Tongue Lateral Movement: Which Muscle Is Responsible?

The human tongue is a muscular organ that is formed by a complex arrangement of intrinsic and extrinsic muscles. The four intrinsic muscles alter the shape of the tongue and are not attached to bone. The four extrinsic muscles, on the other hand, change the position of the tongue and are anchored to bone. One of these extrinsic muscles, the styloglossus muscle, is responsible for retruding the tongue and elevating its lateral margins. Another extrinsic muscle, the hyoglossus muscle, is located in the floor of the oral cavity and is responsible for retruding and depressing the tongue.

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The styloglossus muscle

The styloglossus originates at the styloid process of the temporal bone, near its apex, and from the stylomandibular ligament. It inserts onto the side of the tongue. The muscle is innervated by the hypoglossal nerve (cranial nerve XII), which carries general somatic efferent motor fibres to innervate all intrinsic and most extrinsic muscles of the tongue. The hypoglossal nerve has an estimated 8000-9000 motor neurons and is motor to the muscles of the tongue. The styloglossus is also associated with the soft palate and is therefore innervated by the vagus nerve.

The function of the styloglossus muscle is to elevate and retract the tongue, drawing up the sides to create a trough for swallowing. The contraction of the styloglossus results in the retrusion of the tongue, and it also elevates the tongue's lateral margin. When both styloglossus muscles contract simultaneously, they aid in retracting the tongue. The muscle is involved in functions such as speaking, swallowing, chewing, and buccal cleaning.

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The hyoglossus muscle

The tongue is a muscular organ that is formed by a complex arrangement of intrinsic and extrinsic muscles. The intrinsic muscles change the shape of the tongue, while the extrinsic muscles are responsible for moving it in different directions. One such extrinsic muscle is the hyoglossus muscle.

The hyoglossus is a thin and quadrilateral extrinsic muscle of the tongue. It originates from the hyoid bone and inserts onto the side of the tongue. It is innervated by the hypoglossal nerve (cranial nerve XII), which has an estimated 8,000-9,000 motor neurons. The hypoglossal nerve innervates three of the four extrinsic muscles: the genioglossus, styloglossus, and hyoglossus, as well as all four intrinsic muscles. The hyoglossus muscle acts to depress and retract the tongue, making the dorsum more convex. It forms a part of the floor of the submandibular triangle.

The fibres of the hyoglossus muscle pass almost vertically upward to enter the side of the tongue, inserting between the styloglossus and the inferior longitudinal muscle of the tongue. The styloglossus muscle retrudes the tongue and elevates its lateral margins. The styloglossus is a thin, paired muscle located on either side of the oropharynx. It originates from the styloid process of the temporal bone and inserts onto the lateral aspect of the tongue.

Several important structures lie laterally between the hyoglossus muscle and the mylohyoid muscle, including the sublingual gland, submandibular duct, lingual nerve, vena comitans of the hypoglossal nerve, and the hypoglossal nerve itself.

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The genioglossus muscle

The genioglossus is a paired tongue muscle that is part of the group of extrinsic muscles of the tongue. It is the largest intrinsic tongue muscle. The other extrinsic muscles of the tongue are the hyoglossus, styloglossus, and palatoglossus. All of these extrinsic muscles are within close proximity to one another, and so the entire group of extrinsic muscles usually functions as a unit.

The muscle also responds to airway occlusive stimuli by increasing its activity. It has been considered a major contributor to airway function and dysfunction in OSA. The genioglossus is spontaneously active during wakefulness, and this activity is greater during inspiration than expiration. At the onset of sleep, its inspiratory and expiratory activity rapidly declines, which occurs in both healthy individuals and patients with OSA.

The genioglossus is often used as a proxy to test the function of the hypoglossal nerve, by asking a patient to stick out their tongue. Peripheral damage to the hypoglossal nerve can result in deviation of the tongue to the damaged side.

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The palatoglossus muscle

The muscle also has clinical significance. For example, in cases of OSA (obstructive sleep apnea), the palatoglossus muscle's activity is important in pathogenesis. The decreased tone of the palatoglossus muscle during sleep contributes to increased upper airway resistance and decreased airway space.

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Intrinsic and extrinsic muscles

The tongue is a muscular organ composed of two main muscle groups: the intrinsic and extrinsic muscles. Each half of the tongue contains four intrinsic and four extrinsic muscles.

The intrinsic muscles originate and attach to other structures within the tongue. They are named based on the direction in which they travel: the superior longitudinal, inferior longitudinal, transverse, and vertical muscles of the tongue. These muscles affect the shape and size of the tongue, such as in tongue rolling, and play a role in facilitating speech, eating, and swallowing. The motor innervation to the intrinsic muscles of the tongue is via the hypoglossal nerve (CN XII).

The extrinsic muscles, on the other hand, originate from structures outside the tongue and insert into it. They are responsible for moving the tongue in different directions and also altering its shape. The four extrinsic muscles are the genioglossus, styloglossus, palatoglossus, and hyoglossus muscles. The genioglossus muscle is involved in the depression of the tongue body, ventroflexion, and retrusion of the tongue tip. The styloglossus muscle arises from the styloid process and stylomandibular ligament, and its contraction results in retrusion of the tongue and elevation of its lateral margins. The palatoglossus muscle elevates the posterior tongue, closes the oropharyngeal isthmus, initiates swallowing, and prevents the spill of saliva from the vestibule into the oropharynx. The hyoglossus muscle is located in the floor of the oral cavity, and it causes depression and retraction of the tongue.

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