Tongue Anatomy

  • Musculature of the Tongue:

    • The intrinsic muscles (bilateral superior and inferior longitudinal, transverse, and vertical muscles) interdigitate and have no tissue spaces, which allows invasive cancers to spread easily.

ce507-fig04-intrinsic-tongue-muscles

H8rDTg2yQrkuDKTAMNqhg_the-muscles-of-the-tongue_english

  • On the other hand, infiltration of the extrinsic muscles of the tongue (genioglossus, hyoglossus, styloglossus, and palatoglossus) is a feature of locally advanced cancer.

extrinsic

  • The arterial supply to the tongue and floor of the mouth is from the:.

    • Dorsal lingual, sublingual, and deep lingual branches of the lingual artery.

  • The venous drainage of the tongue is into the lingual veins:

    • Which drain into the facial and retromandibular veins:

      • Which join to form the common facial vein.

    • Vasculature Tongue:

      • Similar to most of the head and neck region, the tongue derives its arterial blood supply from the external carotid artery.

      • The lingual artery branches off the external carotid artery deep to the stylohyoid muscle:

        • At first, it travels superomedially; after a short distance, it changes direction and moves anteroinferiorly.

        • The hypoglossal nerve (cranial nerve XII) crosses over it laterally before it enters the tongue deep in the hyoglossus muscle.

      • Within the tongue, the lingual artery gives rise to its three main branches:

        • The dorsal lingual artery:

          • The dorsal lingual artery supplies the base of the tongue

        • The deep lingual artery:

          • The deep lingual artery travels on the lower surface of the tongue to the tip.

        • The sublingual artery:

          • A branch to the sublingual gland and the floor of the mouth is known as the sublingual artery.

Blood-supply-of-tongue

  • The veins of the tongue parallel the lingual artery branches:

    • The deep lingual vein begins at the tip of the tongue and travels posteriorly to join the sublingual vein:

      • This veins drains into the dorsal lingual vein, which accompanies the lingual artery.

    • The dorsal lingual vein drains into the lingual veins:

      • Which drain into the facial and retromandibular veins, which join to form the common facial vein:

        • Directly or indirectly, this vein empties into the internal jugular vein.

veins-of-tongue

  • The hypoglossal nerve provides motor innervations to all muscles of the tongue except the palatoglossus:

    • Which is supplied by the pharyngeal plexus.

  • The lingual nerve is the sensory nerve to the anterior two thirds of the tongue, the floor of the mouth, and the lower gum, while taste sensation is carried along the chorda tympani branch of the facial nerve.

Hypoglossal-and-accessory-nerve-1

Rodrigo Arrangoiz MS, MD, FACS a head and neck surgeon and is a member of Mount Sinai Medical Center.

prof_739_20190417135234

He is first author on some publications on oral cavity cancer:

Training:

• General surgery:

• Michigan State University:

• 2004 al 2010

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• Fox Chase Cancer Center (Filadelfia):

• 2010 al 2012

• Masters in Science (Clinical research for health professionals):

• Drexel University (Filadelfia):

• 2010 al 2012

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• IFHNOS / Memorial Sloan Kettering Cancer Center:

• 2014 al 2016

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