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Oriental Diagnosis > Tongue Diagnosis > Flashcards

Tongue Diagnosis Flashcards

1
Q

Structures and Functions of the Tongue (List)

A

Filiform papillae
Fungiform papillae
Circumvallate papillae

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2
Q 
Structures and Functions of the Tongue
Filiform Papillae (describe)
A

The most numerous and smallest papillae on the tongue, distributed over the tongue tip, body, and sides of the tongue. They are no taste buds, characterized by increased keratinization

TCM: Filiform papillae are formed by Lung Qi and Ming Men fire.

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3
Q 
Structures and Functions of the Tongue
Fungiform Papillae (describe)
A

Mostly seen on tip of the tongue and scattered among the filiform papillae.

TCM: Fungiform papillae are formed by Heart and Kidney Qi

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4
Q 
Structures and Functions of the Tongue
Circumvallate Papillae (describe)
A

The largest papillae, seven to nine in number, arranged in a V-shaped sulcus terminalis, which separates the tongue body from the tongue root.

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5
Q

Relationship of Tongue and Zang Fu Organs
Heart

Area of Tongue:
Description:
Function:

A

Relationship of Tongue and Zang Fu Organs
Heart

Area of Tongue: tongue body - tip of tongue

Description: sprouts, opens

Function: distinguish tastes, speech

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6
Q

Relationship of Tongue and Zang Fu Organs
Liver

Area of Tongue:
Description:
Function:

A

Relationship of Tongue and Zang Fu Organs
Liver

Area of Tongue: tongue body - side of tongue (middle)

Description: controls tendons

Function: move flexibly, mix food, speech

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7
Q

Relationship of Tongue and Zang Fu Organs
Kidney

Area of Tongue:
Description:
Function:

A

Relationship of Tongue and Zang Fu Organs
Kidney

Area of Tongue: tongue body - back of tongue

Description: Stores congenital jing and yin

Function: normal shape and moisture

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8
Q

Relationship of Tongue and Zang Fu Organs
Spleen

Area of Tongue:
Description:
Function:

A

Relationship of Tongue and Zang Fu Organs
Spleen

Area of Tongue: tongue body - middle/center of tongue

Description: external sign, controls muscle

Function: Normal shape, move flexibly, ability to taste

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9
Q

Relationship of Tongue and Zang Fu Organs
Stomach

Area of Tongue:
Description:
Function:

A

Relationship of Tongue and Zang Fu Organs
Stomach

Area of Tongue: tongue coat - middle/center of tongue

Description: rising, evaporation

Function: thin white coating

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10
Q

Relationship of Tongue and Zang Fu Organs
Lung

Area of Tongue:
Description:
Function:

A

Relationship of Tongue and Zang Fu Organs
Lung

Area of Tongue: tongue coating - just behind tip of tongue

Description:

Function: filiform papillae

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11
Q

Clinical Significance of Tongue Diagnosis

Describe

A

1) To judge the exuberance or decline of the vital Qi
2) To distinguish the nature of the disease
3) To detect the location of the disease
4) To estimate the prognosis of the disease

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12
Q

Contents of Tongue Inspection

List - Full

A 
Tongue Spirit
Tongue Color
Tongue Shape
Tongue Bearing
Hypoglossal Vessels
Coating Color
Coating Properties
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13
Q

Contents of Tongue Inspection

List - Short

A

Tongue Body

Tongue Coating

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14
Q

Normal Tongue

Describe

A

Normal tongue is neither too large or small, soft, neither tough nor tender, moves freely, has a pink color which is covered by a thin and even white coating with moderate moisture. This coating can’t be scraped away and has its root in the tongue body.

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15
Q

Inspection of Tongue Body

Tongue Spirit - Flourish (Define)

A

Refers to the brightness of the tongue body with energetic movement and enough fluid in the body.

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16
Q

Inspection of Tongue Body

Tongue Spirit - Withered (Define)

A

Refers to the dark and dry tongue body with sluggish movement.

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17
Q

Inspection of Tongue Body
Tongue Spirit - Flourished

Tongue Color:
Moisture:
Movement:
Indication:
Prognosis:
A

Inspection of Tongue Body
Tongue Spirit - Flourished

Tongue Color: light red

Moisture: moist

Movement: energetic

Indication: normal stomach qi

Prognosis: good

18
Q

Inspection of Tongue Body
Tongue Spirit - Withered

Tongue Color:
Moisture:
Movement:
Indication:
Prognosis:
A

Inspection of Tongue Body
Tongue Spirit - Withered

Tongue Color: dark and dim

Moisture: dry

Movement: sluggish

Indication: stomach qi exhausted

Prognosis: poor

19
Q

Pathophysiology of the Tongue Color
Pale Tongue

Description:
Pathogenesis:
Indications:

A

Pathophysiology of the Tongue Color
Pale Tongue

Description: the tongue color is lighter than normal, or even bloodless

Pathogenesis: there is insufficient Blood to fill in the tongue body.

Indications:
A. Cold syndrome: moist
B. Yang deficiency: enlarged and moist
C. Qi and blood deficiency: thin and small

20
Q

Pathophysiology of the Tongue Color
Red Tongue

Description:
Pathogenesis:
Indications:

A

Pathophysiology of the Tongue Color
Red Tongue

Description: the tongue is redder than normal

Pathogenesis: heat accelerates Blood movement, which fills up the vessels

Indications:
Heat syndrome
External heat: only slight red or red on tip and edge
Internal heat:
1) Excess heat: red and tough tongue with thick dry coating
2) Deficiency heat: red (with cracks) tongue with little coating

21
Q

Pathophysiology of the Tongue Color
Crimson Tongue

Description:
Pathogenesis:
Indications:

A

Pathophysiology of the Tongue Color
Crimson Tongue

Description: crimson tongue comes from red tongue, but the color is heavy and darker than red, it also called deep red

Pathogenesis: Heat concentrates and accelerates the movement of Blood

Indications:
Heat syndromes
A. Exogenous febrile diseases
B. Yin deficiency or exhausted: dry and small, without coating
C. Blood stagnation: with purple color
22
Q

Pathophysiology of the Tongue Color
Purple Tongue

Description:
Pathogenesis:
Indications:

A

Pathophysiology of the Tongue Color
Purple Tongue

Description: tongue body looks purple

Pathogenesis: blood stagnates and accumulates in the tongue body

Indications: extreme heat: crimson purple

23
Q

Pathophysiology of the Tongue Color
Bluish Tongue

Description:
Pathogenesis:
Indications:

A

Pathophysiology of the Tongue Color
Bluish Tongue

Description: the tongue color is like that of the blue veins exposed on skin, or bloodless like a buffalo’s tongue

Pathogenesis: cold constricts vessels, and so Blood stagnates.

Indications:
A. Pathogenic cold accumulation
B. Blood stagnation

24
Q

Pathophysiology of the Tongue Size
Enlarged Tongue

Description:
Pathogenesis:
Indications:

A

Pathophysiology of the Tongue Size
Enlarged Tongue

Description: the tongue body is wider than normal

Pathogenesis: fluids accumulate in the tongue body

Indications:
A. Dampness accumulation
B. Spleen and Kidney Yang deficiency with dampness

25
Q

Pathophysiology of the Tongue Size
Swollen Tongue

Description:
Pathogenesis:
Indications:

A

Pathophysiology of the Tongue Size
Swollen Tongue

Description: the tongue body is enlarged both horizontally and vertically. It can fill up the mouth and can be difficult to retract, in some cases the mouth can not even shut.

Pathogenesis: Qi, Blood stasis in the tongue body due to heat

Indications:
A. Pathogenic heat invasion Heart and Spleen: red and swollen
B. Alcohol poisoning: purple and swollen
C. Blood stasis caused by chemical toxicity: darkish blue purple, swollen

26
Q

Pathophysiology of the Tongue Size
Teeth Marked Tongue (Scalloped Tongue)

Description:
Pathogenesis:
Indications:

A

Pathophysiology of the Tongue Size
Teeth Marked Tongue (Scalloped Tongue)

Description: teeth marks are visible on the tongue’s edges

Pathogenesis: water or dampness stagnates in the tongue, enlarging the tongue body.

Indications:
A. Dampness: (+pale and moist)
B. Spleen, or Qi deficiency: (+slight red)

27
Q

Pathophysiology of the Tongue Size
Thin Tongue

Description:
Pathogenesis:
Indications:

A

Pathophysiology of the Tongue Size
Thin Tongue

Description: the tongue body is thinner both horizontally and vertically, and thus smaller than normal

Pathogenesis: tongue body lacks nutrition.

Indications:
A. Qi and Blood deficiency: (+pale and thin coating)
B. Yin deficiency with heat: red with little or no coating

28
Q

Pathophysiology of the Tongue Shape
Cracked Tongue

Description:
Pathogenesis:
Indications:

A

Pathophysiology of the Tongue Shape
Cracked Tongue

Description: There are obvious fissures on the surface of the tongue which are not covered with a coating. The size, depth and shape of cracks are different. It may be seen on the whole tongue or restricted to the front part, or both sides of the tongue tip.

Pathogenesis: Malnutrition of the tongue body and eventual atrophy of the tongue surface

Indications:
A. Excess heat: deep red crack with dry coating
B. Yin deficiency: red body with cracks but no coating
C. Blood deficiency: pale or slightly red body with cracks
D. Spleen deficiency with dampness: pale, enlarged with teeth marks and cracks on the edges

29
Q

Pathophysiology of the Tongue Shape
Prickles (Thorns, Dots, Spots) Tongue

Description:
Pathogenesis:
Indications:

A

Pathophysiology of the Tongue Shape
Prickles (Thorns, Dots, Spots) Tongue

Description: there are spots or prickles on the surface of the tongue that look like strawberry thorns. Spots are flat or only slightly raised. They can be red, white, or black. Prickles are raised and can appear red or black. Both can appear on the borders of the tongue, or scattered over the entire surface

Pathogenesis: accumulation of excessive pathogenic heat putrifies tongue’s surface

Indications: excess pathogenic heat
A. Excess heat toxin: bright red with yellow coating
B. Pathogenic heat invasion into Ying or Xue levels: crimson red
C. Damp-heat accumulation: yellow coating

30
Q

Pathophysiology of the Tongue Shape
Ulcerated Tongue

Description:
Pathogenesis:
Indications:

A

Pathophysiology of the Tongue Shape
Ulcerated Tongue

Description: form is like millet kernels, on top there are yellow dimples, after a long time they erode and create ulcerations, and the area may is red and painful.

Pathogenesis: heat flaming upward accumulates on the tongue’s surface and putrefies the tissue.

Indications:
A. Heat toxin in the Heart channel: red with yellow coating
B. Deficiency heat: cracked, red with scanty yellow coating

31
Q

Pathophysiology of the Tongue Body
Tough (Old) Tongue

Description:
Pathogenesis:
Indications:

A

Pathophysiology of the Tongue Body
Tough (Old) Tongue

Description: the striae of tongue are rough and sturdy

Pathogenesis: excessive pathogens invasion and struggle with vital Qi, causing Qi and Blood rise, consuming Qi and body fluids

Indications: excessive heat syndrome

32
Q

Pathophysiology of the Tongue Body
Tender (Young) Tongue

Description:
Pathogenesis:
Indications:

A

Pathophysiology of the Tongue Body
Tender (Young) Tongue

Description: the striae of tongue are delicate, fine and smooth

Pathogenesis: Qi and Blood deficiency, or Yang deficiency failing to transform drink into body fluids and generating cold damp which accumulates and causes the tender tongue.

Indications: Deficiency syndrome
A. Qi and Blood deficiency: tender and dry
B. Yang Qi deficiency: tender and wet

33
Q

Pathophysiology of the Tongue Bearing
Flexibility - Stiff Tongue

Description:
Pathogenesis:
Indications:

A

Pathophysiology of the Tongue Bearing
Flexibility - Stiff Tongue

Description: the tongue’s body has difficulty in moving or turning. It causes slurred speech and difficulty with eating.

Pathogenesis: Tongue tendons spasm due to malnutrition.

Indications:
A. Pathogenic heat invades the pericardium: crimson with dry yellow coating
B. Turbid phlegm obstructs the meridian: flabby tongue, with thick greasy coating
C. Internal wind: Slight red or green purple tongue

34
Q

Pathophysiology of the Tongue Bearing
Flexibility - Flaccid Tongue

Description:
Pathogenesis:
Indications:

A

Pathophysiology of the Tongue Bearing
Flexibility - Flaccid Tongue

Description: it refers to a weak tongue unable to protrude or curl up with atrophy of the tongue muscle. In severe cases it has a crumpled look, with many lines on its surface.

Pathogenesis: tongue tendons and muscles lack nutrition

Indications:
A. Severe Qi and Blood deficiency: pale and flaccid
B. Excessive pathogenic heat injury body fluids: crimson and flaccid
C. Yin fluids exhausted: deep red and dry flaccid, and no coating

35
Q

Pathophysiology of the Tongue Bearing
Abnormal Tongue Movements - Shaking Tongue

Description:
Pathogenesis:
Indications:

A

Pathophysiology of the Tongue Bearing
Abnormal Tongue Movements - Shaking Tongue

Description: the tongue body shivers and sways uncontrollably.

Pathogenesis: tongue tendons spasm due to malnutrition

Indications:
A. Qi and Blood deficiency, or Yang depletion: pale and flaccid
B. Internal wind due to extreme pathogenic heat: red

36
Q

Pathophysiology of the Tongue Bearing
Abnormal Tongue Movements - Deviated Tongue

Description:
Pathogenesis:
Indications:

A

Pathophysiology of the Tongue Bearing
Abnormal Tongue Movements - Deviated Tongue

Description: when tongue protrudes out of the mouth, it points to one side

Pathogenesis: unilateral obstruction of the collateral

Indications:
A. Liver Yang rising: purple red
B. Blood deficiency: pale
C. Wind phlegm: Thick coating
D. Extreme heat: red tongue
37
Q

Pathophysiology of the Tongue Bearing
Abnormal Tongue Movements - Protruding and Licking

Description:
Pathogenesis:
Indications:

A

Pathophysiology of the Tongue Bearing
Abnormal Tongue Movements - Protruding and Licking

Description: The tongue stretching out of mouth is called a protruding tongue. And that tongue stretches out and immediately retracts into mouth or like snack head move around is called licking.

Pathogenesis: heat creates dryness which leads to tendon spasms

Indications:
A. Pathogenic heat in the Heart channel
B. Pathogenic heat in the Spleen channel

38
Q

Pathophysiology of the Tongue Bearing
Contraction of the Tongue - Shortened (Contracted) Tongue

Description:
Pathogenesis:
Indications:

A

Pathophysiology of the Tongue Bearing
Contraction of the Tongue - Shortened (Contracted) Tongue

Description: the tongue contracts and shortens, and is inability to stretch, even can not reach teeth

Pathogenesis: tongue tendon atrophy or construction due to cold, or malnutrition.

Indications: critical condition
A. Excessive pathogenic cold invades: pale with moisten coating
B. Turbid phlegm accumulation: Flabby with greasy coating
C. Excessive pathogenic heat: red tongue with dry yellow coating
D. Spleen and Kidney failure, both Qi and Blood deficiency: pale tenderness tongue and flabby.

39
Q

Pathophysiology of the Tongue Bearing
Contraction of the Tongue - Loose (Protracted) Tongue

Description:
Pathogenesis:
Indications:

A

Pathophysiology of the Tongue Bearing
Contraction of the Tongue - Loose (Protracted) Tongue

Description: the tongue hangs outside the mouth when it is extended, and is difficult to retract. It may drip with saliva

Pathogenesis: tongue tendon couldn’t contract due to malnutrition which may results channels and collaterals obstruction or deficiency

Indications:
A. Excessive heat or heat phlegm
B. Qi deficiency

40
Q

Hypoglossal Vessels
Normal Hypoglassal Vessels

(Describe)

A

In normal condition, beside the frenulum of tongue, two thick bluish purple vessels can be seen. Their diameter is no more than 2.7 mm. Their length is no more than one third of the length from the sublingual caruncle to the tip of the tongue. There are no branches or spots.

41
Q

Hypoglossal Vessels
Abnormal Hypoglassal Vessels

(Describe)

A

The shape of main part are varicosity in some part or diffuse varicosity
The length of main part is over reaching the middle point
The filling degree of main part are filling up all parts with little crooked or dilation with crooked
The color is bluish purple or purple black
The peripheral parts cystic, thick processes just like grapestring
The diameter over 2.7 mm

Indication: Qi and blood stagnation

Oriental Diagnosis (8 decks)

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