What Is the Posterior Tongue?

Tongue: Commonly known as "tongue". At the bottom of the mouth. The human tongue is an important organ for eating and speaking. The muscular organs that move in the mouth have a special sense of taste, which helps chew, swallow, and pronounce. It is closely related to the function of the heart. Observing the change of tongue color, quality, shape and tongue coating is one of the important contents of TCM observation.

Chinese name: tongue
Foreign name: tongue

Pinyin: she
Types of: Human organs
Function: Taste

Tongue overview

Anatomy of the organ of the same name. Also known as Ling Gen, Xin Qiao. Located in the mouth. Inside should be in the heart, Secretary taste. It is closely related to swallowing and pronunciation. "Lingshu · Pulse": "Heart qi flows through the tongue, and the heart can understand the five flavors". "Lingshu · Sadness and Speechlessness": "The person with the tongue also has the opportunity to sound." The root of the tongue is called the tongue; the tip of the tongue is called the tip of the tongue; the sides of the tongue are called the tongue; the tendons at the base of the tongue are called the tongue; the middle of the tongue is called the tongue. Observing the color, quality, morphology, and tongue coating of the tongue is one of the important contents of TCM visits.

Tongue diagnosis: a diagnostic term. It is one of the key contents of the inspection. An important objective indicator of TCM diagnosis of diseases. The tongue is the seedling of the heart, outside the spleen, the moss is born of stomach qi. The viscera is connected to the tongue through the meridians, the tongue of the hand Shaoyin is the tongue, the vein of the foot Shaoyin is the tongue, the vein of the foot Jueyin is the tongue, the vein of the foot Taiyin is connected to the tongue, and the tongue is scattered. It can be reflected on the quality of the tongue and the tongue coating. The tongue diagnosis mainly examines the shape, color, and dryness of the tongue and tongue coating to judge the nature of the disease, the depth of the disease, the rise and fall of qi and blood, the profit and loss of body fluid, and the viscera. False and real. Cao Bingzhang's Tongue Distinguishing Guide: "Distinguish the quality of the tongue to identify the viscera and viscera, and the depth of the six sexes can be detected by looking at the tongue coating." Tongue diagnosis should be combined with tongue coating and syndrome differentiation. Generally speaking, the two reflect the same lesions. Yes, but there are also inconsistencies. This requires comprehensive analysis, comprehensive measurement, and reference to other evidence to make correct judgments.

Tongue Anatomy

The tongue, an organ made of skeletal muscles, has a mucous membrane at the bottom of the mouth, covered with mucus, and the muscles in it are lined up in 3 different directions, so they can move flexibly.

The muscular organs in the mouth are covered with mucous membranes, and the bulge is called the back of the tongue. The tongue can be divided into three parts: the base of the tongue, the body and the tip of the tongue. The mucosa on the surface of the tongue has many small nodular bulges called the tongue tonsils. The mucous membrane on the surface of the tongue has many protrusions of varying thickness, which are called tongue papillae. Some tongue papillary epithelium contains taste buds, which can feel the sense of taste. Under normal circumstances, the epithelium has mild keratosis and shedding. Keratinized epithelium and shedding epithelium, saliva, food debris, and exuding white blood cells filling the nipple space constitute a normal thin and white tongue coating. Traditional Chinese medicine often observes tongue coating as a reference for diagnosis. The mucous membrane below the tongue is thin and smooth. The mucous membrane in the center is attached to the bottom of the mouth, which is called the tongue band. Tongue muscles are skeletal muscles, and they are very flexible. They participate in chewing, swallowing, and language assistance.

Tongue and tongue related diseases and their clinical treatment

Tongue cancer: The tongue is prone to malignant tumors, so lymph drainage of the tongue is particularly important. Malignant tumors in the back of the tongue metastasize to the bilateral deep cervical lymph nodes; whereas malignant tumors in the front of the tongue metastasize to the deep cervical lymph nodes in advanced stages. Because these lymph nodes are close to the internal jugular vein, metastatic tumors of the tongue can spread extensively along the internal jugular vein of the neck in the submandibular and submandibular triangles. It is a malignant tumor that occurs in the tongue mucosa. Symptoms often occur in the body of the tongue, mostly squamous cell carcinoma; those that occur in the root of the tongue are mostly related to pre-cancerous lesions of poorly differentiated squamous cells. Occurs on the 1/3 edge of the tongue. It is more common in ulcerous and infiltrating forms. There is infiltration around it, which can cause dyskinesia of the tongue, affecting language, chewing, swallowing, and eating. Cancerous stench. Regional lymph node metastasis is early and the metastasis rate is high. A biopsy confirms the diagnosis. Comprehensive treatment is effective and can be used for radiotherapy, chemotherapy and surgery. Surgical treatment includes partial tongue resection, hemilateral resection, most tongue resection, total tongue resection and combined tongue, jaw, and neck radical resection. Tissue defects can be repaired with pedicled flaps or free flaps.

Essentials of tongue diagnosis

(1) Occurs in 1/3 of the lateral margin of the tongue, with local ulcers or infiltrated masses, and may have spontaneous pain.

(2) Generally, the degree of malignancy is high, the growth is fast, and the infiltration is strong. It often affects the tongue muscles and hypoglossal nerves, causing restricted tongue movements, and difficulty in speaking, eating and swallowing.

(3) More late invasion of the floor of the mouth is difficult to distinguish from those who invade the tongue originally from the cancer of the bottom of the mouth.

(IV) Chronic stimulating factors often exist in the corresponding parts of the tumor, such as residual roots or sharp tooth margins, etc .; precancerous lesions such as white spots may also exist.

(5) Early stage cervical lymph node metastasis often occurs in tongue cancer, which is more common in the upper and deep neck lymph nodes; it can also be a metastatic jump. Distant metastases to the lungs.

(6) Tumor biopsy can confirm pathological properties.

Tongue treatment

(1) For primary tumors with limited, superficial, well-differentiated tumors and small infiltration. Local surgical resection or cryotherapy and laser treatment can be performed; those with large infiltration can be treated with radiotherapy to control the primary lesions before cervical dissection. Advanced tongue cancer or tongue root lesions should be treated with surgery, supplemented with radiotherapy and Chemotherapy.

(B) The cervical lymph nodes should be treated with therapeutic or selective dissection.

(3) If the tongue defect is more than 1/2, the tissue transplantation tongue plasty should be performed.

(4) Chinese medicine treatment:

1. Yuhuo attack: thickening or induration of the tongue, such as beans such as bacteria; or erosion, bursting out of the lotus. The pain was unbearable, the salivation was stinky, the upset was not upset, the amount of yellow urine was small, the fur was yellow, and the pulse count. Governing Law: Qingxin Jianghuo, detoxification and stasis. Recipe: Dao Chi San plus Coptis chinensis, Gardenia jasminoides, Dandelion, Turmeric, Mountain pea root, Caoheche, Fuji pear root.

2. Fire Sheng Yin injury: purple tongue, swelling and pain, fester stinky, inconvenient rotation, obstruction of diet, body heat and thirst, thinning, thick yellow fur, slippery pulse. Governing method: clearing heat and detoxifying, purging fire and nourishing yin and prescriptions: refreshing nectar drink with mountain bean root, mountain aunt, gentian.

3. Loss of Qi and Blood: Shortened tongue, unable to turn, difficult eating, language difficulties, thin body, palpitations, shortness of breath, fatigue or weakness, thin white fur, weak pulse. Governing Law: nourish the heart and spleen, nourish qi and nourish blood. Recipe: Guipi Decoction. Neck swelling and swelling should be added with seaweed and kelp; yin deficiency and heat should be added to the place of birth, Xuanshen and Dendrobium;

Tongue and tongue tumor resection

Applied anatomy: partial tongue resection.

Indications for tongue surgery

1. Benign tumor or tumor-like lesions at the root of the tongue, such as mixed tumors, lymphangiomas, ectopic thyroid glands, etc.

2. Malignant tumor at the base of the tongue, which has a certain distance from the epiglottis, and does not affect the function of the epiglottis after resection.

Preoperative preparation: Ipsilateral tongue resection. Tracheostomy surgery kit.

Anesthesia: Nasal cannula for general anesthesia.

Posture: supine position, shoulder pads, slightly head up.

Tongue surgery steps

For malignant tumors such as squamous cell carcinoma or adenocarcinoma, unilateral or bilateral cervical lymphadenectomy should be performed first according to the specific situation. If the patient can open the mouth and be a benign tumor, when the tongue is pulled out of the oral cavity to reveal the tumor, the tongue can be split from the midline, and the rhombic tumor can be pulled and sutured.

If the tongue cannot be pulled out, or is a malignant tumor, a longitudinal midline incision of the lower lip is required, and the mandible is even sawn in the middle. Before the mandible is cut in the middle, a micro titanium plate is used to fix the mark on the mandible and cut at the midline. The bottom of the opening and the tongue body were completely resected after the exposure, and the tongue body was sutured in layers after reduction; the solid internal fixation was used to fix the midpoint of the mandible; the lower lip incision was sutured in layers at last.

Surgical accident management: Proper suture and hemostasis should be performed in time to prevent respiratory tract obstruction after operation, and preventive tracheotomy should be performed if necessary.

Tongue surgery

1. Nasal feeding tube is inserted after the operation, and the nasal feeding liquid diet is generally maintained for 6 to 8 days. The tube can only be removed after swallowing and eating. It takes 15 to 30 days for a nasal feeding liquid diet for epiglottic resection of the tongue. The tube can only be removed after swallowing the liquid.

2. Keep your mouth clean and perform oral care twice a day. If a pharyngeal fistula occurs, the nasal feeding liquid diet should be delayed until the fistula is closed.

3. Use antibiotics throughout the body to prevent infection.

4. Remove skin and lower lip mucosa suture 6-7 days after operation. The tongue sutures were removed for 10 days, and the tongue sutures were allowed to fall off.

5. If tracheotomy, postoperative treatment is the same as tracheotomy.

Tongue clinical experience

1. If the tumor is located at the base of the tongue, after cutting the midline of the mandible, cut the open mucosa along the medial lower part of the alveolar ridge, back to the anterior pharynx. Pull the tongue to the healthy side to expose the tumor and remove it. When the root resection area is large, it can be repaired with a pedicled flap or a free flap.

2. If the tumor area on one side of the tongue is large, when the lateral wall of the pharynx is involved, the affected mandible can be truncated at the corner of the mandible, the mandibular muscles are pulled forward and backward, and the tongue root and pharynx lesions are completely removed. Both ends of the mandibular osteotomy were fixed and fixed with strong internal fixation.