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`NAME: Asita Onisodueniya Matno: 17/MHS01/066 COURSE TITLE: Gross Anatomy of the Head and Neck Course Code: ANA 301

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`NAME: Asita Onisodueniya Matno: 17/MHS01/066 COURSE TITLE: Gross Anatomy of the Head and Neck Course Code: ANA 301 `NAME: Asita Onisodueniya MatNO: 17/MHS01/066 COURSE TITLE: Gross Anatomy of the Head and Neck Course Code: ANA 301 Assignment 1. Discuss the anatomy of the tongue and comment on its applied anatomy 2. Write an essay on the air sinuses ANSWER 1 THE GROSS ANATOMY OF THE TONGUE INTRODUCTION The tongue is a muscular organ in the mouth. The tongue is covered with moist, pink tissue called mucosa. Tiny bumps called papillae give the tongue its rough texture. Thousands of taste buds cover the surfaces of the papillae. Taste buds are collections of nerve-like cells that connect to nerves running into the brain. The tongue is anchored to the mouth by webs of tough tissue and mucosa. The tether holding down the front of the tongue is called the frenum. In the back of the mouth, the tongue is anchored into the hyoid bone. The tongue is vital for chewing and swallowing food, as well as for speech. The four common tastes are sweet, sour, bitter, and salty. A fifth taste, called umami, results from tasting glutamate (present in MSG). The tongue has many nerves that help detect and transmit taste signals to the brain. Because of this, all parts of the tongue can detect these four common tastes. FUNCTIONS 1. It aids mastication and deglutition. 2. The tongue is an integral component of the speech pathway, as it helps with articulation. The intrinsic muscles of the tongue enable the shaping of the tongue which facilitates speech. 3. It facilitates the perception of gustatory stimuli. The taste buds on the dorsal surface of the tongue have taste buds which have receptors cells for detecting taste. Parts; the tongue has 3 parts, the apex/tip, the body and the base. Surface; the tongue has a Dorsal (superior) and ventral (inferior) surface. Relation; 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 LINGUAL PAPILLAE There are four types of lingual papillae found on the surface of the human tongue. These include: Filiform papillae are the most abundant of the four types of papillae. They are stretched, conical, grey-white papillae that are covered in a heavy coat of keratinized squamous epithelium. By making the dorsal surface of the tongue rough, these papillae provide friction to allow movement of the food bolus during chewing. It should be noted that these papillae do not possess taste buds. Fungiform papillae are weakly keratinized and less abundant than the filiform papillae. However, they are scattered across the entire dorsal surface of the tongue. These highly vascular, mushroom-shaped papillae contain a few taste buds on the apical aspect. Foliate papillae appear as bilaterally paired, parallel, longitudinal slits on the posterolateral margin of the tongue, near the sulcus terminalis. The mucosa is non-keratinized and the papillae are populated with numerous taste buds. Circumvallate (Vallate) papillae are organized linearly, as a set of four to six large papillae anterior to each limb of the sulcus terminalis (i.e. eight to twelve papillae in total). In longitudinal section, the characteristic furrow found within the papillae can be appreciated. These moats facilitate the drainage of serous salivary von Ebner glands that empty into the structure. The persistent lubrication creates a favorable environment for gustatory particles to dissolve so that they can be detected by the taste buds. TASTE BUDS While taste buds are distributed throughout the entire oral cavity, they are at higher concentrations on the tongue. Each taste bud is clear, oval and covered by stratified squamous epithelium. Taste buds consist of 3 cell types; Elongated taste (gustatory) cells Sustentacular/ supportive cells Basal stem cell The gustatory cells have an apical taste pore surrounded by numerous microvilli that binds dissolved molecules and brings them closer to the receptors responsible for taste. However, these cells have a relatively high turnover rate, as their shelf life is roughly seven to ten days. MUSCLES OF THE TONGUE The muscles of the tongue are classified as either Intrinsic or Extrinsic. Intrinsic Muscles The intrinsic muscles only attach to other structures in the tongue. There are four paired intrinsic muscles of the tongue and they are named by the direction in which they travel: the superior longitudinal, inferior longitudinal, transverse and vertical muscles of the tongue. These muscles affect the shape and size of the tongue – for example, in tongue rolling – and have a role in facilitating speech, eating and swallowing. Extrinsic Muscles These are muscles that extend outside of the tongue to anchor it to surrounding bony structures. There are 4 extrinsic muscles of the tongue, they are; Genioglossus Attachments: Arises from the mandibular symphsis. Inserts into the body of the hyoid bone and the entire length of the tongue. Function: Inferior fibres protrude the tongue, middle fibres depress the tongue, and superior fibres draw the tip back and down Innervation: Motor innervation via the hypoglossal nerve (CNXII). Hyoglossus Attachments: Arises from the hyoid bone and inserts into the side of the tongue Function: Depresses and retracts the tongue Innervation: Motor innervation via the hypoglossal nerve (CNXII). Styloglossus Attachments: Originates at the styloid process of the temporal bone and inserts into the side of the tongue Function: Retracts and elevates the tongue Innervation: Motor innervation via the hypoglossal nerve (CNXII). Palatoglossus Attachments: Arises from the palatine aponeurosis and inserts broadly across the tongue Function: Elevates the posterior aspect of the tongue Innervation: Motor innervation via the vagus nerve (CNX). All of the intrinsic and extrinsic muscles are innervated by the hypoglossal nerve (CN XII), except palatoglossus, which has vagal innervation (CN X). BLOOD SUPPLY Arterial supply The blood supply to the tongue is provided by the lingual artery (a branch of the external carotid artery) and its branches. The branches of the lingual artery are; The dorsal lingual artery; supplies the dorsum of the tongue The sublingual artery; supplies the sublingual gland The lingual artery terminates at the tip of the tongue as the deep lingual artery. The tonsilar artery also aids blood supply to the tongue Venous supply The veins of the tongue are named similarly to the arteries that they accompany. They are formed from numerous venous tributaries that eventually coalesce. As the deep lingual vein forms adjacent to the apex of the tongue, it courses along the ventral surface of the tongue (deep to the mucosa). As the deep lingual vein anastomosis with the sublingual vein, they become the vena comitans of CN XII. This venous network eventually drains to the lingual vein that later join the facial or the anterior division of the retromandibular veins. Here, they form the common facial vein, which is a tributary to the internal jugular vein. Alternatively, the venae comitantes may drain directly to the internal jugular vein. The dorsal lingual veins are responsible for draining the lateral margins and dorsal surface of the tongue. They travel alongside the similarly named artery as they drain into the internal jugular vein. INNERVATION In the anterior 2/3, general sensation is supplied by the trigeminal nerve (CNV). Specifically the lingual nerve, a branch of the mandibular nerve (CN V3). On the other hand, taste in the anterior 2/3 is supplied from the facial nerve (CNVII). In the petrous part of the temporal bone, the facial nerve gives off three branches, one of which is chorda tympani. This travels through the middle ear, and continues on to the tongue. The posterior 1/3 of the tongue is slightly easier. Both touch and taste are supplied by the glossopharyngeal nerve. LYMPHATICS The lymphatic drainage of the tongue is as follows: Anterior two thirds – initially into the submental and submandibular nodes, which empty into the deep cervical lymph nodes Posterior third – directly into the deep cervical lymph nodes. APPLIED ANATOMY Pierre Robin Syndrome; This is pharyngeal arch defect, causes glossoptosis among other symptoms. This particular defect causes the tongue to be displaced posteriorly and may cause airway obstruction or apnea Thrush (candidiasis): Candida albicans (a yeast) grows over the surface of the mouth and tongue. Thrush can occur in almost anyone, but it occurs more often in people taking steroids or with suppressed immune systems, the very young, and the elderly. Oral cancer: A growth or ulcer appears on the tongue and grows steadily. Oral cancer is more common in people who smoke and/or drink alcohol heavily. Macroglossia (big tongue): This can be broken down into various categories based on the cause. These include congenital, inflammatory, traumatic, cancerous, and metabolic causes. Thyroid disease, lymphangiomas, and congenital abnormalities are among some of the causes of an enlarged tongue. Geographic tongue: Ridges and colored spots migrate over the surface of the tongue, periodically changing its appearance. Geographic tongue is a harmless condition. Burning mouth/burning tongue syndrome: a relatively common problem. The tongue feels burned or scalded, or strange tastes or sensations develop. Apparently harmless, burning mouth syndrome may be caused by a mild nerve problem. Atrophic glossitis (bald tongue): The tongue loses its bumpy texture, becoming smooth. Sometimes this is due to anemia or a B vitamin deficiency. Canker sores (aphthous ulcers): Small, painful ulcers appear periodically on the tongue or mouth. A relatively common condition, the cause of canker sores is unknown; they are unrelated to the cold sores caused by herpes viruses. Canker sores are not contagious. Oral leukoplakia: White patches appear on the tongue that can’t be scraped off. Leukoplakia may be benign, or it can progress to oral cancer. Hairy tongue: Papillae can overgrow the surface of the tongue, giving it a white or black appearance.
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