Face

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Face

  1. 1. FACE
  2. 2. FACE Introduction • The face is the anterior aspect of the head from the forehead to the chin and from one ear to the other Muscles of facial expression • They are subcutaneous They are grouped under the following six heads 1. 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. 3. 3. Muscles of the eyelids  Orbicularis oculi  Corrugator supercilli  Levator palpebrae superioris 4. Muscles of the nose  Procerus  Tranverse part of nasalis muscle/ compressor naris  Alar part of nasalis muscle/ dilator naris  Depressor septi 5. Muscles surrounding the mouth  orbicularis oris  Zygomaticus major  Zygomaticus minor  Levator labii superioris alaeque
  4. 4.  Levator labii superioris  Levator anguli oris  Depressor anguli oris  Depressor labii inferioris  Mentalis  Risorius  Buccinator 6. Muscles of the neck  platysma
  5. 5. Functional groups of facial muscles OPENING SPHINCTER DILATORS A} Palpebral fissure Orbicularis oculi 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 1. Dilator naris/ alar part part of nasalis muscle of nasalis muscle 2. Depressor septi 3. Levator labii superioris alaeque nasi
  6. 6. 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
  7. 7. Muscle Orbital group Function Orbicularis oculi Closes the eyelids gently -Palpebral part -Orbital part Closes the eyelids forcefully Corrugator supercilii Draws the eyebrows medially and downward
  8. 8. Nasal group NasalisTransverse 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
  9. 9. Oral group Depressor anguli oris Depressor labii inferioris Mentalis Risorius Zygomaticus major Draws corner of mouth down and laterally Draws lower lip downward and laterally Raises and protrudes lower lip as it wrinkles skin on chin Retracts corner of mouth, grining Draws the corner of the mouth upward and laterally
  10. 10. Zygomaticus minor Levator labii superioris Levator labiisuperioris alaeque nasi Levator anguli oris Orbicularis oris Buccinator Draws the upper lip upward Raises upper lip; helps formnasolabial furrow Raises upper lip and opens nostril Raises corner of mouth; helps form nasolabial furrow Closes lips; protrudes lips, osculation (kissing) Presses the cheek against teeth; compresses distended cheeks,
  11. 11. 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 Draws scalp backward -Occipital belly
  12. 12. Nerves of the face These 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
  13. 13. •    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 orbit Branches  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
  14. 14. • 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 nose Maxillary 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 maxilla Branches: 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
  15. 15. • 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
  16. 16. 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
  17. 17. Clinical anatomy Lesions 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
  18. 18.  • •     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
  19. 19. It gives rise to the 5 terminal branches of the facial nerve: 1. temporal 2. Zygomatic 3. buccal 4. marginal mandibular 5. cervical The 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
  20. 20.  •  •  • •  • 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
  21. 21. • • • • 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

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