Sense organ: gustatory organ(clinical oriented)

dr. Santosa Budiharjo, MKes., PA(K)

Lingua• Lingua berpangkal pada

dasar mulut bagian occipital

• Terdiri otot, dilapisi tunica mucosa

• Dibedakan: apex, dorsum, radix

• Sulcus terminalis, foramen cecum, 1/3 posterior, 2/3 anterior

• Mukosa: papilla lingualis: circumvalata, fungiformis, foliata, filliformis, lenticularis

• Otot extrinsik (longitudinal sup-or & inf-or, transversus, verticalis)& ekstrinsik (palatoglossus, hyoglossus, styloglossus, genioglossus, innervasi: n. hypoglossus, kecuali m. palatoglossus))

Papilla linguales• Papillae foliate berbentuk lembaran daun terdapat

di bagian posterior mendekati margo lingualis. • Papillae Conicae atau papillae filiformis berbentuk

conus bila lebih besar dan • Papilla filiform : papilla kecil, menyerupai jari

dijumpai pada dataran anterior dorsum linguae.• Papilla fungiformes berbentuk cendawan terdapat

pada apex dan sisi lateral lingua. • Papilla lenticularis terdapat di dorsal sulcus

terminalis.

• Distribution and Innervation of Taste Buds Taste buds are located on different types of taste papillae found on the tongue, palate, pharynx, and larynx.

• Types of taste papillae include fungiform and foliate papillae on the anterior and lateral aspects of the tongue and circumvallate papillae on the base of the tongue

• The latter may contain several hundred taste buds. • The tongue in humans may have several thousand taste buds. • The sensitivity of different regions of the tongue for different taste qualities varies only

slightly because taste buds responding to each type of flavor are widely distributed. • The taste buds are innervated by three cranial nerves. • The chorda tympani branch of the facial nerve (CN VII) supplies taste buds on the anterior

two thirds of the tongue, and the glossopharyngeal nerve (CN IX) supplies taste buds on the posterior third of the tongue . The vagus nerve (CN X) supplies a few taste buds in the larynx and upper esophagus.

n. facialis

• Paralysis of the facial nerve causes face drop. • This is more marked with a lower motor neurone

(LMN) lesion than an upper motor neurone (UMN) lesion.

• The best way to differentiate between the two is to test the muscles of the forehead.

• They have bilateral innervation at the upper motor neurone level and so, in a UMN lesion such as a pseudobulbar palsy, they are spared.

• An LMN lesion such as Bell's palsy will involve the forehead.

Homunculus sensoric

Innervasi motorik

photos of Hypoglossal Nerve Palsy affecting the left side of the tongue

• finer control is demonstrated by the ability to say "la" and "ta"

• tongue movements to command - from side to side etc the side of the tongue that is palsied deviates towards the side of the lesion

n.hypoglossus• The Hypoglossal Nerve supplies

motor fibres to all of the muscles of the tongue (ie there is no sensory function) except the Palatoglossus muscle, which is innervated by the Vagus Nerve (Cranial Nerve 10 / CN X) or according to some classifications, by fibres from the Glossopharyngeal Nerve (Cranial Nerve 9 / CN

IX) that "hitchhike" within the Vagus.

• Weakness of the tongue manifests itself as a slurring of speech & by ‘wasting’ of the side of the tongue which has the palsy.

The patient complains that their tongue feels "thick", "heavy" or "clumsy”. Lingual sounds (i.e., l's, t's, d's, n's, r's etc) are slurred and this is obvious in conversation even before direct examination.

UMN vs LMN• If the tongue deviates to one

side when protruded, this suggests a hypoglossal nerve lesion.

• If it is an LMN lesion, the protruded tongue will deviate towards the side of the lesion.

• With an upper motor neurone (UMN) lesion, the tongue will deviate away from the side of the lesion.

• Tractus corticobulbar – menyilang di linea mediana

• Nukleus N. XII khusus m. genioglossus mendapat dari UMN kontralateral (hemisferium lain pihak), dan n XII kiri menginervasi otot kiri (ipsilateral)

• Dysgeusia is the medical term for an altered, distorted or reduced ability to taste.

• Egeusia = can not able to taste• Specific types of taste disorders include

hypogeusia

Glositis: geographic, migratory, median rhomboid,

labiopalatognathoschiziz

sialolithiasis