The Face and Scalp

8/11/2019 The Face and Scalp

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The Face and Scalp

oramosmd


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Muscles of Facial expression

I. Muscles that acts on the eyebrows/eyelids:

1.Occipitofrontalis

elevates eyebrows; wrinkles forehead

(surprise).

2.Corrugator supercilli

draws eyebrows downward and medially

Anger and frowning


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3. Orbicularis oculi

-closes eyelids(squinting).


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II. Muscles that acts on the nose:

1. Nasalis- draws ala of the nose towards the

septum.

2. Depressor septi- constricts the nares.

3. Procerus

wrinkles the skin over the nasal bones.


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III. Muscles that acts on the lips and mouth

1. Orbicularis oriscloses the lips

2. Levator anguli oriselevates angle of themouth medially(disgust).

3. Zygomaticus majordraws angle of the

mouth backward and upward(smile) 4. Zygomaticus minorelevates upper lip.


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5. Depressor labii inferioris- depresses thelower lip.

6. RisoriusRetracts angle of the mouth(false

smile) 7. Depressor anguli orisdepresses angle of

the mouth(frowning).

8. Buccinatorpresses cheek to keep it taut

9. Mentaliselevates and protrudes the lowerlip.


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V. Muscle that acts on the ear:

1. Auricularis muscle-retracts and elevates the

ear

anterior

superior

posterior


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IV Muscles that acts on the nose and upper

lips

1. Levator labii superioris- elevates upper lip

and dilates the nares(disgust)

2. Levator labii superioris alaquae nasae-

elevates ala of the nose and upper lip


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Nerve supply to the face and scalp

A. Facial Nerve:

Exits through the stylomastoid foramen.

Enters the parotid gland and branches in to:

1. Zygomaticotemporal branch that rise to:

a. Temporal branch.

B. Zygomatic branch

2. Cervicofacial branch that branches into:

a. Buccal branch

b. Mandibular branch

c. Cervical branch.


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The Facial Nerve: Innervates the muscles of facial expression.

Also innervates the muscles of the auricle,occipitalis muscle posteriorly and the

posterior digastric and stylohyoid muscle

anteriorly.


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Corneal Blink:

closure of the eyelid in response to blowing on

the cornea or touching it with a cotton wisp.

Efferent limb of the reflex arc is via the facial

nerve, while its afferent limb comes from the

ophthalmic branch of the trigeminal nerve.


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Bells palsy

It is the paralysis of the facial muscles due to a

lesion on the Facial nerve.

Central lesion of the facial nerve: spares the

forehead.

Peripheral lesion of the facial nerve: involves

all the facial muscles.


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Trigeminal nerve

A. Ophthalmic division

Upper eyelid and dorsum of the nose

Branches into:

supraorbital,

supratrochlear,

infratrochlear,

external nasal and

lacrimal nerves.


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B. Maxillary Division

Trigeminal neuralgia(tic douloreux): marked

paroxysmal pain along the course of thetrigeminal nerve especially radiating to themaxillary and mandibular area.

Common ,: aberrant blood vessels, aneurysm,chronic meningeal inflammation,brain tumor andothers like MS.


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C. Mandibular Division;

Innervates the face below the lower lip.

Supplies the face as the auriculotemporal, buccal

and mental nerves.


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Blood Supply

A. Facial artery

Arises from the ECA just above the upper border

of the hyoid bone.

Passes deep to the mandible, winds around the

lower border of the mandible and runs upward

and forward on the face.


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Nxt topic


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Branches of the facial artery:

ascending palatine a.

Tonsillar a.

Glandular a.Submental a.

Inferior labial a.

Superior labial a.Lateral nasal a.


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B. Superficial temporal artery

Terminal br. Of the ECA course anteriorly to the EAM going upto the Scalp.

Accompanies the auriculotemporal nerve

Gives rise to the:

Transverse facial a.Zygomaticotemporal a.

Middle temporal a.

Anterior auricular a.Frontal a.

Parietal a.


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Facial Vein

Begins as Angular vein by the confluence of the supraorbital

and supratrochlear vein.

The angular vein will eventually become the facial vein at the

lower orbital margin.

It receives tributaries from the corresponding branches of the

facial artery, infraorbital and deep facial veins.

It drains directly into the IJV or joins the anterior branch of

the Retromandibular vein to form the COMMON FACIAL

VEIN and eventually draining into the IJV.


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Facial vein

It communicates with the superior

ophthalmic veinand thus with the

CAVERNOUS SINUS, allowing a route of

infection from the face to the CRANIAL FOSSA.


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DANGEROUS AREA OF THE FACE:

area of the face near the nose( from the root of

the nose up to the upper lip) drained by the

facial veins. Septicemia can lead to meningitis andcavernous sinus thrombosis causing neurologic

damage and even death.


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D. Retromandibular vein

Formed by the Union of the superficial

temporal vein and maxillary veins behind the

mandible.


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Branches into:

A. Anterior branch that joins the Facial vein to

form the COMMON FACIAL VEIN.

B.Posterior branch that joins the posterior

auricular vein to form theEXTERNAL

JUGULAR VEIN.


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SCALP

LAYERS:

1. Skinwith hair and sebaceous glands.

2. Connective tissue(close subcutaneous

tissue)- dense connective tissue. Containsblood vessels,and nerves and arteries thatnourish the hair follicles. These arteries are

held by DCT around them and thus theyremain open when cut causing profusebleeding.


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4. Loose Connective Tissuesub aponeurotic

space containing the Emissary veins. It is a

DANGEROUS AREA, because infections from

these area can migrate into the intracranialsinuses via the EMISSARY VEINS.


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5. Pericraniumover the surface of the scalp.

Scalp hemorrhage: results from laceration ofarteriesat the dense subcutaneous tissue that

are unable to contract or retract causing

severe hemorrhage.


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Deep scalp infection : localized in the loose CT

layer and spreads across the calvaria to the

intracranial dural venous sinuses through the

emissary veins causing meningitis orsepticemia


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B. Innervation

Via the SUPRATROCHLEAR, SUPRAORBITAL,

ZYGOMATICOTEMPORAL,

AURICULOTEMPORAL,LESSER OCCIPITAL,

GREATER OCCIPITAL AND OCCIPITAL NERVES.


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C. Blood Supply

I. From the Internal carotid artery:

A. Supratrochlear A.

B. Supraorbital A.

II. From the External carotid artery:

A. Superficial temporal A.

B. Posterior Auricular A.C. Occipital A.

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The Face and Scalp