no 



APPLIED ANATOMY. 



Mucous cysts can occur from the mucous glands of the mouth and tongue itselt. 

 There is a gland on the under side of the tip of the tongue, usually larger than the 

 others, called the anterior lingual gland or gland of Nuhn. As a rule, these mucous 

 cysts are small and are felt as hard rounded bodies beneath the mucous membrane. 

 Dermoid cysts occur in connection with the tongue but very rarely. 



Carcinoma of the tongue is a moderately frequent disease and as the tongue is 

 covered by modified skin, the cancer is of epithelial type. It begins on the surface 

 of the tongue either by a change in the epithelial covering or else in fissures or ulcers 

 at its edges. 



The lymphatics of the tongue pass to the submaxillary nodes beneath the jaw 

 and thence to the deep cervical nodes along the great vessels or directly to the latter 

 without passing through the submaxillary nodes. If the disease exists for any length 

 of time, these are the nodes that become infected. They are only to be reached by 

 an incision in the neck. 



The arteries of the tongue are the lingual and its branches, the hyoid, the 

 dorsalis lingua, sublingual, and ranine. In removing the tongue, the lingual 



Anterior lingual gland 



Ranine artery 



a Lingual nerve 



Orifice of submaxillary 

 and sublingual glands 



- Sublingual gland 



FIG. 137. Under surface of the tongue, mucous membrane removed. 



artery on the side to be removed is sometimes ligated in the neck; this cuts off the 

 blood supply to that side and there is practically no bleeding. There is very little 

 anastomosis between the vessels of the two sides of the tongue. The arteries run 

 lengthwise through the tongue, so that in glossitis or inflammatory swelling of the 

 tongue, incisions should always be made longitudinally into it. 



The ligation of the lingual artery will be found described in the section on the 

 neck. As the lingual artery passes above the hyoid bone, it gives off its first branch, 

 the hyoid. It is quite small and goes above the hyoid bone superficial to the hyo- 

 glossus muscle. The lingual then goes beneath the hyoglossus muscle and near the 

 posterior edge gives off its second branch or dorsalis lingu/z. 



In excision, the tongue is usually cut through on the distal side of the dorsalis 

 linguae artery. When this is the case, the bleeding which occurs from the branches 

 of the dorsalis linguae is not marked because it is not a large artery. 



In order to draw the tongue out, it must be loosened posteriorly by cutting the 

 anterior pillars of the fauces and palatoglossus muscle, and anteriorly at the fraenum 

 by cutting the geniohyoglossus muscle. By drawing the tongue up, the ranine artery 



