Face Flashcards
Muscles chracteristics
- Many
- Small
- Bony origin from skull
- Inserting into skin of face
- Supplied by facial nerves
- Called muscles of facial expression
Types of muscles
- Circumorbital and palpebral
- Nasal
- Buccolabial
- Oral sphincter
Circumorbital and palpebral muscles
Orbicularis oculi
Nasal muscles
Procerus
Buccolabial muscles
- Buccinator
- Levator labbii superioris
- Zygomaticus major
- Depressor anguli oris
Oral sphincter muscle
Orbicularis oris
Orbicularis oculi parts
- Orbital part: around orbital margin
- Palpebral part: eyelids
- Lacrimal part
Orbital part origin
Upper part medial palpebral ligament with bone above and below it
Orbital part insertion
- Lower border medial palpebral ligament
- Many fibers inserted into eyebrows skin
Orbital part curve
Curves around orbital margin
Palpebral part origin
Medial palpebral ligament
Passes in upper and lower eyelids
Palpebral part insertion
Fibers of both lids insert lateral in lateral palpebral raphe (ligament)
Lacrimal part origin
- Posterior lacrimal crest
- Fascia covering lacrimal sac
Lacrimal part insertion
Blends with palpebral part in eyelids
Orbicularis oculi nerve supply
- Temporal branch of facial nerve
- Zygomatic branch of facial nerve
Orbicularis oculi action
- Orbital part: closes eye firmly and suddenly in danger
- Palpebral part: closes eyes gently in sleep
- Lacrimal part: stretches and dilates lacrimal sac to help in tears drainage
Orbicularis oris parts
- Intrinsic part
- External part
Intrinsic part
Surrounds:
1. Mouth
2. Upper lips
3. Lower lips
Extrinsic part
Extension from surrounding muscles such as buccinator
Orbicularis oris nerve supply
- Buccal branch facial nerve
- Mandibular branch facial nerve
Orbicularis oris action
- Movement of lips and sphincter for closure of mouth
Buccinator
Cheek muscle
Buccinator origin upper fibers
Alveolar process of maxilla, opposite upper 3 molars
Buccinator origin lower fibers
Oblique line of mandible, opposite lower 3 molars
Buccinator origin middle fibers
Ptergoidmandibular ligament
From:
A. Pterygoid hamulus
To
B. Mylohyoid line posterior end
Buccinator insertion
- Upper fibers: upper lip
- Lower fibers: lower lip
- Middle fibers: decussate at mouth angle acting as a sphincter
Buccinator nerve supply
Buccal branch of facial nerve
Buccinator action
- Prevents food accumulation in vestibule
- Prevent saliva dribbling from mouth angle
- Blowing
- Whistling
Buccinator superficial relations
- Buccal fat pad
- Buccopharyngeal fascia
- Buccal nerve and vessels
- Facial blood vessels
Buccinator deep relations
Buccal mucosa
Buccinator sutures piercing
- Buccal nerve and vessels
- Parotid duct
Nerve supply
Motor:
1. Temporal nerve
2. Zygomatic branches (upper and lower
3. Buccal nerve
4. Mandibular nerve
5. Cervical branch
Sensory:
3 divisions of trigemnial nerve
1. Ophthalmic nerve
2. Maxillary nerve
3. Mandibular nerve
EXCEPT
Skin area on mandible angle and parotid (greater auricular nerve C2,C3)
Motor
Facial nerve enters parotid and divides into 5 branches
Temporal nerve supply
Supplies
1. Frontal belly of occipitofrontalis
2. Orbicularis upper part
Zygomatic nerve supply
- Lower part of orbicularis oculi
- Muscles between eye and mouth, including nose muscles
Buccal nerve supply
- Buccinator
- Upper part orbicularis oris
Mandibular nerve supply
- Lower part of orbicularis oris
- Lower lip muscle
Cervical nerve supply
Platysma
Applied anatomy: facial nerve injury
Extracranial part
Facial palsy
Paralysis of facial muscles lead to:
1. Patient cannot close his eye in affected
2. Dribbling of saliva from mouth angle in affected side
3. Accumulation of food in mouth vestibule in affected side
4. Deviation of mouth angle to opposite side (healthy side)
Ophthalmic nerve branches and origin
- Supraorbital: frontal nerve
- Supratrochlear: frontal nerve
- Infratrochlear: nasociliary nerve
- External nasal: nasociliary nerve
- Palpebral: lacrimal nerve
Ophthalmic nerve distribution
- Skin of upper eyelid
- Skin of forehead
- Skin of dorsum of nose
Maxillary nerve branches
- Infraorbital:
Gives
- palpebral
- nasal
- labial - Zygomaticofacial: from zygomatic nerve
Maxillary nerve distribution
Skin of face:
1. Lower eyelid
2. Side of nose
3. Upper lip
Skin over zygomatic bone
Mandibular nerve branches
- Buccal
- Mental: from inferior alveolar nerve
Mandibular nerve distribution
- Skin of Cheek
- Skin lower lip
- Mandible
- Chin
Applied anatomy trigeminal neuralgia
Disease affecting sensory root of trigeminal nerve caused by compression of the nerve by large blood vessel or by tumor.
It is characterized by severe episodic pains restricted to areas supplied by maxillary and/or Mandibular nerve.
Atrial supply
- Facial artery
- Transverse facial artery
- Infraorbital artery
- Buccal artery
- Mental artery
- Supratrochlear artery
- Supraorbital artery
- Dorsal nasal artery
Facial artery
Branch of ECA in the neck
It has two parts:
1. Cervical
2. Facial
Facial part of facial nerve course
- Enters face at anteroinferior angle of masseter
- Runs in tortuous course to a point 1cm behind angle of mouth
- Ascends vertically on side of nose
- Reach eye medial angle
- End as angular artery which anastomoses with Supraorbital and Supratrochlear branches of ophthalmic artery
Facial part of facial nerve branches and supply
- Inferior labial: lower lip
- Superior labial: upper lip
- Nasal: nose side and septal branch to nasal septum anterior part
Transverse facial artery course and supply
Supply face
1. Branch of superficial temporal artery inside parotid
2. Leaves gland anterior border
3. Passes on masseter below zygomatic arch and above parotid duct
Infraorbital artery course and supply
- Termination of maxillary artery
- Comes out of Infraorbital foramen
- Divides into
- palpebral: lower eyelid
- nasal: side nose
- labial: upper lip
Buccal artery origin and supply
Branch of maxillary artery
Supplies cheek
Mental artery origin and supply
Branch of inferior alveolar artery from maxillary artery
Supplies chin and lower lip
Supratrochlear and Supraorbital artery origin and supply
Ophthalmic artery
Supply:
1. Upper eyelid
2. Forhead
Dorsal nasal artery origin and supply
Ophthalmic artery
Supply nose dorsum
Venous drainage
- Anterior facial vein or facial vein
- Posterior facial vein or retromandibular vein
Anterior facial vein beginning
Medial angle of eye by union of Supraorbital and Supratrochlear veins
Anterior facial vein course
- Runs a straight course downwards and backwards behind facial artery
2 leaves face at anteroinferior angle of masseter - Crosses mandible body and submandibular gland to enter neck
Anterior facial vein end
In neck by uniting with anterior division of posterior facial vein forming common facial vein which ends in IJV
Anterior facial vein tributaries
- Supraorbital
- Supratrochlear
- In face:
- Nasal
- Superior labial
- Inferior labial
- Veins from buccinator, masseter, and parotid
- Deep facial vein - In neck:
- Tonsillar
- Paratonsillar
- Submental gland veins
- Submandibular gland veins
Posterior facial vein beginning
Inside parotid by union of superficial temporal and maxillary veins
Posterior facial vein course
Descends superficial to ECA and deep to facial nerve
Posterior facial nerve end
- Divide into anterior and posterior divisions leaving gland at its lower end
- Anterior division unites with anterior facial vein forming common facial
- Posterior division unites with posterior auricular vein forming external jugular vein
Applied anatomy dangerous area of the face
Triangular area in the middle of face
1. Nose
2. Upper lip
Infection reaches cavernous sinus:
1. Anterior facial vein to
2. Deep facial vein to
3. Pterygoid venous plexus to
4. Emissary vein through foramen ovals to cavernous sinus
Lymph drainage
- Buccal: drain cheek
- Parotid: drain upper and lateral part face
- Submandibular: drain nose, upper and lower lips