Tongue

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Description[edit | edit source]

The tongue is a oval shaped, Pink ,Moist ,Solid Conical, muscular organ, which is situated in a hollow cavity of mouth. As seen in the diagram it has various structure around and several attachments. It moves freely from the anterior side which not directly attached to any other structure. Posterior part of the tongue is attached to numerous structures thus why Tongue plays several important roles such as facilitation of gustatory stimuli, facilitates mastication, speech pathway, as it helps with articulation.[1][2] In the video entitled Surface anatomy of the tongue (preview) - Human Anatomy and muscles of tongue by Kenhub the overview of Anatomy of tongue is explained. For further understanding of muscles of tongue and movements of tongue this cane be also an helpful watch.

Anatomical Relationships

  • Anterior and lateral - teeth
  • Superior - hard and soft palates
  • Inferior - mucosa of the floor of the oral cavity, sublingual salivary glands, posterior wall of oropharynx
  • Posterior - epiglottis, pharyngeal inlet
  • Lateral - palatoglossal and palatopharyngeal arches[2]

The mylohyoid muscle, which is responsible for raising the body of the tongue in high vowels and velar consonants. The hyoglossus, which pulls it downwards (and slightly backwards). The styloglossus, which pulls the tongue upwards and backwards. The genioglossus, which forms the bulk of the inferior part of the tongue and pulls the body of the tongue forwards.

Muscles[edit | edit source]

Tongue is made of 2 main types of group of muscles that are Intrinsic group and Extrinsic group of muscles

Total 4 types of Intrinsic muscle

  • The superior longitudinal lingual muscle, which shortens the tongue and curls it upward.
  • The inferior longitudinal lingual muscle, which shortens the tongue and curls it downward.
  • The transverse lingual muscle, which elongates and narrows the tongue.
  • The vertical lingual muscle,which flattens the tongue

The extrinsic muscles are

  • The genioglossus muscle protrudes the tongue
  • The hyoglossus muscle depresses and retracts the tongue
  • The styloglossus muscle draws up the sides of the tongue to create a trough for swallowing following adequate mastication. The pair of styloglossus muscles work together on each side to retract the tongue.
  • The palatoglossus muscle, which elevates the posterior tongue, closes the oropharyngeal isthmus, aids in the initiation of swallowing, and prevents the spill of saliva from the vestibule into the oropharynx by maintaining the palatoglossal arch.

Function[edit | edit source]

Areas of tongue-Taste function


Tongue plays several roles in taste, speech, swallowing in oral cavity.

  • Function of Taste(Gustation):  Taste buds situated in the tongue plays role in taste identification. Taste receptors identify taste in 5 category Sweet, Sour, Salty, Bitter, and Umami.[3]
  • Function of Speech(Phonation): tongues movement against teeth, palate and within oral cavity helps in  productions of speech
  • Swallowing and food manipulation(Deglutition): food manipulation occurs in oral cavity, tongue presses food against hard palate and enables mastication, forms the food bolus and promotes swallowing. [4][3][5]

Nerve[edit | edit source]

The motor supply of all Intrinsic as well as extrinsic muscles id done by cranial nerve XII (Hypoglossal) except one which is palatoglossus. Palatoglossus is supplied by Cranial nerve X (Vagus)[1][6]

Sensory supply of tongue

  • Taste sensation of anterior two third- chorda tympani (branch of facial nerve), general sensation of the same by lingual nerve(branch of trigeminal nerve)
  • Taste sensation and general sensations  of posterior two third is supplied by glosspharangeral nerve
  • Perception taste is also partly performed by epiglottis and epiglottic regions. Taste and general sensation is provided by the internal laryngeal branch of vagus nerve. [1][2][6]

Blood Supply[edit | edit source]

Blood supply to the tongue is predominantly from the lingual artery, a branch of the external carotid artery between the superior thyroid artery and the facial artery[4][5]

Clinical relevance[edit | edit source]

According to main 3 functions of tongue Function of Taste, Function of Speech, and Function of Swallowing and food manipulation, Considering assessment of tongue all 3 functions has to tested and treated.

Assessment[edit | edit source]

tongue assessment plays an significant role in tongue rehabilitation[7] and maxillo-facial physiotherapy.[8] [9]tongue strength technique[10][11]

  1. Assessment of function of Taste[12]
  2. Assessment of function of Speech[13]
  3. Assessment of function of Swallowing and food manipulation[14]

Treatment[edit | edit source]

Physiotherapy plays and important role in regaining function of tongue. Tongue rehabilitation An Approach to improve various tongue function : the concept of tongue rehabilitation was introduced by Mrs Fournier years ago, this includes tongue correction of tongue immaturity, resting position of tongue, deglutition and phonation. These changes might involve adaptive cortical neuro-plasticity. Indeed these last years it has been shown in humans that standardised and calibrated tongue lift or protrusion exercises induce such plasticity in the tongue motor cortex.[15] Devices are available for compressing an air-filled bulb between the tongue and hard palate and for Lingual Strength improvement. patient with stroke and other conditions which affect the function of tongue or cause dysphagia shows positive changes after tongue rehabilitation. [16] Several techniques of tongue stretching are also beneficial. for performing the same patient positioned in siting, patient is supposed to protrude tongue as much as possible. with the help of dry gaze the therapist then grasp the tongue tightly with both hands and pull until painless. At this time, The intervention period was 4 weeks, 5 days a week, 30 times a day. The measurement site was measured from the centre of upper lip to the tip of the tongue out of the lips during tongue[15]

Links[edit | edit source]

Resources[edit | edit source]

  1. 1.0 1.1 1.2 Dotiwala AK, Samra NS. Anatomy, Head and Neck, Tongue. [Updated 2021 Apr 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507782/
  2. 2.0 2.1 2.2 Tongue [Internet]. Kenhub. 2022 [cited 7 January 2022]. Available from: https://www.kenhub.com/en/library/anatomy/tongue
  3. 3.0 3.1 AlJulaih G, Lasrado S. Anatomy, Head and Neck, Tongue Taste Buds [Internet]. Ncbi.nlm.nih.gov. 2022 [cited 7 January 2022]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539696/
  4. 4.0 4.1 The tongue: structure and function relevant to disease and oral health. SADJ. 2003;58(9):375-383.
  5. 5.0 5.1 FUCCI D, PETROSINO L. The Human Tongue: Normal Structure and Function and Associated Pathologies. Speech and Language. 1981;:305-374.
  6. 6.0 6.1 Mu L, Sanders I. Human tongue neuroanatomy: Nerve supply and motor endplates. Clinical Anatomy. 2010;23(7):777-791.
  7. Milazzo M, Panepinto A, Sabatini A, Danti S. Tongue Rehabilitation Device for Dysphagic Patients. Sensors. 2019;19(21):4657.
  8. Gil H, Fougeront N. Tongue dysfunction screening: assessment protocol for prescribers. Journal of Dentofacial Anomalies and Orthodontics. 2015;18(4):408.
  9. Gil H, Fougeront N. Treatment of tongue dysfunction: rehabilitation for prescribers’ practice. Journal of Dentofacial Anomalies and Orthodontics. 2018;21(4):504.
  10. Maia A, Furlan R, Moraes K, Amaral M, Medeiros A, Motta A.Tongue strength rehabilitation using biofeedback: a case report:CoDAS. 2019;31(5).
  11. Solomon N. Assessment of tongue weakness and fatigue. International Journal of Orofacial Myology. 2004;30(1):8-19.
  12. Ahne G, Erras A, Hummel T, Kobal G. Assessment of Gustatory Function by Means of Tasting Tablets. The Laryngoscope. 2000;110(8):1396-1401.
  13. Hiiemae K, Palmer J. Tongue Movements in Feeding and Speech. Critical Reviews in Oral Biology & Medicine. 2003;14(6):413-429.
  14. Agarwal J, Palwe V, Dutta D, Gupta T, Laskar S, Budrukkar A et al. Objective Assessment of Swallowing Function After Definitive Concurrent (Chemo)radiotherapy in Patients with Head and Neck Cancer. Dysphagia. 2011;26(4):399-406.
  15. 15.0 15.1 Gil H, Fougeront N. Treatment of tongue dysfunction: rehabilitation for prescribers’ practice. Journal of Dentofacial Anomalies and Orthodontics. 2018;21(4):504.
  16. Robbins J, Kays S, Gangnon R, Hind J, Hewitt A, Gentry L et al. The Effects of Lingual Exercise in Stroke Patients With Dysphagia. Archives of Physical Medicine and Rehabilitation. 2007;88(2):150-158.