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Head and neck chapter 13 copy.pptx

  1. 1. The tongue
  2. 2. Surface anatomy of the tongue
  3. 3. Quick overview
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  14. 14. Introduction • The tongue is a mass of muscle that is almost completely covered by a mucous membrane. It occupies most of the oral cavity and oropharynx. It is known for its role in taste, but it also assists with mastication (chewing), deglutition (swallowing), articulation (speech), and oral cleansing
  15. 15. What color should a healthy tongue be? • A healthy tongue is typically pink, though the shades of light and dark can vary. If your tongue is discolored, it could indicate a health problem.
  16. 16. • As is the case with all of anatomy, it is important to understand the terminology associated with describing the structures of interest. The prefix gloss- and the suffix -glossus are commonly used with reference to the tongue. • Therefore, the name glossopharyngeus refers to the muscle arising from the tongue and inserting in the pharynx. • Similarly, the name hyoglossus speaks of a muscle originating at the hyoid bone and inserting in the tongue.
  17. 17. • Glōssa means tongue or language in Greek, hence the relation with glossus. • Hypo, from Greek, means under or beneath. It is a very useful prefix! • Lingua to lingualis / lingual, which means tongue, language or speech in Latin. This is where we get language or a logo (although logos is Greek for word or reason).
  18. 18. Mucous membrane of the Tongue • The mucous membrane of the upper surface of the tongue can be divided into anterior and posterior parts by a V-shaped sulcus, the sulcus terminals. • The apex of the sulcus projects backward and is marked by a small pit, the foramen cecum. • The sulcus serves to divide the tongue into the anterior two thirds, or oral part, and the posterior one third, or pharyngeal part. • The foramen cecum is an embryologic remnant and marks the site of the upper end of the thyroglossal duct. Three types of papillae are present on the upper surface of the anterior two thirds of the tongue: the filiform papillae, the fungiform papillae, and the vallate papillae.
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  20. 20. The mucous membrane covering the posterior third of the longue is devoid of papillae (without papillae) but has an irregular surface, caused by the presence of underlying lymph nodules, the lingual tonsil. The mucous membrane on the inferior surface of the tongue is reflected from the tongue to the floor of the mouth. In the midline anteriorly, the undersurface of the tongue is connected to the floor of the mouth by a fold of mucous membrane, the frenulum of the tongue.
  21. 21. • On the lateral side of the frenulum, the deep lingual vein can be seen through the mucous membrane. • Lateral to the lingual vein, the mucous membrane forms a fringed fold called the plica fimbriata
  22. 22. Tongue Papillae • There are four types of lingual papillae found on the surface of the human tongue Filiform papillae Fungiform papillae Foliate papillae Circumvallate (Vallate) papillae
  23. 23. Filiform papillae • Filiform papillae are the most abundant of the four types of papillae. shaped like cones and are • found over the entire surface of the tongue, giving it its rough appearance • By making the dorsal surface of the tongue rough, these papillae provide friction to allow movement of the food bolus during chewing. It should be noted that these papillae do not possess taste buds.
  24. 24. Fungiform papillae • Fungiform papillae are weakly keratinized and less abundant than the filiform papillae. These highly vascular, mushroom-shaped papillae contain a few taste buds on the apical aspect. • Found at the tip and sides of the tongue • Fungiform papillae consist of approximately 1,600 taste buds.
  25. 25. Foliate papillae • Foliate papillae appear as bilaterally paired, parallel, longitudinal slits or series of folds on the posterolateral margin of the tongue, near the sulcus terminalis. The mucosa is non-keratinized and the papillae are populated with numerous taste buds. Each person has about 20 foliate papillae, which contain several hundred taste buds.
  26. 26. Circumvallate (Vallate) papillae • Circumvallate (Vallate) papillae are organized linearly, as a set of four to six large papillae anterior to each limb of the sulcus terminalis (i.e. eight to twelve, or fourteen papillae in total). • Circumvallate (Vallate) papillae appear larger than the other types of papillae, and they contain approximately 250 taste buds.
  27. 27. Taste buds • There are five basic tastes that stimulate the taste buds, including: 1.Sweet. 2.Salty. 3.Bitter. 4.Sour. 5.Umami (savory). • There’s a common misconception that different areas of the tongue taste different things. In reality, all of taste buds have the ability to detect all five flavors — some regions of the tongue are just slightly more sensitive to certain tastes.
  28. 28. • While taste buds are distributed throughout the entire oral cavity, they are at higher concentrations on the tongue. Each taste bud is clear, oval and covered by stratified squamous epithelium. • A combination of elongated taste (gustatory), supportive, and basal stem cells can be found within each taste bud.
  29. 29. • There are five gustatory sensations that are perceived by individuals. These are sweet, salty, sour, bitter, and umami. The microvilli found on the apical surface of the taste cells are equipped with various receptors that bind to varying molecules. The reaction generated from this compound-receptor interaction gives rise to varying action potentials that are subsequently perceived as taste. • Saltiness is often associated with the cationic component of a compound (i.e. sodium ions), while sourness is related to the acidity (concentration of hydrogen ions) in the compound. Organic compounds such as carbohydrates or amino acids give rise to sweet taste, while bitterness is associated with long-chain organic compounds. The final taste - umami - also known as savoury, is related to compounds with the left-handed chiral isomer of glutamic acid.
  30. 30. Muscles of the Tongue The tongue is composed of two types of muscles: • Intrinsic • Extrinsic
  31. 31. Intrinsic muscles Confined to tongue No bony attachment Consist of: • Longitudinal fibers • Transverse fibers • Vertical fibers • Function: Alter the shape of the tongue
  32. 32. Extrinsic muscles Connect the tongue to the surrounding structures: the soft palate and the bones (mandible, hyoid bone, styloid process) Include: • Palatoglossus • Genioglossus • Hyoglossus • Styloglossus Function: Help in movements of the tongue
  33. 33. Movements • 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
  34. 34. Sensory Nerve Supply Anterior ⅔: • General sensations: Lingual nerve • Special sensations : chorda tympani Posterior ⅓: • General & special sensations: glossopharyngeal nerve Base: • General & special sensations: internal laryngeal nerve
  35. 35. Motor Nerve Supply Intrinsic muscles:  Hypoglossal nerve Extrinsic muscles:  All supplied by the hypoglossal nerve, except the palatoglossus The palatoglossus supplied by the pharyngeal plexus
  36. 36. Blood Supply • Arteries: Lingual artery Tonsillar branch of facial artery Ascending pharyngeal artery • Veins: Lingual vein, ultimately drains into the internal jugular vein
  37. 37. Lymphatic Drainage • Tip: • Submental nodes bilaterally & then deep cervical nodes • Anterior two third: • Submandibular unilaterally & then deep cervical nodes • Posterior third: • Deep cervical nodes (jugulodigastric mainly)
  38. 38. Tongue functions • The tongue is the most important articulator for speech production. During speech, the tongue can make amazing range of movements • The primary function of the tongue is to provide a mechanism for taste. Taste buds are located on different areas of the tongue, but are generally found around the edges. They are sensitive to four main tastes: Bitter, Sour, Salty & Sweet
  39. 39. • The tongue is needed for sucking, chewing, swallowing, eating, drinking, kissing, sweeping the mouth for food debris and other particles and for making funny faces (poking the tongue out, waggling it) • Trumpeters and horn & flute players have very well developed tongue muscles, and are able to perform rapid, controlled movements or articulations
  40. 40. Clinical Notes Lacerations of the tongue Tongue-Tie (ankyloglossia) (due to large frenulum) Lesion of the hypoglossal nerve • The protruded tongue deviates toward the side of the lesion • Tongue is atrophied & wrinkled