Download The Face514.09

 The
bones of the facial
skeleton include:
1
1. Frontal bone
3
2. Nasal bones
2
3. Lacrimal bones
4. Zygomatic bones
4
5
5. Maxillae
6. Mandible
6
Facial Skin

Posses numerous sweat
& sebaceous glands
 Connected to underlying
bones by loose
connective tissue, which
encloses the underlying
muscles
 Loss of elastic fibers in
skin cause permanent
wrinkles (e.g., “Crow’s
feet” and “worry lines”).
Fascia of the Face
Superficial fascia is
copious and loose
 Dee fascia: there is no
discrete layer of deep
fascia of the face except
in the regions of the
parotid glands and the
masseter muscles. It
forms capsules around
these structures.

Muscles of the Face
 Are
embedded in loose connective tissue
 Mostly arise from the skull bones and get
inserted into the skin
 All developed from the 2nd pharyngeal arch
 All supplied by facial nerve
 Act as sphincters around the orifices of
face (orbit, nose, mouth)
 Modify the expressions of face (muscles of
facial expression)
 Muscles
of facial expression are grouped
as muscles associated with the:
1.
2.
3.
4.
5.
Forehead
Orbit
Nose
Lips
Cheek
1
2
3
5
4
Muscles of the Forehead
Frontal belly of Occipitofrontalis
E. aponeurosis

Origin: skin &
superficial fascia of
the eyebrow
 Insertion: epicranial
aponeurosis
 Nerve supply:
temporal branches of
facial nerve
 Action: raise the
eyebrows in
expressions of
surprise or horror
Corrugator supercilli:
Lies deep to the
orbicularis oculi
 Origin: superciliary
arches
 Insertion: skin of the
eyebrow
 Supplied by
temporal branches of
facial nerve
 Action: Vertical
wrinkles of forehead,
as in frowning
Muscles of the eyelids

Sphincter:
 Orbicularis oculi
 Dilator:
 Levator palpebrae
superioris (muscle
of the orbit) &
 Frontal belly of
occipitofrontalis
palpebral part
Orbital part

Orbicularis oculi



3 parts:
• Palpebral
• Orbital
• Lacrimal
Supplied by temporal & zygomatic
branches of facial nerve
Action:
• palpebral part: acts
involuntarily, closure of eyelids
gently as in blinking
• orbital part: subject to the will
• Both orbital & palpebral parts
acting together: the eyelids are
firmly closed
• Lacrimal part: compreses the
lacrimal sac
Muscles of the nose
 Procerus
 Compressor
nares & Dilator
nares
 Supplied by
buccal branch of
facial nerve
Muscles of the Lips
 Sphincter
muscle:
 Orbicularis oris

Origin & Insertion:
• Near the midline from maxilla
above & mandible below
• From the deep surface of the
skin
• Many fibers derived from the
buccinator muscle
• Encircles oral aperture


Supplied by the buccal
branch of facial nerve
Action: closes lips together,
“pursing” as in whistling and
sucking
 Dilator
1.
2.
3.
4.
5.
6.
7.
8.
muscles:
Levator labii superioris
alaeque nasi
Levator labii superioris
Zygomaticus major &
minor
Levator anguli oris
Risorius
Depressor anguli oris
Depressor labii
inferioris
Mentalis
1
2
6
3
7
8
4
Muscle of the cheek
 Buccinator


Origin:
 Outer surface of the alveolar
margins of the maxilla &
mandible opposite the molar
teeth
 from the pterygo-mandibular
raphe
Insertion: upper & lower fibers
continue in upper and lower lips,
central fibers decussate at the
angle of mouth and blend with
fibers of orbicularis oris

Supplied by buccal
branch of facial nerve
 Pierced by parotid duct
& deep facial vein

Action:
 Compresses lips &
cheek against teeth
(accessory muscle of
mastication).
 Also used in
whistling, blowing
and sucking
Buccinator
Parotid duct
Sensory Nerve Supply

The skin is supplied by the
branches of the three
divisions of trigeminal
nerve (except for the area
over the angle of
mandible and parotid
gland, which is supplied
by the great auricular
nerve (C2, C3)).
 These nerves also supply
proprioceptive fibers to
the underlying muscles
Motor Nerve Supply

Branches of the
facial nerve:
 Temporal
 Zygomatic
 Buccal
 Mandibular
(marginal)
 Cervical
Posterior auricular
Facial Nerve




Emerges from stylomastoid
foramen
Gives:
 Posterior auricular nerve to
occipital belly of occipitofrontalis muscle
 A branch to supply posterior
belly of digastric & stylohyoid
muscle
Then runs forward and enters
into the parotid gland
Breaks up in the gland, forms a
plexus, and then emerges as 5
sets of branches: temporal,
zygomatic, buccal, mandibular
& cervical
Arterial Supply

Rich arterial supply
 Through 2 main
arteries:
 Facial artery (branch
of external carotid
artery)
 Transverse facial
artery (branch of
superficial temporal
artery)

Supplemented by many
smaller arteries which
accompany the sensory
nerves.
 These are branches of the
internal and the external
carotid arteries i.e.
 Supratrochlear
 Supraorbital
 Lacrimal
 External nasal
 Zygomaticotemporal
 Zygomaticofacial
 Infra-orbital
 Mental
Facial Artery

Arises from anterior
aspect of external
carotid artery in the
neck
 Arches upwards & over
the submandibular
salivary gland
 Curves around the
inferior margin of the
body of the mandible at
the anterior border of
the masseter muscle

Runs a tortuous course
towards the angle of
the mouth, and then
along the side of nose
to the medial angle of
the eye
 Lies deeper to the
muscles, anterior to the
facial vein
 Anastomosis with
terminal branches of
ophthalmic artery (a
branch of the internal
carotid artery)
Facial vein
Facial artery
Branches of facial artery
Lateral nasal
Superior labial
Inferior labial
Submental
Transverse Facial Artery

A branch of the superficial
temporal artery (which is
one of the terminal
branches of external carotid
artery)
 Runs forward across the
cheek over the masseter
muscle accompanying the
parotid duct
 Lies above the parotid duct
along with upper zygomatic
branches of facial nerve
Transverse
facial artery
Parotid duct
Venous Drainage
Transverse
facial vein
Facial vein
Smaller veins accompanying small
arteries & sensory nerves
Facial Vein

Formed at the medial angle
of the eye by the union of
supraorbital and
supratrochlear veins
 Descends behind the facial
artery to the lower border of
mandible
 Runs superficial to the
submandibular gland
 Joins the anterior division of
retromandibular vein, and
opens into the internal
jugular vein
 Tributaries:

Lateral nasal, superior
labial, inferior labial
and mental veins
 Communications:

With the pterygoid
venous plexus through
the deep facial vein,
which pierces the
buccinator muscle
 With the cavernous
sinus through superior
opthalmic vein
Transverse facial Vein

Accompanies the
corresponding artery
 Drains into the
superficial temporal
vein (which Joins the
maxillary vein to form
the retomandibular
vein),
Lymphatic Drainage
Vessels carrying lymph from the face pass through
superficial nodes arranged like a “collar” around the base
of the head and finally drain into the deep cervical lymph
nodes that lie along the internal jugular vein.
Occipital
Retro-auricular
(Mastoid)
Deep cervical
lymph nodes
Parotid
Submandibular
Submental
Clinical Anatomy

Facial lacerations tend to gape. Skin needs to be
sutured with great care to prevent scarring
 Bruises & inflammations of the face cause
considerable swelling because of the looseness of
superficial fascia.
 With age, the skin looses its resiliency and wrinkles
appear. Wrinkle lines lie at right angle of pull of
underlying muscles. Surgical incisions along these
wrinkle lines heal with minimum scarring
 Trigeminal neuralgia, a common condition usually
involving maxillary & mandibular nerves and sparing
the ophthalmic division
Damage to facial
nerve results in
Facial (Bell’s) palsy
(paralysis of facial
muscles) on the
side of the lesion
In lower motor
neuron lesion
the whole face
is affected
In upper motor neuron lesion,
only lower face is affected,
upper face is normal as it
receives bilateral supply.

Face is distorted, and
shows:







drooping of lower eyelid
sagging of the angle of the
mouth
dribbling of saliva
loss of facial expressions
loss of chewing, blowing,
sucking
Person is unable to show
teeth or close the eye on
affected side
Test individual branch
of facial nerve

Dangerous zone:
Infection in the marked
triangular area of the
face are dangerous as it
may spread to the
cavernous sinus and
result in thrombosis of
the sinus
 Because of its superficial
position, damage to
parotid duct can occur in
facial lacerations or in
surgical procedure on the
face
Where can one feel the pulsation of
the arteries of the face?
 Facial
artery: Lower
margin of mandible
along the anterior
border of masseter
 Superficial temporal
artery: As it crosses
the zygomatic arch
in front of the auricle
Our faces are a major part of our identity. Our
brains are specialized for recognizing faces; we
identify each other by our faces. A person's face
provides a wealth of information; within seconds of
seeing a person's face we immediately know much
about him or her (including gender, age, race,
emotional state, overall health etc. etc.).
why do we look different from one another?
 Familial traits
 Size & shape of bones
 Amount & distribution of subcutaneous fatty
tissue
It takes 43 muscles to frown and only 17
muscles to smile, but it doesn't take any to
just sit there with a dumb look on your face
SO…..
….And keep on smiling….
What matters
most is how
you see
yourself….…