

27. Taste Buds
 Sensory receptors for taste
The sensation of taste is called gustation
Taste buds are located on the surfaces of papillae
except filiform papillae

28. Electron microscopic structure of taste
buds

29. Taste Buds
 Four taste sensations, recently a fifth basic taste has
been added: sour, sweet, salty, bitter and the recently
added umami
UMAMI

30. Umami Taste
 Umami is from japanese
word which means ‘pleasant
savory taste’
 Human tongue has
glutamate receptors, which
is the source of umami
flavour
 Kikunae ikeda, japanese
scientist proposed its
existence in 1908
 This taste is mostly found in
fish, cured
meats, mushrooms, cheese,
spinach etc.

32. Interesting Facts
 Women have shorter tongue than men.
 Blue whale has the largest tongue in animal
kingdom and weighs 5400 lbs
 About half of all bacteria in your mouth live on
your tongue
 Tongue heals faster than any part of the body
 Your tongue is germ free only if it is pink. If it is
white there is a thin film of bacteria on it.

33.  Chinese believe that
tongue is
representative of
organs of body

35. Muscles of Tongue
BY
TAIF AHMAD
Class No; 74

36. MUSCLES
OF TONGUE
EXTRINSIC
MUSCLES
INTRINSIC
MUSCLES

37. The tongue is divided
into two halves by a
median septum and
the muscles of each
half consist of Intrinsic
And Extrinsic Muscles
 Therefore each muscle
occur in Pair.

38. INTRINSIC MUSCLES
 These muscles are confined to the tongue,
 They originate and inserts within the tongue,
 No bony attachments,
 FUNCTION: They alter the shape of tongue

39. Types of Intrinsic Muscles
There are four types
Superior Longitudinal,
Inferior Longitudinal,
Vertical muscles,
And
Transverse muscles.

40. Superior Longitudinal Muscle
It lies just
beneath the
dorsum of the
tongue.
ACTION: It
curls the tip
upward and
rolls it
posteriorly

42. Action of Superior Longitudinal
Muscle

43. Inferior Longitudinal Muscles
 Lies on each side
lateral to the
Genioglossus
muscles,
 ACTION:
They curl the tip of
tongue inferiorly.

45. Transverse Muscles
 Lies inferior to the
superior longitudinal
muscle and run from
the septum to margins
 ACTION:
They narrow the
tongue and increase its
height.

46. Vertical muscles
 It runs
inferolaterally
from the dorsum,
 ACTION:
Flattens the
dorsum.

48. EXTRINSIC MUSCLES
 These muscles take origin from parts outside the

1
2
3
4
tongue, therefore move the tongue as well as alter the
shape.
Divided into four types namely;
) GENIOGLOSSUS
) HYOGLOSSUS
) STYLOGLOSSUS
) PALATOGLOSSUS

49. STYLOGLOSSUS and PALATOGLOSSUS
attach the tongue superiorly, while
GENIOGLOSSUS and HYOGLOSSUS attach
the tongue inferiorly.

50. GENIOGLOSSUS
 ORIGIN: From
superior mental spines,
 INSERTION: Into the
mucous membrane of
the tongue.
 Action: Protrudes the
tongue, depress central
part of tongue and
increase the volume of
mouth as in sucking.
GENIOGLOSSUS

52. HYOGLOSSUS
 ORIGIN: Arises from
greater horn and body
of hyoid bone,
 INSERTION: Side of
tongue.
 ACTION: It depresses
side of tongue assisting
GENIOGLOSSUS to
enlarge oral cavity.
HYOGLOSSUS

54. STYLOGLOSSUS
 ORIGIN: Lower part of
Styloid process and
upper part of
stylohyoid ligament,
 INSERTION: Side of
tongue.
 ACTION: Elevates and
retracts the tongue.
STYLOGLOSSUS

56. PALATOGLOSSUS
 ORIGIN: From soft
palate.

INSERTION:
Lateral margin of
tongue.
 ACTION: Elevates
back of tongue and
depresses soft palate.

57. • Protrusion:
• Genioglossus on both sides acting together
• Retraction:
• Styloglossus and hyoglossus on both sides acting
together
• Depression:
• Hyoglossus and genioglossus on both sides acting
together
• Elevation:
• Styloglossus and palatoglossus on both sides acting
together

58. INNERVATION
 Both extrinsic and intrinsic muscles are
supplied by HYPOGLOSSAL NERVE
except PALATOGLOSSUS muscle
which is in turn supplied by VAGUS
NERVE.

60. FACTS
1). The tongue is the strongest muscle in the body and
the only muscle that is connected only at one end.
2). Using a tongue scraper to clean your tongue is proven
to prevent heart attacks, pneumonia, premature
births, diabetes.
3). Your tongue never stops working. Even when you
sleep it is pushing saliva into your throat.

61. VASCULATURE &
INNERVATION OF TONGUE
HUMAYUN AFRIDI
CLASS No. 55

62. BLOOD SUPPLY
Arterial Supply
 Lingual artery - supplies
tongue and floor of the
mouth.
 Originates from external
carotid artery in neck
 Passes between
hyoglossus and
genioglossus muscles of
tongue
ILingual
artery

63. Arterial Supply
• Lingual artery mainly gives three branches within the
tongue namely
• Dorsal lingual artery
• Deep lingual artery
• Sub lingual artery

65. Arterial Supply
 Also secondary supply to the tongue by:
 Tonsillar branch of facial artery
 Ascending pharyngeal artery (branch of external
carotid artery)

66. Venous Drainage
 Drained by dorsal lingual
vein and deep lingual veins
Dorsal lingual vein
 Deep Lingual Veins:
 Begins near tip of tongue
and run beneath the
mucous membrane
 Visible on the inferior
surface of tongue
 Anterior to lingual artery
 Ultimately drains into
internal jugular vein
Deep lingual vein

67. Deep lingual vein

68. Venous Drainage
 Dorsal Lingual Veins
 Drain the dorsum and
sides of tongue
 Runs along the
lingual artery
 Drains into internal
jugular vein
Dorsal lingual vein

69. Lymphatics
Apical Vessels:
Drains into Submental
nodes & deep cervical
nodes
Marginal Vessels:
Drains into Submandibular
nodes & deep cervical
nodes
Basal Vessels:
Drains into Deep cervical
nodes (jugulodigastric
mainly)

71. LYMPH
VESSELS
1. APICAL
2. MARGINAL
AFFERENT(RECEIVING)
i. TIP
ii. FRENULUM
SIDE OF TONGUE IN FRONT OF
SULCUS TERMINALIS
POSTERIOR 1/3RD or Base
3. BASAL
EFFERENT(DRAINING)
- SUBMENTAL
( MAJOR LYMPH NODE )
- SUBMANDIBULAR NODE
- JUGULODIGASTRIC
JUGULO- DIGASTRIC (deep
cervical nodes)

72. Innervation
 Innervation is complex and consists of three different
supplies
 Motor supply
 General sensory supply
 Special sensory supply

73. Motor Supply
 All extrinsic and intrinsic muscles are supplied by
HYPOGLOSSAL NERVE except PALATOGLOSSUS muscle
which is supplied by VAGUS NERVE.

74. Sensory supply
 General sensory
sensation is by three
nerves
 Lingual nerve –
anterior 2/3rd of
tongue
 Glossopharyngeal
nerve – posterior
1/3rd of tongue
 Vagus nerve –
posterior most part of
tongue

75. Special sensory supply
 Supplied by three nerves
 Chorda tympani (facial)
– taste sensation of
anterior 2/3rd of tongue
 Glossopharyngeal (ix) –
taste sensation of
posterior 1/3rd of
tongue
 Vagus nerve (x) – taste
sensation of posterior
most part

77. Functions
 Deglutition
 Taste sensation
 Speech production
 Breast feeding
 Self cleansing system
 Mastication

79. CLINICAL ASPECTS
FAISAL MANSOOR

80.  GLOSSITIS is usually a part of generalized
ulceration of mouth cavity . In certain anaemias
due to atrophy of filiform papillae tongue
becomes smooth.
 The presence of a rich network of lymphatics and
loose areolar tissue in the substance of tongue is
responsible for the enormous swelling of the
tongue in acute glossitis.
Clinical aspects

81.  The under-surface of the tongue is good site for
observation of jaundice.
In unconscious patients, the tongue may fall
back and obstruct the air passage. This can be
prevented either by lying the patient on one side
with head down or by keeping the tongue out
mechanically.
 Referred pain is felt in the ear in diseases of
posterior part of tongue, as ninth nerve
commonly supply to both the regions
Clinical aspects

82.  Carcinoma of tongue is quite common. The
affected side is removed surgically. Carcinoma of
posterior one third is more dangerous.
Clinical aspects

83. Now,
Lets find how attentive were
you…


85. Q1) WHICH PAPILLAE ARE RIGHT ANTERIOR TO
SULCUS TERMINALIS?
A. Foliate
B. Vallate
C. Fungiform
D. Filiform

86. Q2) WHICH OF THE ONLY MUSCLES OF THE
TONGUE IS INNERVATED BY THE VAGUS
NERVE[X]?
A. Styloglossus
B. Genioglossus
C. Palatoglossus
D. Hyoglossus

87. Q3) DEEP LINGUAL VEINS DRAIN INTO:
A. External Jugular Vein
B. Internal Jugular Vein

88. Q4) CHORDA TYMPANI IS BRANCH OF WHICH
CRANIAL NERVE?
A. Vestibulocochlear
B. Facial
C. Glossopharyngeal
D. Hypoglossal

89. Q5) CHORDA TYMPANI IS THE NERVE OF TASTE
FOR ALL EXCEPT WHICH PAPILLAE?
A. Filiform
B. Fungiform
C. Foliate
D. Vallate

90. Q6) WHICH OF THE PAPILLAE ARE NUMEROUS
OF ALL IN NUMBER?
A. Filliform
B. Fungiform
C. Foliate
D. Vallate

91. Think About This
In Medical School we have a
hundred classes that teach us
how to fight off death…And not
one lesson on how to go on
living.”
“