Hello, how are you? Welcome to a new video on this anatomical channel easy anatomy by Juan José Sánchez, today I bring you a video about the anatomy of the tongue, in previous videos we talked about the anatomy of the palate, we talked about the let's say general anatomy of the cavity oral, right now we are going to make specialists explain this anatomy of the tongue region, already celebrating because just today that I am recording this video I reached 100,000 subscribers on YouTube and this is video number 201 on the channel, so I am proud to have We have already reached these levels and well we continue to grow, speaking of the tongue it is a muscular organ, it is composed entirely of striated muscle which in turn is covered by a really fibrous apparatus and also of an epithelial type mucosa, so it is a central organ It is an organ that is quite mobile and that will be in its place thanks to powerful muscles that are inserted into the one that will hold it in that central place and in the lower part of the oral cavity, then through these structures muscular insertion will be inserted into the hyoid bone, as we will see later, it will have a very important insertion at the level of the lower jaw, which is what practically prevents the tongue from going backwards and we will not swallow them, thanks to this muscular insertion that it has at the level of the lower jaw or mandible will also have a muscular fold that will hold it to the stylodes process of the temporal bone, as well as muscular folds that take it towards the pharynx, finally through one of its muscles it goes to have grip at the level of the palate, so I well know that there are quite a few muscles that hold the tongue in place and that not only their function is to hold it but we are also going to see that they have a function of movement of the tongue. itself, now what are the functions of that language going to be?
Why does language occupy precisely that place? It has many important functions, here we are going to describe four to see that first it has a great swallowing function thanks to a movement that the tongue makes backwards that bolus of food can be pushed towards the pharynx when we are eating, then its first function by listing them with order, let's say specifically, is the function of swallowing, deglutition; Then we are going to see that at the level of the back of the tongue we find many structures called taste buds, which are what help us to have the sense of taste, so it also has an important gustatory function of being able to perceive and differentiate flavors, it will have an important function also in chewing since thanks to its movements that bolus can be pushed against the palate for example and it will be squeezed so it also has a function that helps to mix during chewing and finally a function is also attributed to the tongue Since we are going to articulate the words thanks to the movement of the tongue, pay attention and speak in the mirror so that you can see the number of movements you make with your tongue when we say any word. Now, we are going to talk about the general parts of the language and we are going to break down each of these parts, but first don't let go of this video, it is important that you subscribe to the channel below where you see what it says To subscribe, you click on it and you are automatically subscribed to the more than 200 videos that you find on the channel.
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com but well I'm going back to it again, let's say the videos of the channel, so we had stayed in the general parts of the tongue, we are going to see that towards the anterior part it presents a region called the tip or vertex of the tongue, towards the back we are going to see views I have a superior vision I am seeing as if I were the palate, then this entire region is called the back of the The tongue itself is the largest region, let's say, from the point of view of anatomical study. Well, I show you this image so that we can see a portion that is the counterpart of the region of the back. Remember that the back in which you look upwards towards the palate which would be the lower surface of the tongue and finally we will study the region that joins it to the floor of the mouth which is the root of the tongue, this root of the tongue would function practically as the hilum of the tongue because here it is the place where the vascular structures and the nervous structures pierce towards the tongue so that the entire part of the innervation, the irrigation, the lymphatic drainage goes in this direction, it goes from bottom to top because of course if it is the venous and lymphatic drainage more Well, it comes from the top down through all the structures that reach the tongue, whether entering or exiting, they enter through the root specifically, very well, let's start then first talking about the tip or vertex, this tip or vertex of the tongue is called like this Also, we are going to see that it is extended towards the bones, not the bones, towards the incisor teeth, both the central and upper lateral incisors, as well as the lower central and lateral incisors, towards the back we then find the back of the tongue, it is important to see that this entire dorsum of the tongue is really concave upwards both in an anteroposterior sense and it is concave in a laterolateral sense if the tongue is practically visible that we can see when opening the mouth this dorsum of the tongue tongue, to make its study a little easier we are going to divide it into two large portions, an anterior portion that occupies the anterior two thirds of the tongue, which we are going to call the buccal portion because it is the portion that remains inside my mouth, and then The pharyngeal portion, which is the portion found inside the oral pharynx, is the posterior portion, also called the base of the tongue.
Generally, sometimes students confuse it. I have even seen it in some anatomical texts as the base of this root, but it is really It is the root and this is the base, that is, the base is a part of the dorsum that what passes through the buccal portion, which is the anterior two-thirds, looks upward, but this portion of the base, pharynx portion of this same dorsum of the tongue is rather, let's say arranged in a vertical sense, in a frontal sense, and really this is looking backwards and not as much upwards as if the oral portion sees it, very well, what is the cut-off point going to be? When I am looking at this dorsal surface of the tongue to say, look, from here forward it is the buccal portion and from here backwards it is the pharynx portion or portion of the base.
Note that the portion is going to be delimited by this v-shaped groove, which is a small v. inverted whose vertex is the sulcus, this sulcus is called the terminal sulcus, from the terminal sulcus forward it is the buccal portion and from the terminal sulcus backwards in the pharynx portion, we see that both sides of that terminal sulcus converge a blind foramen called precisely that foramen cecum, which is the vertex of that terminal groove, we can see that there is an internal depression that does not involve any particular place and actually that blind hole is part of the remnants of the thyroglossal duct, an embryological structure that helps form the tongue and between other things also to the thyroid gland, very well then in that oral portion that is the previous one we are going to see a groove in the middle part quite a bit or rather it is very little marked, many times it is not so easy to see that middle groove in all languages and something that should catch our attention one of the most important things that we find in this dorsal region is the lingual papilla which are the famous taste buds, those lingual papillae we talk about can basically be of four types, first you want they can be somewhat pointed conical with a lower base and the tip facing upwards, which are the filiform papillae, now we are going to see them in a slightly more microscopic section but they are the most abundant that we find at the level of the back, they are precisely those filiform papillae, then we have the fungiform papillae that are located more towards the tip of the tongue and Towards the lateral regions of the dorsum as well as the lateral edges of the tongue , which would be these edges that you see here, those fungiform papilla have a narrow base and at the top it looks like a little mushroom because it widens at the top; Then we are going to have the circumvallate papillae, which are from 3 to 14 and are arranged just anterior to that terminal groove, it can be from 3 to 14, as I told you, those circumvallate papillae are characterized because they have , let's say, a depression that surrounds it, right now the We are going to see more microscopically so that you can notice that they are quite circular papillae and quite symmetrical in their arrangement, then we are going to have finally the foliated papillae, which are papillae that we find in the most posterior part, they are like some wrinkles that we find in the posterior part. more posterior of those lingual edges, notice here the pharyngeal portion, which is the portion that is posterior to the terminal sulcus and is located within the buccopharynx and remember that it rather sees backwards, posteriorly, what it does not have to call The attention is that that number of structures that look like lingual papillae but do not have any gustatory function but rather a lymphoid function, these are together the famous or called together the lingual tonsil that together with the rest of the palatine tonsils, the tubal tonsils and the nasopharyngeals make up the famous Waldeyer's ring, the lymphatic ring of the neck or Waldeyer's lymphatic ring, we are also going to see that there are some mucosal folds that hold the back of the epiglottis to that base of the tongue, so we are going to see a central fold called the middle glossoepiglottic fold is what it is called and two lateral folds called lateral glossoepiglottic folds, we are going to see that there are some spaces that are between the middle glossoepiglottic fold and each of the lateral glossoepiglottic folds on each side called the epiglottic lavalecula, each of those gaps that you can notice there very well see this cut in more or less microscopic here we can see this is so that you do not get confused this is a lingual tonsil, part of the lingual tonsils in front have lymphoid tissue or these that are pointed are the filiform ones that They generate the most abundant of these and it is a lingual papilla or taste buds, see this shape that we find here which is a narrow base with an upper part that takes on the shape of a mushroom, that fungiform area that is why they receive that name and here further back we can see it circumambulated, notice that I told you that it was surrounded by an excavation and in that excavation we are precisely going to find a certain group of glands, they are serous glands that excrete products that are going to fill those depressions and are going to finally come out on the tongue, I do not have microscopic images of the foliate papillae but these are, let's say, the most abundant and the most that we are going to notice at the level of the dorsum of the tongue, we are already talking about the dorsum, we are talking about the tip or vertex, We are going to talk about the lower surface.
That lower surface is the one that would be in contact with the floor of the mouth. We are going to talk about a structure called the tongue frenulum, which in many people can be short and is what makes the tongue fit. The tongue is very close to the floor and sometimes they cannot articulate words because they have a short lingual frenulum.
This is what you from here are going to see that on the sides we are going to find some folds called the fringed fold that we find in this place, well here I don't know. You see because here they really cut a piece of the line, we are going to see that at the junction of the lower surface of the tongue and the floor of the mouth we find the ducts at the mouth of the major salivary glands, I explained this in the mouth video but Well, since I don't know if you saw it, I'm going to tell you that these two most medial orifices, each on the side of the lingual frenulum, are the orifices at the mouth of the Wharton duct, so this green one that you see here is the duct or mouth of the maxillary gland, while all these little ones that you see here are the mouth ducts of the sublingual glands, very well we can also find on the underside of the tongue you can see the deep artery of the tongue which is the ranine artery. If we can see when we raise the tongue we can see in the background that it looks somewhat purple and basically that is the ranine artery and vein, which is also the deep vein of the tongue, very close to the tip of the tongue but on the underside we find a set of glands called anterior lingual glands that are also saliva-producing glands, finally the root of the tongue, which is the part that connects it to the floor of the mouth and what we are going to find in a set of muscles, which are the ones we are going to see below.
This is a frontal cut of the tongue, more or less, so that they can be located. This is the hyoid bone this is the submaxillary gland and here we see the submaxillary mat itself in fact and that is enveloping the hyoglossus, this is the lower jaw and these are the most posterior molars, very well understanding this we are going to see again that the tongue It has two groups of muscles. It has a group of intrinsic muscles that are the muscles of the tongue.
They only make up the tongue that you touch. The muscles are skeletal and I can move them. They help make certain movements of the tongue and we are going to find the muscles.
extrinsic, which are those that come from the adjacent bones and that are inserted into the tongue and give it the greatest capacity for movement, we are going to start first by talking about the intrinsic muscles of these intrinsic muscles, which are four groups, we are going to see first, it is longitudinal. upper part, which is the only odd one and because we are going to see that all the other muscles that I am going to name, both intrinsic and extrinsic, are even muscles in length. In the upper ones, the only muscle of the pair that is found practically in the entire upper part, running along that back of the same, we are going to see that downwards, towards each side we have the lower longitudinal muscle and in the central portion we are going to see a group of fibers that goes in a transverse direction and a group of figuration in a longitudinal direction, these help to make the movements When we roll the tongue both in the anteroposterior sense, as do the longitudinal ones, and in the lateral sense that we ourselves roll the tongue thanks to this intrinsic musculature, something important is that some authors name a middle structure so it is not a cartilage as such They name it rather as a clear lingual septum, it is not a perfect septum that will separate half of the tongue from the other, but more or less a fibrous septum that some authors call it the skeleton of the tongue, in fact, very well, look at this image this is of the sobotta in this also frontal section of the tongue all this white that you see is called lingual aponeurosis, on the outside this would be the mucosa of the tongue the epithelium, so here we see the transverse fibers 'I am from the transverse intrinsic muscle here we see the Of the longitudinal here more or less would be the superior longitudinal but in these are the verticals up here we see in the superior longitudinal and here on the sides we would see that of the inferior longitudinal muscle what we see in the middle would then be more or less that lingual septum part of the extrinsic muscles of the tongue we are going to see five first we talk about the genioglossus muscle which is a muscle that has several fascicles it originates in the upper genis process of the lower jaw or mandible, some of its fibers grab towards the lower face of the tongue but see that there is a group of fibers that grips the hyoid bone, do not confuse it with the genihyoid which is a muscle that is in the neck videos as the suprahyoid muscle, we are not talking about from here up to the top anyway I will return it to mark so that they are not confused, it is not seen that there is an inferior fascicle that reaches the hyoid bone.
The function of this genioglossus muscle actually brings the tongue downwards, it is a depressor of the tongue, but it also carries it forwards, it sticks out the tongue, while protrusion of sticking out the tongue it is important to know that when we secure an airway for example a polytraumatized patient and they do As anesthesiologists, we open our mouths a lot so that when we open the lower jaw through the Genioglossus, the tongue comes forward and clears the entire airway so that the patient can breathe better, so that maneuver that we sometimes do because of the theory that we have Opening the patient's mouth to ensure the airway also partly helps me bring the tongue forward and the maneuver is much more effective. Very well, we're talking, then we're talking about Genioglossó. When you see the word glossó, it means tongue, everything you say.
the globe is because something is going to do to the tongue because that is the anatomical prefix that the tongue indicates to me, then we have the hyoglossus muscle that another of the extrinsic muscles pairs, all the extrinsic muscles really are pairs this muscle, ah well something important to know is that the geniusglossus is in contact with the geniusglossus on the other side that they are in contact because the lingual septum is a little more developed from the upper part towards the part of the tongue, this hyoglossus originates in the greater horn and in the body of the hyoid bone, it goes upwards until it reaches the lateral edge and the lower surface of the tongue, this hyoglossum its function will be that when it contracts it takes the tongue backwards, which is the opposite movement of protrusion because this is called retraction or retraction, then we have the styloglossus muscle, it is a muscle that originates in the styloid process of the temporal bone as well as in this ligament called the maxillary style ligament and you there as if it is originating it goes forward these muscles of the tongue twitch , they intermingle with each other, their fibers practically join together, but finally we are going to see that the fascicle is going to be inserted into the lateral edge of the tongue and on the underside, an insertion quite similar to that of the hyoglossus muscle that we are naming right now, the function of The way that styloglossus grips the tongue is backwards when contracting to bring the tongue backwards, which is in the movement of retraction or retrusion, however you want to say, we do not have the palatoglossus muscle, which is a muscle that we name when we talk about the palate but Since I don't know if you've seen a video on the palate, I'm going to name it for you, that palatoglossus originates at the level of the soft palate at the level of the palatine aponeurosis to finally insert into the lateral edge of the tongue, the function is going to be, let's say that there is the same oropharyngeal muscle that is contracted and with them closes both anterior pillars, finally a muscle that is a little difficult to find in the atlas, which is the chondroglossus muscle. Look, this is an image of the sobotta, this would be The hyoglossus, see that we have to cut the hyoglossus to be able to find this fascicle that is the chondroglossus, this fascicle originates from the hyoid bone, specifically the minor until, remember that it is the minor until of the hyoid bone most of the time of life the cartilage does not It means until when people are older and that is why it is called chondrus which means cartilage and glossed because it reaches towards the back of the tongue of course it is drawn cortico that does not reach the back but the theory says that this chondroglossus reaches towards the back of the tongue, look at this image, what we see more or less, we see in white, it is more or less so that you can see what that lingual septum is, these fibers would be the upper longitudinal one and all these points are the transverse ones and the vertical one very well in this previous vision and I already showed them to you a while ago to show the intrinsic ones but I'll take the opportunity here to let you see this would be your styloglossus as it reaches the lateral edges of the tongue and see up here, sorry this is the hyoglossus See how the lateral edge of the tongue reaches the hyoid bone and the styloglossus that is cut here. Also see that it is looking for the lateral edge of the tongue.
Very well, to finish, we are going to talk about the irrigation of the venous drainage and the innervation. First, the irrigation comes from a branch of the external carotid called the lingual artery. This lingual artery will in turn give dorsal branches, which are several dorsal arteries of the tongue and an artery that you grab in the back anterior called deep artery of the tongue also called ranine artery, then the reverse venous drainage will end up draining the lingual veins.
This lingual vein is formed by the union of dorsal veins of the tongue and by the deep vein of the tongue that passes to This lingual vein generally drains together with the facial vein and after it forms a trunk called the lingofacial trunk. Sometimes, in addition to receiving the facial vein, it also receives the superior thyroid vein and forms the thyrolingofacial trunk indistinctly, and it drains alone and drains with the facial vein or together with the native bird superior idea in the end that trunk will reach the internal jugular vein of the blood of the tongue ends up reaching the internal jugular vein by part of the innervation well the tongue is a very rich structure innervation and It is convenient to study it because the innervation is going to be motor and it is going to be sensitive. Note, the motor one is a little easier because all the really extrinsic muscles of the tongue are innervated by the hypoglossal nerve , which is the twelfth cranial nerve, the only one of them that It is not innervated, learn it hypoglossus is precisely the palatoglossus muscle, what is this one that you see here because that palatoglossus is innervated by the pharyngeal plexus, that pharyngeal plexus has branches from the vagus but mainly the branches are from the eleventh cranial nerve, which is the accessory or spinal nerve as well as it also receives little input from the glossopharyngeal, so you already know the dense irrigation, sorry innervation that it has motorally, that is, it moves the palatoglossus muscle, with respect to the sensory innervation it is going to be of two types and I will explain one thing to you: the sensitivity of the tongue that we can feel hot feel cold and another thing is the gustatory sensitivity which is that of us being able to perceive flavors thanks to the papillae then the anterior two thirds of the tongue which is what corresponds to let's say the oral region of the back goes to be sensitively innervated by the lingual nerve, which is the one here, by the way, the lingual nerve is a branch of the lower maxillary nerve, which in turn is a branch of the trigeminal nerve, which is why I put it v3 because it is the third branch of the fifth cranial nerve.
which is the trigeminal, that is the part of sensitivity to touch or painful sensitivity, hot cold sensitivity; Now the gustatory part of those anterior two-thirds is ensured by a branch of the facial nerve called the chorda tympani nerve, so that chorda tympani nerve called the seventh cranial nerve is what gives gustatory sensitivity to the anterior two-thirds of the tongue from From the point of view of the posterior third of the tongue, you remember that they were more or less the pharynx portion of the dorsum of the tongue. We are going to see that the sensory and gustatory innervation is given by the glossopharyngeal, which gives a branch of the tongue as well as the branch of the facial nerve. of a lingual branch that serves for the innervation of taste to that posterior third and finally the vagus nerve through the internal branch of the superior laryngeal nerve also gives sensory and gustatory innervation to that posterior third of the tongue, however, most of the innervation The sensory and gustatory function of the posterior third of the tongue is given by the first one I name them, which is the glossopharyngeal nerve or ninth cranial nerve.
See it in this image here. The anterior two thirds of these transverse fibers correspond to the trigeminal nerve through the lingual nerve. sensitive, what you see in green a little further over there is the innervation that it gives to the facial through the chorda tympani, as I mentioned just now, in the anterior two thirds, see that the posterior third has fibers from the vagus, which are the oranges that They are oblique although that vagus through the superior laryngeal nerve and blue branches that come from the glossopharyngeal through the lingual branch of the glossopharyngeal, of course in this image they did not draw the branch that gives the facial also so that I explained that the facial also gives a branch that helps the gustatory part of the posterior third, finally to the lymphatic drainage of the tongue, it is important to study it because it drains to superficial cervical nodes such as these here is the submental and here what I pointed out to you is the submaxilla and this is The sub mental is here and it also has direct drainage into the deep cervical nodes such as the jugulomohyoid ganglion, well no, this is the jugulodigastric, excuse me, and this one that is further down, which is the jugulomohyoid ganglion, it is important to know because in tongue carcinoma, these are the most frequent sites of lymphatic metastases, they pass through these nodes.
