Tongue

Last revised by Craig Hacking on 9 Dec 2021

The tongue is a complex, principally muscular structure that extends from the oral cavity to the oropharynx. It has important roles in speech, swallowing and taste. 

The tongue has a tip, dorsum, inferior surface and root. The tongue is made of a midline lingual septum and hyoglossus membrane, and multiple muscles 1,2,4. The muscles are divided into intrinsic and extrinsic muscle groups:

The tongue is divided into two parts at the level of the circumvallate papillae 1,3:

  • mobile tongue: anterior two-thirds; part of the oral cavity
  • base of tongue: posterior one-third; fixed; part of the oropharynx

The tongue is covered by a mucosa, which is roughened on the dorsal surface covered by filiform, fungiform and circumvallate papillae. Posteriorly, the base of the tongue contains the lingual tonsils 4.  

On its inferior surface the tongue is usually joined to the floor of the mouth by a thin midline membrane, the frenulum of the tongue.

The dorsal mucosal surface of the pharyngeal part of the tongue contains groups of lymphoid follicles forming the lingual tonsils

The anterior tongue drains to several nodal groups:

  • apex: drains to submental and submandibular nodes
  • body: drains to submandibular nodes then to the deep cervical nodes (especially the jugulodigastric and jugulo­omohyoid nodes)

The posterior tongue drains directly to deep cervical nodes.

Of clinical significance in tumors approaching the midline, central regions of the tongue may drain bilaterally, especially if lymphatic vessels on one side are obstructed.

The word tongue is derived from an Old English word tunge, meaning the organ of phonation, or speech itself, and ultimately is thought to be derived from lingua, the Latin for tongue 7.

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