Introduction:
The tongue is a muscle organ related to the function of gang, taste and vocalization. It acts as an easily accessible organ for the assessment of individual health and indicates the state of hydration of the body. The tongue is a mirror of the gastrointestinal system, it is said that the abnormal function of the stomach and intestines is reflected on the tongue.
Some characteristic changes occur in the tongue, a certain disease. Therefore, the examination of the tongue is very important, it becomes a clue for diagnosis. All doctors examine the tongue and consider ect changes in teat size, shape, color, moisture, coating, nature and movement.
The appearance of the tongue in several abnormal situations: -
1) Tongue movement: -
a) The tongue of the unilateral paralysis (hemiplegia) of the body moves towards the side that was localized when it protrudes.
b) Tongue shaking is seen in diseases like thyrotoxicosis, delirium tremens and parkinsonisum. Tremor is also seen in nerve patients.
c) In progressive bulbar paralysis, there is tongue fatigue and paralysis accompanied by fibrillation. Eventually the tongue is supple and it is not functional on the floor of the mouth. This condition is related to saliva dribbling and loss of remark.
d) Patients with chorea (involuntary rhythm movement) may not be able to keep a protruding tongue at rest, but it moves unconsciously.
2) Tongue moisture: -
The moist feeling of the tongue gives some indication about the state of hydration of the body. Depletion of the water volume results in peripheral circulation failure characterized by weakness, thirst, restlessness, anorexia, nausea, vomiting, dry and parched tongue.
Drying of the tongue can be seen under the following conditions.
a) diarrhea
b) stage after severe illness
c) Advanced uraemia
d) Hypovolemic shock
e) Thermal fatigue
f) hyponatremia
g) Acute bowel obstruction
h) Hunger
i) Prlonged fasting.
3) Changes in tongue color: -
a) Central cyanotic: -
Cyanosis is a bluish discoloration of the mucous membrane due to a decrease in the amount of oxygen in the blood. This is seen in heart failure, respiratory failure and anoxia. With cyanotic tongue, ect of lips becomes bluish and thin.
b) Jaundice: -
This is a yellowish discoloration of all the mucous surfaces (including the tongue) of the body due to increased bilirubin in the blood. Hepatitis is observed due to hepatitis, bile duct obstruction, increased destruction of Rbc, etc. .
c) Advanced uremia: -
This is an increase in blood urea and other nitrogenous waste due to renal failure. Here, the color of the tongue turns brown.
d) Ketoacidosis: -
This is acidosis with accumulation of ketone bodies, which is mainly found in diabetes mellitus. Here, the tongue turns brown and the typical ketone smell comes out of the mouth.
e) Riboflavin deficiency: -
The deficiency of this vitamin (vitamin B2) is the color of the tongue with lips pain and cracks.
f) Lack of niacin: -
The deficiency of niacin (vitamin B3) and some other complex b vitamins result in bright crimson or beefy red tongue.
g) Anemia: -
That is a decrease in the percentage of blood hemoglobin. In severe anemia the tongue becomes thin.
4) Tongue coating: -
a) halitosis: -
The main cause of bad breath is breeding thousands of anaerobic bacteria and forming harmful gas by forming a pasty coating (biofilm) on the tongue. Those who complain about bad breath may have a thick coating at the back of the tongue.
b) typhoid fever: -
In typhoid fever, the tongue turns white like fur.
c) candidiasis; -
It is a fungal infection that affects the surface of mucus in the body. There is a white lesion on the tongue.
d) In white diabetes and low adrenalism, white lesions are dropped.
e) Secondary syphilis: -
Syphilis is a sexually transmitted disease caused by Syphilis trepenoma infection. In the secondary stage of this disease, you can see the mucous patch which is a painless, smooth white glystening milk vitiligo that can not be easily scraped off.
f) Leokoplakia: -
Here, a white horn-like patch is seen in the tongue and oral cavity. This is a precancerous condition.
g) AIDS: -
Hairy leukoplakia is seen in these patients.
h) Peritonitis: -
In this state, there is a white fur of the tongue.
i) Acute diseases: -
Furring is also seen in some severe illness.
5) Papilla: -
These are small projections related to taste. There are different types of teats on healthy tongue. In some diseases, there are several abnormal changes as follows.
A) Hairy tongue: -
This condition is due to poor verbal hygeine, general debilitation and filamentous papilla extension seen in dyspepsia.
b) Geographical tongue: -
Here irregular red and white patches appear on the tongue. These lesions look like geographical maps. The cause is unknown.
c) median value of diamond glossitis: -
In this state, there is a smooth nodular red region at the midline behind the tongue. This is a congenital condition.
d) Nutritional deficiency: -
There is glossitis (ignition of the tongue) which causes papillary hypertrophy which is preceded by atrophy in malnutrition deficiency.
e) Benign Migratory glossitis: -
This is the inflamatory state of the tongue where multiple annular areas of papilla desquamation appear on the tongue shifted from area to area in a few days.
f) Thiamine and riboflavin deficiency: -
These vitamin deficiencies cause enlarged filamentous and fungal papillae.
g) Niacin and iron deficiency: -
In this state, there is atrophy of the nipple. Iron deficiency has a smooth tongue.
h) Vitamin a deficiency: -
This causes the groove tongue.
i) trophic megaloblastic anemia smooth tongue.
j) Folate deficiency: -
Here, huge megaloblastic anemia with glossitis is seen.
k) Cyanocoblamine deficiency: -
Here, macrocytic megaloblastic anemia and glossitis accompanied by peripheral neuropathy are encountered.
l) scarlet fever; -
In this streptococcal infection, there is a bright red papilla standing outside the thick white fur, after which the white coat disappears leaving the enlarged papilla on the bright red surface and strawberry tongue
6) Tongue ulcer: -
a) Aphthous ulcer: -
These circulatory ulcers emphasize individuals. It may be related to food allergies. The usual places are tongue, lips, oral mucosa and ect.
b) herpes simplex: -
This is an acute bullous rash produced by herpes simplex virus. When these vesicles rupture, it forms ulcers.
c) Ulcer in cancer: -
Cancerous ulcers have an everted edge with a solid foundation. Bleeding can also be seen. Tongue cancer is common in cigarette tubers.
d) Syphilitic ulcer: -
The split of syphilis is the longitudinal direction. In primary syphilis, an extra reproductive pancreas is seen in the tongue. Secondary syphilis and numerous shallow ulcers are seen on the surface and side of the lower tongue. In tertiary syphilis, sesame may be seen in the midline of the back of the tongue.
e) Dental ulcer: -
These ulcers are produced by sharp edges of decayed teeth.
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