Tongue Anatomy PDF

## Tungens bevægelighed - Undersøges ved at lade patienten række tunge og bevæge den i forskellige retninger - Normally, the tongue has an impressive range of movement - Reduced mobility is seen particularly in hypoglossal paralysis and sometimes with a short frenulum - Severe peripheral hypoglossa...

## Tungens bevægelighed - Undersøges ved at lade patienten række tunge og bevæge den i forskellige retninger - Normally, the tongue has an impressive range of movement - Reduced mobility is seen particularly in hypoglossal paralysis and sometimes with a short frenulum - Severe peripheral hypoglossal paralysis causes muscle atrophy, observable during inspection - In milder cases, atrophy can be difficult to see, but there will be weakness - An impression of the tongue’s strength can be obtained by asking the patient to press their tongue against the inside of their cheek while the examiner applies counterpressure from the outside - Observe how much resistance the patient can generate - It is important to compare both sides - A key part of the examination is to ask the patient to stick their tongue straight out - In hypoglossal paralysis, the tip of the tongue will deviate towards the side of the paralysis - This is because only the genioglossus muscle on the healthy side can pull the tongue out - If, for example, the right hypoglossal nerve is cut, the tongue will deviate to the right ## Palpation - The tongue and, in particular, the consistency and volume of the tongue muscles are examined - The tongue’s sensory functions can be examined for general “feeling”, i.e. pressure and touch, which are highly developed on the tongue ## Taste - Another important sensory function of the tongue is taste - This can be tested qualitatively for sweet, salty, sour, and bitter using, respectively, sugar, table salt, lemon juice, and quinine in weak solution - The taste can sometimes be examined quantitatively using a special method (electrogustometry) ## Valleculae Epiglotticae - Objects swallowed, such as fishbones, can lodge in one of the valleculae epiglotticae ## Mucosa - The mucosa of the vallecula and the folds that define it medially and laterally are highly sensitive and innervated by the vagus nerve - Coughing and even vomiting can easily be induced by touching the mucosa in this area - The inferior surface of the tongue is best seen when the tip of the tongue is raised towards the palate - It forms, together with the mucosa of the floor of the mouth, the superficial part of the sublingual region - From the midline of the inferior surface of the tongue, the lingual frenulum (frenulum linguae) extends towards the alveolar process of the mandible - The surface is further characterized by the plica fimbriata, a mucosal fold on both sides of the midline - It has the shape of a V with the tip pointing forward, the posterior ends extending as far as the plica sublingualis in the floor of the mouth ## Plica Fimbriata - The plica fimbriata is irregular (fimbriata means fringed) and forms the boundary between two distinct mucosal areas - Medial to the plica fimbriata, the mucosa is very loosely bound, and it is also red and shiny - Lateral to the plica fimbriata, the mucosa is tightly bound, and it is pale red and less shiny ## Lingual Gland - Near the lower surface of the tongue, covered by the plica fimbriata, is the anterior lingual gland (glandula lingualis anterior) - It is mixed with the predominant mucous secretion being released onto the inferior surface of the tongue - Often, the venous pattern on the inferior surface of the tongue (v. profunda linguae or v. ranina) is visible ## Tongue Papillae - A tongue papilla (papilla linguae) consists of a large epithelium-covered lamina propria papilla (2) that “protrudes” on the surface of the tongue - Tongue papillae are found exclusively on the dorsal surface of the tongue and include: - Filiform papillae - Fungiform papillae - Vallate papillae - Foliate papillae (folia linguae) - The latter are mucosal folds but are considered tongue papillae because they have taste buds and resemble papillae - Filiform papillae are the largest group of tongue papillae and are densely distributed over the entire pre-sulcal part of the dorsal surface of the tongue - They are thread-like (filum: thread) and lack taste buds - The “threads” are about 3 mm tall and make the surface uneven - Filiform papillae have a mechanical function - For example, they prevent food particles from slipping off the tongue ## Mucosa - The mucosa of the dorsal surface of the tongue is generally tightly bound, but it is more firmly bound in the pre-sulcal part than in the post-sulcal part - At the posterior end of the post-sulcal part, right before the epiglottis, there is a depression on each side of the midline, the vallecula epiglottica - This depression is bounded by the lateral glosso-epiglottic folds (4) and the median glosso-epiglottic fold (vallecula: small valley) - Because of their sharp edges, these depressions are clinically interesting