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FACE
FACE Introduction• The face is the anterior aspect of the head from the forehead to the
chin and from one ear to the otherMuscles of facial expression• They are subcutaneousThey are grouped under the following six heads1. Muscles of the scalp Occipitofrontalis: is a flat diagastric muscle with two
bellies(frontal and occipital bellies) which share a common tendon called the epicranial aponeuroses
2. Muscles of the Auricle Aurcularis anterior Aurcularis superior Aurcularis posterior
3. Muscles of the eyelids Orbicularis oculi Corrugator supercilli Levator palpebrae superioris4. Muscles of the nose Procerus Tranverse part of nasalis muscle/ compressor naris Alar part of nasalis muscle/ dilator naris Depressor septi5. Muscles surrounding the mouth orbicularis oris Zygomaticus major Zygomaticus minor Levator labii superioris alaeque
Levator labii superioris Levator anguli oris Depressor anguli oris Depressor labii inferioris Mentalis Risorius Buccinator6. Muscles of the neck platysma
Functional groups of facial muscles
OPENING
A} Palpebral fissure
SPHINCTER
Orbicularis oculi
DILATORS
1. Levator palpebral superioris
2. frontalis part of occipitofrontalis
B} Oral fissure Orbicularis oris All the muscles around the mouth, except the orbicularis oris and the mentalis muscles
C} Nostrils Compressor naris/ tranverse part of nasalis muscle
1. Dilator naris/ alar part of nasalis muscle
2. Depressor septi3. Levator labii superioris
alaeque nasi
Common facial expression and the muscles producing them• Surprise : frontalis• Smiling and laughing : zygomaticus major• Sadness : levator labii suprioris, levator anguli oris, depressor
labii superioris, depressor anguli oris• Frowning: corrugator supercili and procerus• Anger: dilator naris (alar part of nasilis), depressor septi• Doubt: mentalis• Grinning: risorius• Closing of the mouth: orbicularis oris• Whistling: buccinator, and orbicularis oris• Tension and stress: platysma
Muscle FunctionOrbital group
Orbicularis oculi
Closes the eyelids gently
-Palpebral part
-Orbital part Closes the eyelids forcefully
Corrugator supercilii
Draws the eyebrows medially and downward
Nasal groupNasalis-Transverse part
Compresses nasal aperture
-Alar part Draws cartilage downward and laterally opening nostril
Procerus Draws down medial angle of eyebrows producing transverse wrinkles over bridge of nose
Depressor septi Pulls nose inferiorly
Oral groupDepressor anguli oris
Draws corner of mouth down and laterally
Depressor labii inferioris
Draws lower lip downward and laterally
Mentalis Raises and protrudes lower lip as it wrinkles skin on chin
Risorius Retracts corner of mouth, grining
Zygomaticus major
Draws the corner of the mouth upward and laterally
Zygomaticus minor
Draws the upper lip upward
Levator labii superioris
Raises upper lip; helps formnasolabial furrow
Levator labiisuperioris alaeque nasi
Raises upper lip and opens nostril
Levator anguli oris
Raises corner of mouth; helps form nasolabial furrow
Orbicularis oris Closes lips; protrudes lips, osculation (kissing)
Buccinator Presses the cheek against teeth; compresses distended cheeks, whistling
Other muscles or groups
Anterior auricular
Draws ear upward and forward
Superior auricular
Elevates ear
Posterior auricular
Draws ear upward and backward
Occipitofrontalis-Frontal belly
Protracts scalp, Wrinkles forehead; raises eyebrows
-Occipital belly Draws scalp backward
Nerves of the faceThese include:1. Cutaneous(sensory) innervation of the face is provided
primarily by the trigeminal nerve (CN V)2. Motor innervation to the face is from the facial nerve (CN
VII)Cutaneous nerves of the face Trigeminal nerve ( main contribution) A small contribution from the cervical nerves The trigeminal nerve [V] divides into 3 major divisions namely:• ophthalmic nerve[V1] exit through the supraorbital fissure• maxillary nerve [V2] exit through the foramen rotundum• mandibular nerve[V3] exit through the foramen ovale
• they are named according to their main areas of their termination Eye…………………..ophthalmic divison maxilla……………….Maxillary division mandible……………..mandibular division
Ophthalmic nerve (CN V1)• superior division of the trigeminal nerve• smallest of the three divisions of CN V• Arises from the trigeminal ganglion as a wholly sensory nerve• The ophthalmic nerve [V1] exits the skull through the superior orbital
fissure and enters the orbitBranches Its branches that innervate the face include:• supratrochlear nerve which leaves the orbit superiorly and supplies the
upper eyelid and forehead• supraorbital nerve which leaves the orbit superiorly and supplies the
upper eyelid, forehead and scalp
• infratrochlear nerve: exits the orbit in the medial angle to innervate the medial parts of both eyelids
• lacrimal nerve: exits the orbit in the lateral angle to innervate the lacrimal gland and the lateral part of the upper eyelid
• external nasal nerve: supplies the anterior part of the noseMaxillary nerve (CNV2)• is the intermediate division of the trigeminal nerve• arises from the trigeminal ganglion as a wholly sensory nerve• leaves the cranium through the foramen rotundum in the base of the
greater wing of the sphenoid • it enters the orbit through the inferior orbital fissure of the maxillaBranches:Branches that innervate the face include:• a small zygomaticotemporal branch, which exits the
zygomaticotemporal foramen on the zygomatic bone and supplies the anterior part of the temporal fossa
• a small zygomaticofacial branch, which exits the zygomaticfacial foramen on the zygomatic bone and supplies the skin on the upper part of the cheek
• the large infra-orbital nerve, which exits the maxilla through the infra-orbital foramen and immediately divides into multiple branches to supply the lower eyelid, side of the nose, and upper lip
Mandibular nerve• the inferior and largest division of the trigeminal nerve• formed by the union of sensory fibers from the sensory ganglion
and the motor root of CN V in the foramen ovale in the greater wing of the sphenoid
• CN V3 has 3 sensory branches that supply the face• It also supplies motor fibers to the muscles of mastication Note: CN V3 is the only division of CN V that carries motor fibers
Branches: 3 major cutaneous branches that supply the face are; Auricotemporal nerve: supplies the external acoustic meatus,
temporal region Buccal nerve: skin of the lower part of the cheek mental nerve: skin over chin
Cervical plexus branches that supply that face:• Anterior division of great auricular nerve : supply skin over the
mandible and over the parotid gland
Clinical anatomyLesions of the Trigeminal Nerve
Can affect;• Corresponding anterior half of the scalp• Face, except for an area around the angle of the
mandible, the cornea, and conjunctiva• Mucous membranes of the nose, mouth, and anterior
part of the tongue• Paralysis of the muscles of mastication also occurs
Motor innervation to the Face The motor nerves of the face are;• the facial nerve to the muscles of facial expression • the motor root of the mandibular division of the trigerminal nerve
(CNV3) to the muscles of mastication which are; masseter temporal Medial pterygoid lateral pterygoid
Facial nerve (CN VII) • The motor root of CN VII supplies the muscles of facial expression, • The main trunk of CN VII which runs anteriorly is engulfed by the
parotid gland, in which it forms the parotid plexus
It gives rise to the 5 terminal branches of the facial nerve:1. temporal2. Zygomatic3. buccal4. marginal mandibular5. cervicalThe names of the branches refer to the regions they supply Temporal branch of CNVII :• emerges from the superior border of the parotid gland and crosses
the zygomatic arch to supply the; • auricularis superior • auricularis anterior• frontal belly of the occipitofrontalis• and,most important, the superior part of the orbicularis oculi
Zygomatic branch of CNVII: emerge from the anterosuperior border of the parotid gland to supply the;
• inferior part of the orbicularis oculi (supra orbital area), lateral part of the nose and upper lip
Buccal branch of CN VII: emerge from the anterior border of the parotid gland to supply the;
• muscles of the upper lip (upper parts of orbicularis oris and inferior fibers of levator labii superioris)
marginal mandibular branch of CN VII: emerge from the anterior inferior border of the parotid gland to supply the;
• risorius • muscles of the lower lip and chin Cervical branch of CN VII: emerge from the inferior border
of the parotid gland to supply the;• platysma
CLINICAL ANATOMY• Injury to branches of the facial nerve causes
paralysis of the facial muscles (Bell palsy)• A lesion of the zygomatic branch of CN VII causes
paralysis, including loss of tonus of the orbicularis oculi in the inferior eyelid
• Paralysis of the buccal branch of CN VII causes paralysis of the buccinator and superior portion of the orbicularis oris and upper lip muscles
• Paralysis of the marginal mandibular branch of CN VII causes paralysis of the inferior portion of the orbicularis oris and lower lip muscles
Note: Because the branches of the facial nerve are superficial, they are subject to injury by stab and gunshot wounds, cuts, and injury at birth