Muscles of Facial Expression Flashcards by O S

Where are the muscles of facial expression found (with regards to fascia)

Muscles of facial expression are found in the superficial fascia around facial orifices

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Where do muscles of facial expression tend to originate?

Bone or fascia

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Where do muscles of facial expression tend to insert?

Skin

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Where do wrinkles form?

Wrinkles form at 90 degrees to the muscle fibre direction

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What cranial nerve innervates the muscles of facial expression?

CN VII (facial nerve)

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What are the 2 functions of muscle of facial expression

Dilators and Sphincters -
control the opening of facial orifices

Movers of overlying skin -
reflect various facial expressions

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How are the muscles of facial expression grouped?

By regions

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What are the 5 muscles of facial expression of the mouth?

1- Obicularis Oris
2-Levator Anguli Oris
3- Depressor Anguli Oris
4- Zygomaticus Major
5- Risorius

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Obicularis Oris? (OPENS)

Sphincter encircling mouth.

Fibres originate mainly from contributions of other facial muscles, also from labial alveolar bone

Closes oral aperture, protrude lips, press lips against teeth

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Levator Anguli Oris? (SMILE)

Originates at the canine fossa

Inserts at the angle of the mouth, blends with fibres of Obicularis Oris

Acts to lift the angle of the mouth

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Depressor Anguli Oris? (SAD)

Triangular muscle

Base: originates from external oblique line of mandible
Apex: fibres ascend and converge to apex at angle of mouth, blend with fibres of obicularis oris

Acts to pull angle of mouth downwards

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Zygomaticus Major (LAUGHING)

Arises: facial aspect of zygomatic bone
Inserts: fibres descend down and medially to the angle of the mouth, blend with fibres of obicularis oris

Acts to lift angle of mouth upward and backward

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Risorius (GRINNING)

Thin, wispy but large

Arises: parotid fascia, small contribution from platysma fibres
Inserts: transversely into angle of mouth

Acts to retract angle of the mouth backwards

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What are the 3 muscles of facial expression associated with the lips of the mouth?

Quadratus Superioris
Depressor Labii Inferioris
Depressor Anguli Oris

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What 4 muscles compose the quadratus superioris?

1-Zygomaticus Major (as above)

2-Zygomaticus Minor - just medial to z major, lifts angle of mouth

3-Levator Labii Superioris -, medial to z minor, lifts UPPER lip
[[levator anguli oris - medial to LLS, lifts corner of mouth]]

4- Levator Labii Superioris Alaeque Nasi - lifts upper lip and alar cartilage of nose

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Depressor Labii Inferioris?

Arises: lower portion of oblique line of mandible
Inserts: lower lip
Acts: depresses LOWER lip

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Depressor Anguli Oris?

Most superficial of all lower oral muscles

Arises: chin
Inserts: modiolus (corner of mouth)

Acts: depresses angle of mouth

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What is the muscle of facial expression which extends from the front of the head to the back of the head?

The occipitofrontalis:
Starts at Occipital belly: 
   arises - from superior nuchal line and mastoid process 
   inserts - epicranial aponeurosis 
Ends with Frontal belly:
   arises - epicranial aponeurosis
   inserts - obicularis oculi

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What is the acronym for SCALP?

Skin
Connective tissue (highly vascularised)
Aponeurosis
Loose connective tissue
Pericranium

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What is the muscle of facial expression associated with the cheek?

Buccinator

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Buccinator?

Origin: pterygomandibular raphé, alveolar processes of maxilla and mandible

Fibres sweep forward through cheek as flattened sheet

Insertion: Inferior fibres sweep upwards and superior fibres sweep downwards to blend with obicularis oris

Action:
Prevents cheeks from expanding when forcefully pushing out air (brass instruments)
AIDS in mastication (but still classed muscle of facial expression) as pushes cheeks against vestibular surfaces of molar teeth and so pushes food onto occlusal surfaces of teeth.

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What is the muscle of facial expression associated with the chin?

Mentalis

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Mentalis?

deep to depressor labii inferioris and depressor anguli oris.

Conical muscle

Origin: incisive fossa
Insertion: skin of chin

Acts: contraction puckers skin overlying chin which help obicularis oris to clear food from mandibular labial vestibule

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What is the muscle of facial expression associated with the eye?

Obicularis Oculi

Briefly describe Obicularis Oculi

Sphincter muscle which opens/closes eye

What are the 3 components of the obicularis oculi?

Orbital portion Palpebral portion Lacrimal portion

What is the origin, insertion and action of the orbital portion?

Origin: bone of upper medial orbital margin Insertion: from below at prominent medial palpebral ligament (ligament into anterior lacrimal crest of maxilla) Action: FORCIBLY squeeze eyes shut

What is the origin, insertion and action of the palpebral portion?

Origin: medial palpebral ligament Fibres sweep across upper and lower eyelids individually from medial palpebral ligament to interdigitate at the lateral palpebral ligament Action: lightly approximates eyelids (light blinking/sleeping)

What is the origin, insertion and action of the lacrimal portion?

(small) Origin: lacrimal bone deep behind lacrimal sac Insertion: medial portions of lids Action: holds lids against eyeballfor more even distribution of moistening tears and guides tears to tear duct

What is the muscle associated with the nose?

Nasalis

What are the 2 portions of the nasalis?

transverse portion and alar portion

What is the origin, insertion and action of the transverse portion of the nasalis?

Origin: upper portion of the canine ridge of the maxilla Insertion: midline aponeurosis (then into bilateral counterpart) Action: flare nostrils

What is the origin, insertion and action of the alar portion of the nasalis?

Origin: nasal margin of maxilla Insertion: skin of nostrils Action: flare nostrils

What are the branches of the facial nerve?

``` Posterior Auricular Temporal Zygomatic Buccal Mandibular Cervical ```

Where does the facial nerve divide?

Within the parotid gland

Where does the facial nerve exit the skull?

into internal acoustic meatus, through facial canal and out through stylomastoid foramen.

What causes Bell's Palsy and what is the recovery like?

Bell's Palsy is a viral infection of the facial nerve. there is good recovery after a course of corticosteroids

What are the clinical tests for motor function of the facial nerve?

ask patient: - frown - close eyes TIGHTLY - smile - puff out cheeks

Where does the facial artery arise from?

The external carotid

Which facial veins drain to the external jugular?

Facial vein, common facial vein

What is the pterygoid venous plexus?

collection of veins forming a plexus of considerable size which sits between the temporalis muscle and lateral pterygoid

What does the pterygoid venous plexus communicate with and what does this mean clinically?

namely with: the deep facial vein, incl. alveolar, palatine, buccal veins etc. and the cavernous sinus, which surrounds the pituitary gland This means that infection of the superficial face may travel to the cavernous sinus and cause cavernous sinus thrombosis.

What are the symptoms of cavernous sinus thrombosis?

Edema of eyelids, Conjunctivitis, Paralysis of cranial nerves

What is the general path of the facial artery?

anterior to the anterior aspect of the massester, and then of buccinator, crosses angle of mouth

What is the general path of the facial vein?

Runs anterior to the anterior aspect of the massester. Superior to the facial artery. Crosses at the corner of the nose.

What do superficial lymphatics follow?

VEINS

What do deep lymphatics follow?

ARTERIES

If facial controls MOTOR of face, what controls SENSORY to face??

Greater Auricular Nerve (C2, C3) Cranial Nerve V (Trigeminal)

Where does the greater auricular nerve innervate?

The angle of the mandible and lower part of ear lobe

Where is the dermatome for the ophthalmic branch of V? (V1)

orbit, mid-nose, forehead

Where is the dermatome for the maxillary branch of V? (V2)

maxilla, anterior temple

Where is the dermatome for the mandibular branch of V? (V3)

mandible, mid-temple, anterior ear

What are the branches of the ophthalmic division?

SUPRAORBITAL, lacrimal, supra-trochlear, infra-trochlear, external nasal

What are the branches of the maxillary division?

INFRAORBITAL, zygomatico-facial, zygomaticotemporal

What are the branches of the mandibular division?

MENTAL, long buccal, auriculo-temporal

Where do the mental nerves, infra-orbital nerves, zygomatico-facial nerves and supra-orbital nerves exit the viscerocranium?

Through their respective foramina of the same name

Where do the the supra-orbital, infra-orbital and mental nerves divide?

The trigeminal sensory ganglion

What are the clinical testsfor sensory innervation to the face?

Ask patient to close their eyes Gently brush the skin in each dermatome with a fine tip of cotton wool Ask the patient to tell you when they feel their skin is being touched Compare the 2 sides