Download The facial veins are

Auricle
Forehead
Skin of the face
•Very vascular,rich in sweat&
sebaceous glands .
•Receives the insertion of
facial muscles .
Contains :Facial muscles
Deep fascia
vessels & nerves & fat .
ABSENT except ………
Auricle
Buccinator
Facial vessels
Parotid gland
Masseter
Supraorbital A.
Superficial
temporal A.
Supratrochlear
A.
Buccal A.
Infraorbital A.
Facial A.
Mental A.
Facial vein
Masseter
Facial artery
Lat.nasal a.
Sup.labial A.
Inf.labial A.
Facial A.
Superficial
temporal A.
Transverse
facial A.
Parotid duct
Superficial
temporal A.
Facial A.
Pulsation sites
Transverse facial Vs.
superficial temporal Vs.
Tragus
Lat.Nasal Vs.
Sup.Labial Vs.
Inf.Labial Vs.
Facial A.
Facial V.
Masseter
Supratrochlear V.
Supra-orbital V.
facial vein
Maxillary V.
Superficial
Temporal V.
RetroMandibular V.
Facial Vs.
Post.auricular
V.
Ext.jugular V.
C.Facial V.
Int.jugular V.
Superficial
Temporal V.
Maxillary V.
RetroMandibular V.
I.J.V.
Anterior
devision
Posterior
devision
+
+
Facial vein
Post.auricular
V.
=
=
Common facial
vein
External
Jugular vein
Supratrochlear V.
Cavernous
sinus
Emissary Vs.
Pterygoid venous
plexus
Supraorbital V.
To sup.ophthalmic V.
facial V.
Deep Facial V.
Cavernous
Sinus
Pterygoid
Venous Plexus
Sup.Ophth.
V.
Facial V.
facial vein
Sup.oph.V.
Deep facial V.
Pterygoid venous
plexus
Cavernous sinus
Emissary veins
Parotid L.N.
Lymph drainage of the face
•Lat.part of the face……..parotid lymph
nodes .
•Medial part of the
face…submandibular lymph nodes .
•Central part of lower lip &
chin…………submental lymph nodes .
Nerve supply of the face
Sensory
Motor
Ophthalmic n
Maxillary n.
Great
auricular n.
Mandibular n.
Zygomaticotemporal
nerve
Supra-orbital n.
Supra trochlear n.
Lacrimal n.
Infra trochlear n.
External nasal
Infra orbital n.
Buccal n.
Mental n.
Auriculotemporal n.
Zygomaticofacial n.
Supra-orbital nerve
Infra-orbital nerve
Mental nerve
Ophthalmic nerve
•Supraorbital & supratrochlear
nerves…...forehead & upper eyelid.
•Lacrimal nerve…lateral part of upper
eyelid
•Infratrochlear nerve…lower eyelid .
•External nasal…nose till the tip .
Maxillary nerve
•Infraorbital….palpebral & nasal &labial .
•Zygomaticofacial….skin over zygomatic
bone .
•Zygomaticotemporal….skin of temple.
Mandibular nerve
• Mental……lower lip&chin
• Buccal….skin over buccinator .
• Auriculotemporal…skin over auricle&temple .
Important short account
Important artery
facial artery
Begin: It is a branch from the front of the E.C.A. above the tip of the hyoid bone.
Course : It ascends in the anterior triangle of the neck till it reaches the submandibular
salivary
gland . The artery grooves the post. end of the gland → descends between the gland and mandible
→ curves around the lower border of the mandible → pierces the cervical investing fascia at the
antero-inferior angle of masseter m. → enters the face where it ascends in a tortuous course (lat.
To buccinator) towards the med. angle of eye (end = angular a.) .
Branches:
(1) In the neck :
a) Tonsillar a. → tonsil.
b) Ascending palatine a. → soft palate.
c) Submental a.
d) Glandular branches. : To the submandubular salivary gland.
(2) In the face :
a) Inferior labial a.
b) Superior labial a.
c) Nasal br.
Important artery
facial vein
Beginning: At the med. angle of the eye by the union of supratrochlear and
supraorbital veins.
- Course: It descends posterior to the facial a. (untortuous) to pierce the cervical
investing fascia at the antero-inferior angle of masseter.
- End: It unites with the ant. division of retromandibular v. → common facial v.
→ ends in the internal jugular vein (I.J.V) .
- Connections of ant facial v.:
a) At the beginning, it is connected to the ophthalmic veins.
b) On the buccinator, it is connected to the pterygoid plexus of veins by the deep facial vein
which passes deep to the masseter.
Both the ophthalmic veins and the pterygoid plexus of veins are connected also to the cavernous
sinus. So, pus in the dangerous area of the face shouldn't be squeezed for fear of spread of
infection with a resulting cavernous sinus thrombosis.
N.B. : The facial veins are :
* Anterior facial v. (facial vein)
* Posterior facial v. (retromandibular v.).
* Common facial v.
* Deep facial v.
Nerves : Motor and sensory :
[A] The motor supply: By the temporal, zygomatic, buccal and mandibular
terminal brs. of the
facial n.
N.B. : The cervical br. of facial n. supplies the platysma of the neck.
[B] The sensory supply : By the trigeminal n. except the area of skin
covering the angle of the
mandible which is supplied by branches from the upper cervical spinal nerves.
The trigeminal n. supplies the facial skin by the branches of its 3 divisions :
a) The ophthalmic division .
b) The maxillary division . Notice that it supplies the skin of the upper lip.
c) The mandibular division . Notice that it supplies the skin of the lower lip.
Important nerve
facial nerve
• Begin: the 7th crasnial nerve start as motor and
sensory roots
• End: enter parotid gland then divided into 5
branches
• Branches:
1. Grater petrosal nerve.
2. Chorda tympanic nerve
3. Nerve to stapedius
4. Posterior auricular nerve
5. 5 terminal: temporal, zygomatic, buccal,
mandibular and cervical branches
Clinical case
A 17-year-old girl visited her dermatologist because of severe acne of the
face. On examination, it was found that a small abscess was present on the
side of the nose. The patient was given antibiotics and was warned not to
press the abscess.
The following facts concerning this patient emphasize why it is important to
adequately treat this condition except which?
(a) The skin area between the eye, the upper lip, and the side of the nose is a
hazardous area to have an infection of the skin.
(b) The danger area is drained by the facial vein.
(c) Interference with a boil by squeezing or pricking it can lead to spread of the
infection and thrombosis of the facial vein.
(d) The facial vein communicates with the cavernous sinus via the superior
and inferior ophthalmic veins.
(e) Cavernous sinus thrombosis can occur by the spread of infection by the
venous blood.
(f) The blood in the facial vein is unable to spread upward because of valves.
Clinical case
A 7-year-old boy with right-sided otitis media was treated with
antibiotics. The organisms did not respond to the treatment,
and the infection spread to the mastoid antrum and the
mastoid air cells. The surgeon decided to perform a radical
mastoid operation. After the operation, it was noticed that
the boy's face was distorted.
The following signs and symptoms suggest that the right facial
nerve had been damaged during the operation except
which?
(a) The mouth was drawn upward to the right.
(b) He was unable to close his right eye.
(c) Saliva tended to accumulate in his right cheek.
(d) The saliva tended to dribble from the corner of his mouth.
(e) All the muscles of the right side of his face were paralyzed.
MCQ
MCQ.1- Pulse felt in front of auricle
against the zygomatic arch is that of:a.Facial A.
b.Transverse facial A.
c.Zygomatico facial A.
d.Superficial temporal A.
e.Infraorbital A.
MCQ.1- Pulse felt at the inferior margin of
the body of the mandible is that of:a.Facial A.
b.Transverse facial A.
c.Zygomatico facial A.
d.Superficial temporal A.
e.Infraorbital A.
MCQ.2. Nerve supply of skin of forehead
includes:a.Auriculotemporal nerve.
b.Infraorbital nerve.
c.Supra-orbital nerve
d.Supratrochlear nerve.
e. © and (d)
Superficial
Temporal V.
Maxillary V.
RetroMandibular V.
I.J.V.
Anterior
devision
Posterior
devision
+
+
Facial vein
Post.auricular
V.
=
=
Common facial
vein
External
Jugular vein