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Lesson Plans: Chapter 3—The Head, Face, and Neck Goals of the Lesson: Cognitive: Students will be able to identify the major muscles of the head, face, and neck. Motor: Students will practice locating and treating the muscles of the region. Affective: Students will understand the connection between headache pain and muscles of the neck. Learning Objectives: 3.1 State the correct terminology for the muscles of the head, face, and neck. 3.2 Palpate the muscles of the head, face, and neck. 3.3 Identify the attachments at their origins and insertions. 3.4 Describe their pain referral areas. 3.5 Recall related muscles. 3.6 Recognize any endangerment sites and ethical cautions for massage therapy. 3.7 Demonstrate proficiency in manual therapy techniques for the muscles of the head, face, and neck. Note: The correct terminology, palpation, muscle attachments, pain referral areas, related muscles, endangerment sites and ethical cautions, and manual therapy techniques are addressed under the heading of each individual muscle. You Will Need: Gather the following materials and teaching aids for this chapter’s lessons: Skeletal/muscle model Massage table, sheets, lubricants Colored pencils or crayons Non‐latex gloves, if intraoral massage is allowed in your state Note: Instructor and student ancillaries available at http://thePoint.lww.com Allen, Clay & Pounds’ Basic Clinical Massage Therapy, 3rd ed. Lesson plans ©2016 Wolters Kluwer Page 1 Lesson Plans: Chapter 3—The Head, Face, and Neck Lecture Outline Content Text Page PPT Slides Figures, Tables, and Features Overview of the region •
The head houses the brain •
The head is the home of the face •
The voice issues from the head •
The head is home to four of the five traditional senses •
The head contains the entrance to the respiratory and digestive systems •
The neck has two major functions: o Connects the head and its functions to the rest of the body o Supports and moves the head 62‐64 1‐6 Plates 3‐1 Skeletal features of the anterior and lateral head and neck (p 52) 3‐ 2 Skeletal features of the posterior head and neck (p 53) 3‐3 Muscles of the anterior head and neck (p 54) 3‐4 Muscles of the lateral head and neck (p 55) 3‐5 The scalene Resources and In‐Class Activities
Use Resources from thePoint (Flash Cards, Video Clips, Test Generator) throughout the course Outside Assignments/ Evaluation Instructor’s Notes Assignments Handout—fills in the blanks to name muscles of the head, face, and neck. Have students note “O” for origin and “I” for insertion. Review the pronunciation and etymology of the muscles of the head, Fill in the blank: List endangerment sites face, and neck. of the head, face and neck and have students fill in the Palpate the muscles structures that it are endangerment sites.
of the head, face, and neck. Assignment Have students Identify attachments choose a pathology of the muscles of the related to the head, neck, or face, and Allen, Clay & Pounds’ Basic Clinical Massage Therapy, 3rd ed. Lesson plans ©2016 Wolters Kluwer Page 2 Lesson Plans: Chapter 3—The Head, Face, and Neck •
Headaches are the second most common cause of pain in adults over the age of 18 •
Neck muscles are numerous and strong, and also susceptible to pain and dysfunction. •
Avoid dragging downward on the skin of the face. The skin around the eyes is very thin, so exercise extra caution. Having hands on the face and the front of the neck makes some people feel claustrophobic, so be attentive of the client’s comfort. muscles and lateral neck anatomy (p 56) 3‐6 Superficial muscles of the posterior head and neck (p 57) 3‐7 Deep muscles of the neck (p 58) 3‐8 Intraoral anatomy (p 59) 3‐9 Surface anatomy of the anterior neck (p 60) 3‐10 Surface anatomy of the head, face, and neck. write a one‐page report to share with the class. Possibilities include Describe pain headaches, referral areas. craniofacial deformities, herniated discs, TMJ Recall related dysfunction. muscles of the head, face, and neck. Recognize endangerment sites and ethical cautions. Students should be reminded that although many areas of the body/muscles may not have any endangerment sites or ethical cautions listed, being touched in a certain area may be uncomfortable or objectionable to a client for any health or personal reason, that the client’s comfort with the session is the first Allen, Clay & Pounds’ Basic Clinical Massage Therapy, 3rd ed. Lesson plans ©2016 Wolters Kluwer Page 3 Lesson Plans: Chapter 3—The Head, Face, and Neck lateral and posterior neck Figures consideration at all times, and the client’s wishes should always be respected. Practice clinical massage therapy 3‐1 Muscles techniques on the produce facial muscles of the head, expression (p 62) face, and neck. Be sure to check your state board’s rules 3‐2 Posture with on intraoral ear forward of massage, which is sagittal midline (p not allowed in many 63) jurisdictions. Give students three 3‐3 Anatomy of minutes to write frontalis down the names of (occipitofrontalis), all the muscles they and galea can think of that are aponeurotica (p related to the 63) muscles of the head, face, and neck. Use a muscle Allen, Clay & Pounds’ Basic Clinical Massage Therapy, 3rd ed. Lesson plans ©2016 Wolters Kluwer Page 4 Lesson Plans: Chapter 3—The Head, Face, and Neck diagram and have students color the pain referral areas for each trigger point of the head, face, and neck. Frontalis 64‐65 8 Figure 3‐4 Cross‐fiber stroking of frontalis (p 65) Palpate the frontalis. Identify attachments of the frontalis. Describe pain referral areas of the frontalis. Recall related muscles of the frontalis. Recognize endangerment sites and ethical cautions of the frontalis. Practice clinical massage therapy techniques on the frontalis. Allen, Clay & Pounds’ Basic Clinical Massage Therapy, 3rd ed. Lesson plans ©2016 Wolters Kluwer Page 5 Lesson Plans: Chapter 3—The Head, Face, and Neck Occipitalis 65‐67 9 Figures 3‐5 Anatomy of occipitalis (p 66) 3‐6 Stripping occipitalis with the fingertips (p 67) 3‐7 Stripping occipitalis with the thumbs (p 67) Orbicularis oculi 10 Figures 3‐8 Anatomy of orbicularis oculi (p 67) Palpate the occipitalis. Identify attachments of the occipitalis. Describe pain referral areas of the occipitalis. Recall related muscles of the occipitalis. Recognize endangerment sites and ethical cautions of the occipitalis. Practice clinical massage therapy techniques of the occipitalis. Palpate the orbicularis oculi. Identify attachments of the orbicularis Allen, Clay & Pounds’ Basic Clinical Massage Therapy, 3rd ed. Lesson plans ©2016 Wolters Kluwer Page 6 Lesson Plans: Chapter 3—The Head, Face, and Neck oculi. 3‐9 Trigger point compression of the orbicularis oculi (p 68) Describe pain referral areas of the orbicularis oculi. Recall related muscles of the orbicularis oculi. Recognize endangerment sites and ethical cautions of the orbicularis oculi. Practice clinical massage therapy techniques of the orbicularis oculi. 3‐10 Stripping orbicularis oculi superior to the Orbit (p 68) 3‐11 Stripping orbicularis oculi pressing upward against the orbit (p 68) Zygomaticus major and minor 69‐70 11 Figures 3‐12 Anatomy of zygomaticus major and minor (p 69) Palpate the zygomaticus major and minor. Identify attachments of the zygomaticus Allen, Clay & Pounds’ Basic Clinical Massage Therapy, 3rd ed. Lesson plans ©2016 Wolters Kluwer Page 7 Lesson Plans: Chapter 3—The Head, Face, and Neck 3‐13 Stripping of zygomaticus (p 70) 3‐14 Intraoral pincer compression of zygomaticus (p 70) major and minor. Describe pain referral areas of the zygomaticus major and minor. Recall related muscles of the zygomaticus major and minor. Recognize endangerment sites and ethical cautions of the zygomaticus major and minor. Practice clinical massage therapy techniques of the zygomaticus major and minor. Allen, Clay & Pounds’ Basic Clinical Massage Therapy, 3rd ed. Lesson plans ©2016 Wolters Kluwer Page 8 Lesson Plans: Chapter 3—The Head, Face, and Neck Temporalis 70‐72 12 Figures 3‐15 Anatomy of temporalis (p 71) 3‐16 Cross‐fiber stroking of temporalis with thumbs (p 72) Palpate the temporalis. Identify attachments of the temporalis. Describe pain referral areas of the temporalis. Recall related muscles of the temporalis. Recognize endangerment sites and ethical cautions of the temporalis. Practice clinical massage therapy techniques of the temporalis. Allen, Clay & Pounds’ Basic Clinical Massage Therapy, 3rd ed. Lesson plans ©2016 Wolters Kluwer Page 9 Lesson Plans: Chapter 3—The Head, Face, and Neck Masseter 72‐73 12 Figures 3‐17 Anatomy of masseter (p 73) 3‐18 External stripping of masseter (A) with the thumb and (B) with the fingertips (p 73) Palpate the masseter. Identify attachments of the masseter. Describe pain referral areas of the masseter. Recall related muscles of the masseter. Recognize endangerment sites and ethical cautions of the masseter. Practice clinical massage therapy techniques of the masseter. Allen, Clay & Pounds’ Basic Clinical Massage Therapy, 3rd ed. Lesson plans ©2016 Wolters Kluwer Page 10 Lesson Plans: Chapter 3—The Head, Face, and Neck Pterygoids 
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Medial or internal pterygoid Lateral or external pterygoid 74 14 Figures 3‐19 Anatomy of the pterygoids (p 74) 3‐20 Compression of pterygoids (1) (p 75) 3‐21 Compression of pterygoids (2) (p 75) Palpate the pterygoids. Identify attachments of the pterygoids. Describe pain referral areas of the pterygoids. Recall related muscles of the pterygoids. Recognize endangerment sites and ethical cautions of the pterygoids. Practice clinical massage therapy techniques of the pterygoids. Allen, Clay & Pounds’ Basic Clinical Massage Therapy, 3rd ed. Lesson plans ©2016 Wolters Kluwer Page 11 Lesson Plans: Chapter 3—The Head, Face, and Neck Levator veli palatini, tensor veli palatine, and the palatine aponeurosis 76‐79 15 Figures 3‐22 Anatomy of tensor and levator veli palatine (p 76) The levator veli palatini and tensor veli palatine are not palpable. The palatine aponeurosis may be palpated (gloved and if internal work is allowed by your state board). 3‐23 Release of palatine aponeurosis (1) (p 77) Identify attachments of the Levator veli 3‐24 Release of palatini, tensor veli palatine palatine, and the aponeurosis (2) (p palatine 77) aponeurosis. 3‐25 Stroking between the maxilla and mandible (p 78) Describe pain referral areas of the Levator veli palatini, tensor veli palatine, and the palatine aponeurosis. 3‐26 Intraoral stroke over the Recall related Allen, Clay & Pounds’ Basic Clinical Massage Therapy, 3rd ed. Lesson plans ©2016 Wolters Kluwer Page 12 Lesson Plans: Chapter 3—The Head, Face, and Neck coronoid process (p 78) 3‐27 Intraoral moving compression of masseter: (A) intraoral view, (B) lateral view (p 79) muscles of the Levator veli palatini, tensor veli palatine, and the palatine aponeurosis. Recognize endangerment sites and ethical cautions of the Levator veli palatini, tensor veli palatine, and the palatine aponeurosis. Practice clinical massage therapy techniques of the Levator veli palatini, tensor veli palatine, and the palatine aponeurosis. Platysma 79‐80 16 Figures 3‐28 Anatomy of the platysma (p Palpate the platysma. Allen, Clay & Pounds’ Basic Clinical Massage Therapy, 3rd ed. Lesson plans ©2016 Wolters Kluwer Page 13 Lesson Plans: Chapter 3—The Head, Face, and Neck 79) Identify attachments of the platysma. 3‐29 Stripping platysma with the Describe pain referral areas of the fingertips (p 80) platysma. Recall related muscles of the platysma. Recognize endangerment sites and ethical cautions of the platysma. Practice clinical massage therapy techniques of the platysma. Muscles attached to the hyoid 80‐82 17 Figures 3‐31 Anatomy of the hyoid bone Palpate the muscles attached to the hyoid. Allen, Clay & Pounds’ Basic Clinical Massage Therapy, 3rd ed. Lesson plans ©2016 Wolters Kluwer Page 14 Lesson Plans: Chapter 3—The Head, Face, and Neck and attached muscles (p 81) 3‐32 Stripping of suprahyoids (p 82) 3‐33 Stripping of infrahyoids (p 82) Identify attachments of the muscles attached to the hyoid. Describe pain referral areas of the muscles attached to the hyoid. Recall related muscles of the muscles attached to the hyoid. Recognize endangerment sites and ethical cautions of the muscles attached to the hyoid. Practice clinical Allen, Clay & Pounds’ Basic Clinical Massage Therapy, 3rd ed. Lesson plans ©2016 Wolters Kluwer Page 15 Lesson Plans: Chapter 3—The Head, Face, and Neck massage therapy techniques of the muscles attached to the hyoid. Digastric 82‐83 18 Figures 3‐34 Anatomy of digastric and stylohyoid (p 83) 3‐35 Stripping of posterior belly of digastric (p 83) Digastric is palpable but not truly discernible. Identify attachments of the digastric. Describe pain referral areas of the digastric. Recall related muscles of the digastric. Recognize endangerment sites and ethical cautions of the digastric. Allen, Clay & Pounds’ Basic Clinical Massage Therapy, 3rd ed. Lesson plans ©2016 Wolters Kluwer Page 16 Lesson Plans: Chapter 3—The Head, Face, and Neck Practice clinical massage therapy techniques of the digastric. Sternocleidomastoid 84‐85 18 Figures 3‐36 Anatomy of SCM (p 84) 3‐37 Stripping of sternal head of SCM (p 85) 3‐38 Stripping of clavicular head of SCM with thumb (A) and fingertips (B) (p 85) 3‐39 Pincer compression of SCM (p 85) Palpate the sternocleidomastoid.
Identify attachments of the sternocleidomastoid. Describe pain referral areas of the sternocleidomastoid.
Recall related muscles of the sternocleidomastoid.
Recognize endangerment sites and ethical cautions Allen, Clay & Pounds’ Basic Clinical Massage Therapy, 3rd ed. Lesson plans ©2016 Wolters Kluwer Page 17 Lesson Plans: Chapter 3—The Head, Face, and Neck of the sternocleidomastoid. Practice clinical massage therapy techniques of the sternocleidomastoid.
Scaleni 85‐89 19 Figures Palpate the scalenes.
3‐40 Anatomy of the scalenes and the thoracic outlet (p 86) 3‐41 Stripping of anterior scalene (p 87) Describe pain referral areas of the scalenes. Identify attachments of the scalenes. 3‐42 Stripping of posterior scalene Recall related with thumb (p 87) muscles of the scalenes. 3‐43 Stripping of scalenes with fingertips (p 87) Recognize endangerment sites and ethical cautions Allen, Clay & Pounds’ Basic Clinical Massage Therapy, 3rd ed. Lesson plans ©2016 Wolters Kluwer Page 18 Lesson Plans: Chapter 3—The Head, Face, and Neck of the scalenes. 3‐44 Deep compression of scalenes (p 88) 3‐45 Stripping of scalenes with client prone: thumb is on the scalenes (inset shows thumb under the edge of trapezius) (p 88) Practice clinical massage therapy techniques of the scalenes. 3‐46 Stripping of the scalenes with the knuckles (p 88) 3‐47 Stripping of the scalenes with the client seated (p 88) Allen, Clay & Pounds’ Basic Clinical Massage Therapy, 3rd ed. Lesson plans ©2016 Wolters Kluwer Page 19 Lesson Plans: Chapter 3—The Head, Face, and Neck Posterior neck muscles overview 89 Trapezius 89‐91 20 Figures Palpate the trapezius. 3‐48 Anatomy of trapezius (p 89) 3‐49 Deep stripping of trapezius (p 90) 3‐50 Deep stripping of superolateral trapezius (p 91) 3‐51 Pincer compression of trapezius (p 91) Identify attachments of the trapezius. Describe pain referral areas of the trapezius. Recall related muscles of the trapezius. Recognize endangerment sites and ethical cautions of the trapezius. Practice clinical massage therapy techniques of the Allen, Clay & Pounds’ Basic Clinical Massage Therapy, 3rd ed. Lesson plans ©2016 Wolters Kluwer Page 20 Lesson Plans: Chapter 3—The Head, Face, and Neck trapezius. Semispinalis capitis and cervicis, longissimus capitis 91‐92 21 Figures 3‐52 Anatomy of posterior neck muscles (p 92) Palpate the semispinalis capitis and cervicis, longissimus capitis. Identify attachments of the semispinalis capitis and cervicis, longissimus capitis. Describe pain referral areas of the semispinalis capitis and cervicis, longissimus capitis. Recall related muscles of the semispinalis capitis and cervicis, longissimus capitis. Recognize Allen, Clay & Pounds’ Basic Clinical Massage Therapy, 3rd ed. Lesson plans ©2016 Wolters Kluwer Page 21 Lesson Plans: Chapter 3—The Head, Face, and Neck endangerment sites and ethical cautions of the semispinalis capitis and cervicis, longissimus capitis. Practice clinical massage therapy techniques of the semispinalis capitis and cervicis, longissimus capitis. Splenius capitis, splenius cervicis 92‐93 22 Figures 3‐53 Anatomy of splenius capitis and splenius cervicis (p 93) Palpate the splenius capitis and splenius cervicis. Identify attachments of the splenius capitis and splenius cervicis. Describe pain referral areas of the splenius capitis and splenius cervicis. Allen, Clay & Pounds’ Basic Clinical Massage Therapy, 3rd ed. Lesson plans ©2016 Wolters Kluwer Page 22 Lesson Plans: Chapter 3—The Head, Face, and Neck Recall related muscles of the splenius capitis and splenius cervicis. Recognize endangerment sites and ethical cautions of the splenius capitis and splenius cervicis. Practice clinical massage therapy techniques of the splenius capitis and splenius cervicis. Multifidi and rotatores 93‐94 23 Figures 3‐54 Attachment patterns of multifidi and rotatores of entire spine (p 94) 3‐55 Anatomy of cervical multifidi Palpate the multifidi and rotatores. Identify attachments of the multifidi and rotatores. Allen, Clay & Pounds’ Basic Clinical Massage Therapy, 3rd ed. Lesson plans ©2016 Wolters Kluwer Page 23 Lesson Plans: Chapter 3—The Head, Face, and Neck and rotatores (p 94) Describe pain referral areas of the multifidi and rotatores. Recall related muscles of the multifidi and rotatores. Recognize endangerment sites and ethical cautions of the multifidi and rotatores. Practice clinical massage therapy techniques of the multifidi and rotatores. Suboccipital muscles 95‐97 24 Figures 3‐56 Anatomy of suboccipital Palpate the suboccipital muscles. Allen, Clay & Pounds’ Basic Clinical Massage Therapy, 3rd ed. Lesson plans ©2016 Wolters Kluwer Page 24 Lesson Plans: Chapter 3—The Head, Face, and Neck muscles (p 95) 3‐57 Stripping of posterior neck muscles with thumb (p 96) 3‐58 Bidirectional stripping of posterior Identify attachments of the suboccipital muscles. Describe pain referral areas of the suboccipital muscles.
Recall related muscles of the suboccipital muscles. neck muscles with thumb (A) or fingers (B) (p 97) Recognize endangerment sites and ethical cautions 3‐59 Compression of the suboccipital of suboccipital muscles. muscles (p 97) Practice clinical 3‐60 Moving massage therapy compression of techniques of the posterior neck suboccipital muscles.
muscles with fingertips (p 97) Allen, Clay & Pounds’ Basic Clinical Massage Therapy, 3rd ed. Lesson plans ©2016 Wolters Kluwer Page 25 Lesson Plans: Chapter 3—The Head, Face, and Neck 3‐61 Cross‐fiber stroking of posterior neck muscles with fingertips (p 97) 3‐62 Cross‐fiber stroking on posterior neck muscles with the thumb (p 97) Chapter Review 98 Assignments Review Case Study Answer Review Questions Evaluation Use Test Generator to create end of chapter test. Allen, Clay & Pounds’ Basic Clinical Massage Therapy, 3rd ed. Lesson plans ©2016 Wolters Kluwer Page 26