Neurovasculature of the tongue
After completing this study unit, you will be able to:
1. Understand the motor and sensory innervation of the tongue.
2. Name the nerves responsible for the innervation of each part of the tongue.
3. Describe the arterial supply and venous drainage of the tongue.
The tongue receives both motor and sensory innervation. Motor innervation mainly stems from the hypoglossal nerve (CN XII), which innervates most of the muscles of the tongue. The only exception is the palatoglossus muscle, which is supplied by the pharyngeal plexus, originating from the vagus nerve (CN X). Sensory innervation of the tongue consists of general (touch and temperature) and special (taste) sensory innervation. The posterior third of the tongue and the vallate papillae receive both general and special sensory innervation from the glossopharyngeal nerve (CN IX), more specifically from its lingual branch. The anterior two-thirds of the tongue receives double innervation. The general sensory innervation is supplied by the lingual nerve, a branch of the mandibular nerve (CN V3). Meanwhile, the special sensory innervation is supplied by the chorda tympani, a branch of the facial nerve (CN VII).
The arterial supply of the tongue comes primarily from the lingual artery, a branch of the external carotid artery. The lingual artery gives off 3 branches for the tongue: dorsal lingual artery, deep lingual artery and sublingual artery. These arteries are accompanied by their corresponding veins of the same names, which drain into the vena comitans of hypoglossal nerve and later into the internal jugular vein.
Watch the video below for a comprehensive explanation of the neurovasculature of the tongue.
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Motor innervation: Hypoglossal nerve (CN XII) innervates all except palatoglossus muscle (pharyngeal plexus from vagus nerve, CN X)
Sensory and parasympathetic innervation:
- Anterior ⅔: lingual nerve for general sensory (branch of mandibular nerve V3) and chorda tympani nerve for special sensory (branch of facial nerve, CN VII)
- Posterior ⅓ and vallate papillae: glossopharyngeal nerve (CN IX)
Lingual artery and its branches:
- Dorsal lingual artery: Supplies the root of tongue
- Deep lingual artery: Supplies the body of tongue
- Sublingual artery: Supplies the floor of the oral cavity and sublingual glands
Dorsal lingual vein: Drains the root of tongue → lingual vein → internal jugular vein (IJV)
Deep lingual vein: Drains the body of tongue → lingual vein → IJV
Sublingual veins: Drain the floor of oral cavity and sublingual glands to vena comitans of hypoglossal nerve → lingual vein → IJV