Download Region 2: Superficial Face and Parotid Area Landmarks on Face

Region 2: Superficial Face and Parotid Area
Landmarks on Face
--Frontal Eminences: 2 prominences of the forehead
--Superciliary arches: just below frontal eminence w/ glabella b/w arches
--Nasion: depression below glabella and commencement of nose
--Supraorbital margins and notches
--Infraorbital foramen: below orbit, in maxilla, below supraorbital notch
--ala and vestibule of nose
--philtrum: vertical, midline groove running from upper lip to nasal septum
--vestibule: area of oral cavity b/w cheeks and teeth
--frenulum of lips: attaches lips to gums at midline of vestibule
--mandible: body, angle, oblique line, ramus, head and neck
--mental foramen: on mandible, in line with supra and infraorbital foramina
Skin of Face
--Sensory Innervation of face is TRIGEMINAL NERVE (CN V)
*V1: Ophthalmic Division
a. supraorbital nerve (off frontal n.): through supraorbital
notch/foramen
b. supratrochlear nerve (off frontal n.): pierces orbital fascia
c. lacrimal nerve: pierces orbital fascia
d. infratrochlear nerve (off nasociliary n.)
e. external nasal nerve (off anterior ethmoidal n.  branch of
nasociliary n.)
*V2: Maxillary Division
a. infraorbital nerve: through infraorbital forament
b. zygomaticotemporal nerve (off zygomatic n.): enters temporal fossa
c. zygomaticofacial nerve (off zygomatic n.): supply cheek
*V3: Mandibular Division
a. auriculotemporal nerve: travels with superficial temporal artery
b. buccal nerve (enters face over buccinators muscle): supplies skin
over buccinators and mucous membranes in gums and mouth in
same area
c. mental nerve (off inferior alveolar n.): supplies chin and lower lip
Fascia
--Temporal fascia: strong fascia over temporal fossa, attached to superior temporal
line above and zygomatic arch below
Muscles of Facial Expression: ALL innervated by FACIAL NERVE
--Muscles of Scalp
*Epicranius: consists of frontal (frontalis) and occipital (occipitalis) bellies
with galea aponeurotica between
--Muscles Around Eye
*Obicularis Oculi: encircles palpebral fissure, closes orbit and covers globe
*Corrugator Supercilii
--Muscles Around Nose
*Procerus
*Nasalis: alar and transverse parts
*Depressor Septi
--Muscles Around Mouth
*Obicularis Oris: important in closing the mouth
*Buccinator: important accessory muscle of mastication
~pterygomandibular raphe: one of the origins of buccinators,
attached above to hamulus of medial pterygoid plate and below to
mandible behind the third molar tooth, serves as origin for superior
pharyngeal constrictor
*Levator Labii Superioris Alaeque Nasi
*Levator Labii Superioris
*Zygomaticus Minor
*Zygomaticus Major: pulls angle of mouth upward and lateral as in laughing
*Levator Anguli Oris
*Risorius: retracts angle of mouth
*Depressor Anguli Oris
*Depressor Labii Inferioris
*Mentalis
*Platysma
Parotid Gland
--largest salivary gland in head and neck
--facial nerve and its branches basses THROUGH the gland
--structures emerging from the margins of the gland
*parotid/Stensen’s duct: crosses masseter muscle and passes through
buccinators muscle at level of 2nd upper molar
*superficial temporat artery and vein
*auriculotemporal nerve
*branches of facial nerve
*transverse facial artery
Facial Nerve
--nerve to muscles of facial expression
--after emerging from stylomastoid foramen it supplies: posterior belly of digasric
and stylohyoid muscles
--gives off posterior auricular nerve
--in parotid gland divides into upper and lower divisions
*Upper division: temporal, zygomatic, and buccal branches
*Lower division: buccal, marginal mandibular, and cervical branches
Blood Supply: Arterial
--Facial artery (from external carotid artery)
*Angular artery (terminal brach of facial artery): anastomoses with dorsal
nasal branch of ophthalmic artery
*Often makes a loop at angle of mouth to prevent stretching during opening
of mouth
--inferior labial artery
--superior labial artery
--Transverse facial artery (from superficial temporal artery)
Blood Supply: Venous
--Facial Vein: empties into internal jugular vein
--Retromandibular Vein (joins with Posterior auricular v. to form external jugular v.)
Scalp
--Layers of Scalp
*S: Skin
*C: Connective tissue (dense, gapes when cut, hence bleeds profusely)
*A: Aponeurosis of the epicranius muscle (galea aponeurotica)
*L: Loose CT (allowing epicranius muscle to move)
*P: Periosteum of skull
--Nerves
*Trigeminal Nerve (CN V): all 3 divisions
*Anterior Primary Rami of C2 and C3 of cervical Plexus
~Lesser occipital nerve
~Great auricular nerve
*Posterior primary rami of C2 and C3
~greater occipital nerve (C2)
~least occipital nerve (C3)
--Blood Supply
*Internal Carotid Artery
~ophthalmic artery
--supraorbital branches
*External Carotid Artery
~maxillary and superficial temporal arteries (terminal branches of
external carotid)
~posterior auricular artery
~occipital artery