Tongue
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.
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Gross anatomy
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:
- intrinsic muscles of the tongue which do not have attachments outside the tongue and whose action is to alter the shape of the tongue:
- extrinsic muscles of the tongue (mnemonic) which have attachments outside the tongue and therefore their actions alter the position of the tongue:
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
- includes root of tongue, which is considered separately due to its importance in oropharyngeal cancer
- 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.
Arterial supply
- lingual artery (principally) but also branches from the facial and ascending pharyngeal arteries 4
Venous drainage
- follows arterial supply draining to the lingual, facial and/or internal jugular veins 4
Innervation
- hypoglossal nerve (CN XII): intrinsic and extrinsic muscles (except palatoglossus muscle, which is supplied by the pharyngeal plexus)
-
lingual nerve
- sensory supply to the anterior two-thirds
- special sensory (taste) fibers diverge from the lingual nerve and travel with the facial nerve (CN VII) via chorda tympani
- glossopharyngeal nerve (CN IX): sensory supply to posterior one-third 2
Lymphatic drainage
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.
History and etymology
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.
Related pathology
- neoplastic
- squamous cell carcinoma of the tongue
- hemangioma
- lipoma
- non neoplastic
Related Radiopaedia articles
Anatomy: Head and neck
- skeleton of the head and neck
-
cranial vault
- scalp (mnemonic)
- fontanelle
-
sutures
- calvarial
- facial
- frontozygomatic suture
- frontomaxillary suture
- frontolacrimal suture
- frontonasal suture
- temporozygomatic suture
- zygomaticomaxillary suture
- parietotemporal suture (parietomastoid suture)
- occipitotemporal suture (occipitomastoid suture)
- sphenofrontal suture
- sphenozygomatic suture
- spheno-occipital suture (not a true suture)
- lacrimomaxillary suture
- nasomaxillary suture
- internasal suture
- basal/internal
- skull landmarks
- frontal bone
- temporal bone
- parietal bone
- occipital bone
- skull base (foramina)
-
facial bones
- midline single bones
- paired bilateral bones
- cervical spine
- hyoid bone
- laryngeal cartilages
-
cranial vault
- muscles of the head and neck
- muscles of the tongue (mnemonic)
- muscles of mastication
-
muscles of facial expression
- occipitalis muscle
- circumorbital and palpebral muscles
- nasal muscles
- buccolabial muscles
- elevators, retractors and evertors of the upper lip
- levator labii superioris alaeque nasalis muscle
- levator labii superioris muscle
- zygomaticus major muscle
- zygomaticus minor muscle
- malaris muscle
- levator anguli oris muscle
- risorius muscle
- depressors, retractors and evertors of the lower lip
- depressor labii inferioris muscle
- depressor anguli oris muscle
- mentalis muscle
- compound sphincter
- orbicularis oris muscle
- incisivus superior muscle
- incisivus inferior muscle
- muscle of mastication:
- elevators, retractors and evertors of the upper lip
- muscles of the middle ear
- orbital muscles
- muscles of the soft palate
- pharyngeal muscles
- suprahyoid muscles
- infrahyoid muscles
- intrinsic muscles of the larynx
- muscles of the neck
- accessory muscles of the neck
- deep cervical fascia
-
deep spaces of the neck
- anterior cervical space
- buccal space
- carotid space
- danger space
- deep cervical fascia
- infratemporal fossa
- masticator space
- parapharyngeal space
- stylomandibular tunnel
- parotid space
- pharyngeal (superficial) mucosal space
- perivertebral space
- posterior cervical space
- pterygopalatine fossa
- retropharyngeal space
- suprasternal space (of Burns)
- visceral space
- surgical triangles of the neck
- orbit
- ear
- paranasal sinuses
- nose
- oral cavity
- pharynx
- larynx
- viscera of the neck
- blood supply of the head and neck
-
arterial supply
-
common carotid artery
- carotid body
- carotid bifurcation
- subclavian artery
- variants
-
common carotid artery
- venous drainage
-
arterial supply
- innervation of the head and neck
-
cranial nerves
- olfactory nerve (CN I)
- optic nerve (CN II)
- oculomotor nerve (CN III)
- trochlear nerve (CN IV)
-
trigeminal nerve (CN V) (mnemonic)
- trigeminal ganglion
- ophthalmic division
- maxillary division
- mandibular division
- abducens nerve (CN VI)
- facial nerve (CN VII)
-
vestibulocochlear nerve (CN VIII)
- vestibular ganglion (Scarpa's ganglion)
- glossopharyngeal nerve (CN IX)
-
vagus nerve (CN X)
- superior laryngeal nerve
- recurrent laryngeal nerve (inferior laryngeal nerve)
- (spinal) accessory nerve (CN XI)
- hypoglossal nerve (CN XII)
- parasympathetic ganglia of the head and neck
- greater occipital nerve
- third occipital nerve
-
cervical plexus
- muscular branches
- longus capitis
- longus colli
- scalenes
- geniohyoid
- thyrohyoid
-
ansa cervicalis
- omohyoid (superior and inferior bellies separately)
- sternothyroid
- sternohyoid
- phrenic nerve
- contribution to the accessory nerve (CN XI)
- cutaneous branches
- muscular branches
- brachial plexus
- pharyngeal plexus
-
cranial nerves
- lymphatic drainage of the head and neck
- embryological development of the head and neck