Inspection: Tongue Coating Flashcards by Jonathan Bench | Brainscape

Q

Tongue Coating
Normal

Description:
Clinical Significance:

A

Description: A normal tongue coating is thin, white and evenly distributed, and moist. It is generated by Stomach Qi.

Clinical Significance:
Distinguish condition of right Qi
Depth of the disease

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Q

Tongue Coating
Normal

How formed?

A

Indication: A normal tongue coating is created by the upward tide of the Spleen and Stomach Yang Qi evaporating and transforming damp turbidity

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Q

What does the tongue coating color indicate?

A

1) Nature and severity of the pathogens (heat/cold)

2) Locations (organs)

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Q

What are the tongue coating color changes?

A

White
Yellow
Gray
Black

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Q

Tongue Coating - Color
White

Description:
Indication:
Location:

A

Tongue Coating - Color
White

Description: Tongue coating color is white in color

Indication:

(1) . Exterior syndrome
(2) . Cold syndrome

Location: Lung and Large Intestine

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Q

Tongue Coating - Color
Yellow

Description:
Indication:
Location:

A

Tongue Coating - Color
Yellow

Description: The tongue coating color is yellow, it may vary from light yellow to dark or brown yellow

Indication:

(1) . Interior syndrome
(2) . Heat syndrome

Location: Spleen and Stomach

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Q

Tongue Coating - Color
Gray

Description:
Indication:
Location:

A

Tongue Coating - Color
Gray

Description: Same as a slightly black coating, it develops from the white or yellow coating.

Indication:

(1) . Heat syndrome: dry and gray
(2) . Cold syndrome: moist and gray

Location:

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Q

Tongue Coating - Color
Black

Description:
Indication:
Location:

A

Tongue Coating - Color
Black

Description: the tongue coating color looks black and usually evolves from gray coating or yellow coating

Indication:

(1) . Extreme heat: Dry and cracked
(2) . Extreme cold: Moist and greasy Black dry or thorn tongue coating
(3) . Recent history of bismuth based medicines for indigestion

Location:

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Q

Tongue Coating - Thickness

Description:

A

The so-called “fur” or thin to thick coating found atop the tongue body proper.

The tongue coating is regarded as thin if the underlying tongue surface shows through faintly, whereas a thick coating is one that blots out the tongue surface completely

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Q

What does the tongue coating thickness indicate?

A

Distinguish condition of right Qi

Depth of the disease

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Q

Physiopathology of Thickness of the Tongue Coating
Little or No Coating

Stomach Qi:
Turbidity:

A

Physiopathology of Thickness of the Tongue Coating
Little or No Coating

Stomach Qi:
Spleen/Stomach impaired; Kidney, Stomach Yin deficient

Turbidity:
Not enough powder or less (or no) turbidity to steam up

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Q

Physiopathology of Thickness of the Tongue Coating
Thin Coating

Stomach Qi:
Turbidity:

A

Physiopathology of Thickness of the Tongue Coating
Thin Coating

Stomach Qi: Right amount

Turbidity: Right amount

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Q

Physiopathology of Thickness of the Tongue Coating
Thick Coating

Stomach Qi:
Turbidity:

A

Physiopathology of Thickness of the Tongue Coating
Thick Coating

Stomach Qi: Spleen/Stomach dysfunction; Dampness; Phlegm; Food stagnation

Turbidity: Too much turbidity steams up

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Q

Physiopathology of Thickness of the Tongue Coating
Thick Coating

Description:
Pathogen:
Location:

A

Physiopathology of Thickness of the Tongue Coating
Thick Coating

Description: Tongue body can not be seen clearly through its coating

Pathogen: Strong

Location: Interior

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Q

Physiopathology of Thickness of the Tongue Coating
Thick Coating

Severity:
Stage:
Indication:
Prognosis:

A

Physiopathology of Thickness of the Tongue Coating
Thick Coating

Severity: Severe

Stage: Later stage

Indication: Dampness, water, food or phlegm retention or stagnation

Prognosis: Thick to thin- better

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Q

Physiopathology of Thickness of the Tongue Coating
Thin Coating

Description:
Pathogen:
Location:

A

Physiopathology of Thickness of the Tongue Coating
Thin Coating

Description: Tongue body can be seen clearly through its coating

Pathogen: Weak

Location: Exterior or mild interior disorder

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Q

Physiopathology of Thickness of the Tongue Coating
Thin Coating

Severity:
Stage:
Indication:
Prognosis:

A

Physiopathology of Thickness of the Tongue Coating
Thin Coating

Severity: Mild

Stage: Initial Stage

Indication: Normal, exterior syndrome, or mild, early stage disease

Prognosis: Thin to thick: worse

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Q

Physiopathology of Moistness of the Tongue Coating

Description:

A

Physiopathology of Moistness of the Tongue Coating

Description: A healthy tongue is kept moist naturally by saliva. A normal tongue coating is moist and lustrous

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Q

Physiopathology of Moistness of the Tongue Coating
Moist Coating

Description:

A

Tongue coat is enriched and moist with saliva

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Q

Physiopathology of Moistness of the Tongue Coating
Glossy (Slippery) Coating

Description:

A

A tongue covered with a transparent or semitransparent film of fluid, even to drop when stretching out tongue.

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Q

Physiopathology of Moistness of the Tongue Coating
Dry Coating

Description:

A

Fur whose surface is dry and without saliva

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Q

Physiopathology of Moistness of the Tongue Coating
Rough Coating

Description:

A

The tongue coating granules very rough that likes sands, give a roughness feeling which tough it by hand

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Q

Physiopathology of Moistness of the Tongue Coating
Moist Coating

Description:
Body Fluid:
Indications:
Prognosis:

A

Physiopathology of Moistness of the Tongue Coating
Moist Coating

Description: Normal condition, neither slippery nor dry

Body Fluid: Sufficiency

Indications: Health person, or body fluid has not been injury even under illness

Prognosis: From dry to moist: better

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Q

Physiopathology of Moistness of the Tongue Coating
Dry Coating

Description:
Body Fluid:
Indications:
Prognosis:

A

Physiopathology of Moistness of the Tongue Coating
Dry Coating

Description: The coating is very dry without fluid on it.

Body Fluid: Injured or deficiency

Indications:
Excess heat
Yin deficiency
Yang deficiency which failure transform water into body fluid
Exopathogenic dryness invades the Lung

Prognosis: From moist to dry: worse

Q

Physiopathology of Moistness of the Tongue Coating
Glossy (Slippery) Coating

Description:
Body Fluid:
Indications:

A

Physiopathology of Moistness of the Tongue Coating
Glossy (Slippery) Coating

Description: A tongue covered with a transparent or semitransparent film of fluid, even to drop when stretching out tongue

Body Fluid: sufficiency

Indications:
Cold syndrome
Dampness, phlegm, water retention
Yang deficiency

Q

Physiopathology of Moistness of the Tongue Coating
Rough Coating

Description:
Body Fluid:
Indications:

A

Physiopathology of Moistness of the Tongue Coating
Rough Coating

Description: The tongue coating granules very rough that likes sands, give a roughness feeling which tough it by hand

Body Fluid: severe injury

Indications: Body fluids sever injury

Q

What are the tongue moisture types:

A

Moist
Glossy
Dry
Rough

Q

Physiopathology of the Tongue Coating
Appearance/Components of the Tongue

List:

A

Thickness
Moistness
Viscosity
Distribution
Rooted
Peeling
Wax/Wane

Q

Physiopathology of Viscosity of the Tongue Coating

Description:
Clinical Significance:

A

Physiopathology of Viscosity of the Tongue Coating

Description: Viscosity of tongue coating is the appearance of the tongue coating

Clinical Significance: To observer viscosity of the tongue coating can help to identify the pathogenic factors as well as the condition of water transformation

Q

Physiopathology of Viscosity of the Tongue Coating
Clean Coating

Description:

A

A normal health tongue coating should be extremely fine coating with a grainy appearance.

Q

Physiopathology of Viscosity of the Tongue Coating
Moldy Tongue Coating

Description:

A

Also known as “bean curd”, “tofu”. The coating is thick and patchy looks like coarse mulch granules as small curd cottage cheese on the tongue, and is easy to be scraped off

Q

Physiopathology of Viscosity of the Tongue Coating
Greasy Tongue Coating

Description:

A

Also know as “sticky coating”. The greasy coating is make of fine particles, it is thicker in middle and thinner in margin and difficult to be scraped off. Looks like wet peanut butter smeared on to tongue’s surface

Q

Physiopathology of Viscosity of the Tongue Coating
Moldy Coating

Description:
Coating Particles:
Adhere:
Indication:

A

Physiopathology of Viscosity of the Tongue Coating
Moldy Coating

Description: The coating is thick and patchy looks like coarse mulch granules as cottage cheese piling on tongue

Coating Particles: Big and loose which look like cottage cheese

Adhere: Easy to wiped or scraped off

Indication:
Food stagnation
Phlegm
Internal Abscess

Q

Physiopathology of Viscosity of the Tongue Coating
Moldy and Greasy

Pathogenesis:
Remark(s):

A

Physiopathology of Viscosity of the Tongue Coating
Moldy and Greasy

Pathogenesis: Excessive Yang heat steaming the turbid and putrid Qi rise to the tongue surface

Remark(s): Moldy coating and Greasy coating can be show at same time as moldy and greasy coating

Q

Physiopathology of Viscosity of the Tongue Coating
Greasy Coating

Description:
Coating Particles:
Adhere:
Indication:

A

Physiopathology of Viscosity of the Tongue Coating
Greasy Coating

Description: The greasy coating is made of fine particles. It is thicker in middle and thinner in margin. It looks like being covered by greasy mucus

Coating Particles: Fine and small which like greasy fat (oily)

Adhere: Difficulty to wiped or scraped off

Indication:
Food stagnation
Phlegm
Dampness

Q

Physiopathology of Distribution of the Tongue Coating

Description:

A

Under normal conditions there is thin white coating distributed evenly all over of the tongue body, with the center part and the posterior part being relatively thick

Q

Physiopathology of Distribution of the Tongue Coating
Even Coating

Description:

A

Refers complete tongue coating

Q

Physiopathology of Distribution of the Tongue Coating
Uneven Coating

Description:

A

Also call partial coating, the coating covers only a localized area of the tongue surface, such as the anterior, posterior, left, right, central or peripheral area.

Q

Physiopathology of Distribution of the Tongue Coating
Even Coating

Clinical Significance:

A

The wide spread of pathogens in the body and stagnation of damp phlegm in middle-jiao

Q

Physiopathology of Distribution of the Tongue Coating
Uneven Coating - Coating on Anterior Area

Clinical Significance:

A

Stomach Qi deficiency before the invasion of external pathogens to the internal organs of the body. Pathogens in the interior but not deep.

Q

Physiopathology of Distribution of the Tongue Coating
Uneven Coating - Coating on Posterior Area

Clinical Significance:

A

Mild exopathogens invasion with Stomach function disorder

Q

Physiopathology of Distribution of the Tongue Coating
Uneven Coating - Coating on One Side

Clinical Significance:

A

Pathogens in between exterior and interior, or in liver and gallbladder

Q

Physiopathology of Distribution of the Tongue Coating
Uneven Coating - Coating Absence on Center

Clinical Significance:

A

Stomach Qi, Yin, or Kidney Yin insufficient, or deficiency of all Yin, essence, Qi and blood

Q

Physiopathology of Distribution of the Tongue Coating
Peeling

Description:

A

Under certain condition, the tongue coating suddenly comes off completely or partly, the tongue body can be seen in exfoliated part. Different terms are given according to the site, state and range of the exfoliation

Q

Physiopathology of Distribution of the Tongue Coating
Peeling

List:

A

Partial Exfoliative Peeling
Geographic Tongue
Mirror Tongue
Exfoliative Like Coating

Q

Physiopathology of Distribution of the Tongue Coating
Peeling - Partial Exfoliative Peeling

Description:

A

There partial peeling of coating and there is no coating at the exfoliated part

Q

Physiopathology of Distribution of the Tongue Coating
Peeling - Geographic Tongue

Description:

A

Scattered peeling with borders that are raised above the surface

Q

Physiopathology of Distribution of the Tongue Coating
Peeling - Mirror Tongue

Description:

A

The tongue has no coating at all, as smooth and glassy as a mirror

Q

Physiopathology of Distribution of the Tongue Coating
Peeling - Exfoliative Like Coating

Description:

A

The exfoliated part is somewhat rough and covered with new produced particles

Q

Physiopathology of Distribution of the Tongue Coating
Peeling

Indication:
Pathogenesis:

A

Physiopathology of Distribution of the Tongue Coating
Peeling

Indication: Stomach Yin and Qi deficiency

Pathogenesis: Stomach Yin is exhausted and Stomach Qi fails to produce tongue coating, there is no coating on tongue surface

Q

Physiopathology of Distribution of the Tongue Coating
Wax and Wane

Description:

A

Physiopathology of Distribution of the Tongue Coating
Wax and Wane

Description: It also call increase or decrease of tongue coating. It means the changes of the thickness of the tongue coating.

Q

Physiopathology of Distribution of the Tongue Coating
Wax

Indication:

A

Wax: increase the thickness of the tongue coating

A. From thin coating to thick coating: Pathogenic factors getting stronger or invade deeper.

B. From no coating to have coating: Stomach Qi recovered

Q

Physiopathology of Distribution of the Tongue Coating
Wane

Indication:

A

Wane: decrease the thickness of the tongue coating

A. From thick coating to thin coating: right Qi overcome the pathogenic factors

B. From have coating to no coating: Stomach Qi failure

Q

Physiopathology of Distribution of the Tongue Coating
Rooted and Non-rooted

Rooted (Description):

A

Under normal condition, tongue coating should attach with the tongue surface tightly and is relatively difficult to scrape or wiped off. It grows out of it much like grass grows from the soil

Q

Physiopathology of Distribution of the Tongue Coating
Rooted and Non-rooted

Non-rooted (Description):

A

The tongue coating looks like being put on tongue body, easy to be wiped or scraped off. The surface of the tongue body looks very smooth after scraped off the coating

Q

Physiopathology of Distribution of the Tongue Coating
Rooted

Indication:
Pathogenesis:
Prognosis:
Remark:

A

Physiopathology of Distribution of the Tongue Coating
Rooted

Indication: Have Stomach Qi and right Qi

Pathogenesis: Stomach Qi and right strong enough to tide up to the surface of the tongue

Prognosis: Good

Remark: Can be see in all stage of the illness

Q

Physiopathology of Distribution of the Tongue Coating
Non-rooted

Indication:
Pathogenesis:
Prognosis:
Remark:

A

Physiopathology of Distribution of the Tongue Coating
Non-rooted

Indication: Stomach Qi and right failure

Pathogenesis: Stomach Qi exhausted and failure to tide up to generate new coat, old coat separate from tongue body

Prognosis: Poor

Remark: Only see in chronic, and critical condition

Q

Observation of Tongue Body

Indication:

A

Judge the condition of vital Qi, and differentiation the nature of pathogenic factors

Q

Observation of Tongue Coating

Indication:

A

Differentiation of the nature and location of the pathogenic factors