Dr. Mansi Mehta (MDS) - Seminar on Facial Musculature

1. FACIAL
MUSCULATURE
SEMINAR
By Dr. Mansi Mehta
MDS - 2019

2. Source
Introduction
Definition
Types of muscles
Development
Neuromuscular junction
Functions
Muscles of face
Muscles of mastication
Applied aspect
Fun facts
Conclusion
References

3. INTRODUCTION
There are more than 600
muscles in the body, doing everything
from pumping blood to moving food
through the intestines, to helping lift
heavy objects (like backpacks).
Hugh Huxley (1924-) and Andrew Huxley (1917-)
(the scientists were unrelated) researched theories
regarding muscle contraction. Hugh Huxley was
initially a nuclear physicist who entered the field of
biology at the end of World War II.
Swiss biologist Victor Albrecht von Haller
(1708–1777) was the first scientist to
discover the relationship between nerves
and muscles

4. Source
MUSCLE (L. Musculus) – A type of tissue composed of contractile cells or fibres that effects movement of an
organ or part of the body
The outstanding characteristic of a muscular tissue is its ability to shorten or contract. It
also possesses the properties of irritability, conductivity and elasticity. Muscle tissue
possesses little intercellular materials, hence its cells or fibers lie close together.
Ref: Taber’s Cyclopedic Medical Dictionary

5. TYPES OF MUSCLES
CARDIAC
MUSCLE
SMOOTH
MUSCLE
SKELETAL
MUSCLE
There are three types
of muscles that occur in
the body ,
differentiated on the
basis of histologic
structure

6. SMOOTH SKELETAL CARDIAC
Involuntary, non-striated, Visceral Voluntary, Striated Involuntary, Striated, Myocardial
Located in internal organs especially
digestive tract, respiratory passages,
urinary and genital ducts, urinary
bladder, gall bladder & walls of blood
vessels
Located in upper & lower limbs,
tongue, pharynx & upper portion of
esophagus
Located in the heart & walls of large
veins where they enter heart
Fibre length: 50-200m Fibre length: 25,000m -
Thickness: 4-8m Thickness: 75m -
Spindle or fusiform shaped fibres Cylindrical shaped fibres -
Single & central nucleus Multinucleated Single nucleus
Cells are arranged in layers or sheets,
may occur as isolated units in
connective tissue
Parallel bundles Branching network of individual cells
that are linked electrically and
mechanically to function as a unit
Capable of slow but sustained
contractions, though it is less powerful
than skeletal muscle the amount of
shortening can be much greater
Powerful contractions by virtue of
regular organization of its contractile
proteins
Less powerful than a skeletal muscle
but far more resistant to fatigue &
helps in rhythmic contractions
Ref: Gray’s Anatomy & Taber’s Cyclopedic Medical Dictionary

9. MORPHOLOGICALFORMS

10. SKELETAL
MUSCLE
DEVELOPMENT OF MUSCLE
Derived from somites, somitomeres & from lateral plate of mesoderm. At
these sites there are cells that are precursors of muscles. These cells undergo
many divisions & finally differentiate into myoblasts. Myoblasts synthesize the
proteins actin & myosin. Several myoblasts fuse to form multinucleated tube
like elements that are called myotubes. Molecules of actin, myosin & other
contractile proteins form myofibrils that are arranged in definite orientation.
Aggregation of fibrils pushes nuclei to the periphery, thus a muscle fibre is
formed. Satellite cells present around muscle fibres can help in growth of the
fibres
Derived from mesenchyme
SMOOTH
MUSCLE
CARDIAC
MUSCLE
Derived from splanchanopleuric mesoderm in relation to developing heart
tubes & pericardium
Ref: Human Embryology- Inderbeer Singh

11. FUNCTIONS

12. MUSCLES OF
FACIAL
EXPRESSIONS MUSCLES OF
MASTICATION

13. FACIAL MUSCLES
They are embedded in the superficial fascia, and most
arise from the bones of the skull and are inserted into the
skin.
The orifices of the face, namely the orbit, nose and mouth
are guarded by the eyelids, nostrils and lips respectively.
It is the function of facial muscles to serve as sphincters or
dilators of these structures.
A secondary function is to modify expressions of face.
DERIVED FROM
SUPPLIED BY
Second pharyngeal arch or
hyoid arch
Facial nerve

14. SCALP
Occipito-
frontalis
AURICLE
Auricularis
superior
Auricularis
anterior
Auricularis
posterior
EYELIDS
Orbicularis oculi
Corrugator
supercilii
Levator
palpebrae
superioris
NOSE
Procerus
Compressor
naris
Dilator naris
Depressor septii
NECK
Platysma
Orbicularis
oris
Levator
kabii
superior
is
alaquae
nasii
Zygomaticus
major
Levator
labii
superior
is
Levator
anguli oris
Zygoma
ticus
minor
Depressor
anguli oris
Depress
or labii
inferioris
Mentalis Risorius Buccinator

15. OCCIPITOFRONTALIS01
MUSCLE ORIGIN INSERTION ACTION
Occipital belly Highest nuchal
line of occipital
bone
Epicranial
aponeurosis
Moves scalp on
skull and raises
eyebrows
Frontal belly Skin & superficial
fascia of eyebrows
Ref: Snell Book

16. CORRUGATOR SUPERCILII02
ORIGIN INSERTION ACTION
Medial end of
superciliary arch
Skin of mid eyebrow Vertical wrinkles of
forehead as in
frowning
Ref: BD Chaurasia Book

17. ORBICULARIS OCULI03
MUSCLE ORIGIN INSERTION ACTION
Orbital part, on and
around the orbital
margin
Medial part of
medial palpebral
ligament and
adjoining bone
Concentric rings
return to the point of
origin
Close lids tightly;
wrinkling; protects
eye from bright light
Palpebral part, in the
lids
Lateral part of
medial palpebral
ligament
Lateral palpebral
raphe
Closes lids gently;
blinking
Lacrimal part, lateral
and deep to the
lacrimal sac
Lacrimal fascia and
lacrimal bone
Upper and lower
eyelids
Dilates lacrimal sac;
directs lacrimal
puncta into lacus
lacrimalis; supports
the lower lid
Ref: BD Chaurasia Book

18. PROCERUS04
ORIGIN INSERTION ACTION
Nasal bone Skin between eyebrows Wrinkles skin of nose
Ref: Snell Book

19. COMPRESSOR NARIS05
ORIGIN INSERTION ACTION
Frontal process of
maxilla
Aponeurosis of bridge of
nose
Compresses mobile
nasal cartilages
Ref: Snell Book

20. DILATOR NARIS06
ORIGIN INSERTION ACTION
Maxilla Ala of nose Widens nasal aperture
Ref: Snell Book

21. ORBICULARIS ORIS07
MUSCLE ORIGIN INSERTION ACTION
Intrinsic part, deep
stratum, very thin
sheet
Superior incisivus
from maxilla
Inferior incisivus
from mandible
Angle of mouth Closes & purses the
mouth, numerous
extrinsic muscles
make it most
vulnerable for
various types of
grimaces
Extrinsic part, two
strata, formed by
converging muscles
Thickest middle
stratum, derived
from buccinator,
thick superior
stratum, derived
from elevators &
depressors of lips &
their angles
Lips & angle of
mouth
Ref: BD Chaurasia Book

22. DILATOR MUSCLES OF LIPS08
MUSCLE ORIGIN INSERTION ACTION
Levator labii
superior alaquae
nasi
Levator labi
superioris
Zygomaticus major
Zygomaticus minor
Levator anguli oris
Risorius
Depressor anguli
oris
Depressor labi
inferioris
Mentalis
Bones & fasia
around oral aperture Lips Separate lips

23. BUCCINATOR09
ORIGIN INSERTION ACTION
Upper fibres, from maxilla
opposite molar teeth
Upper fibres, straight to
the upper lip
Flattens cheek against
gums and teeth; prevents
accumulation of food in
the vestibule. This is a
WHISTLING muscle
Lower fibres, from
mandible, opposite molar
teeth
Lower fibres, straight to
the lower lip
Middle fibres, from
pterygomandibular raphe
Middle fibres decussate
before passing to the lips
Ref: BD Chaurasia Book

24. PLATYSMA10
ORIGIN INSERTION ACTION
Upper part of
pectoral and deltoid
fascia, fibres run
upwards & medially
Anterior fibres to the
base of the mandible
Posterior fibres to the
skin of lower face & lip
& may be continuous
with the risorius
Releases pressure of
skin on subjacent
veins, depresses
mandible, pulls angle of
mouth downwards as in
horror or surprise
Ref: BD Chaurasi Book
A thin sheet of striated muscle lying within or just beneath the superficial fascia, serving to
produce local movement of the skin, and well developed in many lower mammals is called
as PANNICULUS CARNOSUS but in humans represented primarily by the Platysma.
NOTE:

25. BRANCHES OF
FACIAL NERVE

26. EXPRESSIONS MUSCLES
SMILING & LAUGHING ZYGOMATICUS MAJOR
SADNESS LEVATORLABISUP&LEVATORANGULIORIS
WHISTLING BUCCINATOR & ORBICULARIS ORIS
CLOSING THE MOUTH ORBICULARIS ORIS
GRINNING RISORIUS
DOUBT MENTALIS
CONTEMPT ZYGOMATICUS MINOR
ANGER DILATOR NARIS & DEPRESSOR SEPTII
GRIEF DEPRESSOR ANGULI ORIS
FROWNING CORRUGATOR SUPERCILII & PROCERUS
HORROR TERROR FRIGHT PLATYSMA
SURPRISE FRONTALIS

27. Develop from mesoderm of first branchial arch
Supplied by mandibular nerve
MUSCLES OF
MASTICATION
PRIMARY
MASSETER
MEDIAL
PTERYGOID
LATERAL
PTERYGOID
TEMPORALIS
SECONDARY
SUPRAHYOID INFRAHYOID

28. GENIOHYOID
MYLOHYOID
STYLOHYOID
DIGASTRIC
SUPRAHYOID
THYROHYOID
OMOHYOID
STERNOTHYROID
STERNOHYOID
INFRAHYOID

29. MASSETER01
Ref: Okeson & BD Chaurasia Book
ORIGIN
Sup: from ant 2/3 of lower border of zygomatic
arch & adjoining zygomatic process of maxilla
Mid: from ant 2/3 of deep surface & post 1/3 of
lower border of zygomatic arch
Deep: from deep surface of zygomatic arch
INSERTION
Sup: into lower part of lateral surface of ramus
of mandible
Mid: middle part of ramus
Deep: upper part of ramus
FUNCTION:
elevates the
mandible and
contributes to
protrusion
Masseteric
branch of the
mandibular nerve
of the trigeminal
nerve
Masseteric
artery

30. TEMPORALIS02
Ref: Okeson & BD Chaurasia Book
ORIGIN
Temporal fossa, excluding zygomatic
bone
Temporal fascia
INSERTION
Anterior border of coronoid process &
anterior border of ramus of mandible
as far forward as the last molar tooth
FUNCTION:
elevates the
mandible, contributes
to retrusion & side to
side grinding
Deep temporal
nerve from the
mandibular
branch of the
trigeminal nerve
Anterior,
posterior &
superficial
temporal arteries

31. MEDIAL PTERYGOID03
Ref: Okeson & BD Chaurasia Book
ORIGIN
Sup head: from tuberosity of maxilla &
adjoining bone
Deep head: Medial surface of lateral
pterygoid plate & grooved surface of
pyramidal process of palatine bone
INSERTION
Roughened area on the medial surface of
angle & adjoining ramus of mandible,
below and behind mand foramen &
mylohyoid groove
FUNCTION:
elevates the
mandible and
contributes to
protrusion
Mandibular
branch of
trigeminal nerve
Pterygoid
branch of
maxillary artery

32. SUPERIOR LATERAL PTERYGOID04
Ref: Okeson & BD Chaurasia Book
ORIGIN
Lower part of the lateral surface of the
greater wing of sphenoid bone & from
the infratemporal crest
INSERTION
Neck of the mandibular condyle & into
the front margin of the articular disc
FUNCTION:
stabilizes condyle &
disc during mandible
loading (ex-unilateral
chewing)
Pterygoid branch
of the trigeminal
nerve
Pterygoid
branch of
maxillary artery

33. INFERIOR LATERAL PTERYGOID04
Ref: Okeson & BD ChaurasiaBook
ORIGIN
Lateral surface of the lateral pterygoid
plate
INSERTION Neck of the mandibular condyle
FUNCTION:
protrudes mandible,
contributes to lateral
movements & mouth
opening
Pterygoid branch
of the trigeminal
nerve
Pterygoid
branch of
maxillary artery

34. TYPES OF
ATTACHMENT
INCIDENCES UPPER HEAD LOWER HEAD
TYPE I 36% Into disc capsule
complex & condyle
Into condyle
TYPE II 28% Into disc capsule
complex
Into condyle
TYPE III 26% Into condyle Into condyle
TYPE IV 8% Into disc complex
capsule
Into disc complex
capsule & condyle
Sometimes
third head
is also
found
The type of lateral pterygoid muscle
attachments may determine the tendency for
TMJ dislocation

36. MUSCLE PROXIMAL
ATTACHMENT
DISTAL
ATTACHMENT
NERVE
SUPPLY
ACTIONS
STERNO-
HYOID
Posterior surface of
manubrium sterni
Adjoining parts of
clavicle & posterior
sternoclavicular
ligament
Medial part of lower
border of hyoid bone
Ansa
cervicalis
Depresses the hyoid bone following its
elevation during swallowing & during
vocal movements
STERNO-
THYROID
(lies deep to
sternohyoid)
Posterior surface of
manubrium sterni
Adjoining part of
first costal cartilage
Oblique line on the
lamina of thyroid cartlage
Ansa
cervicalis
Depresses the larynx after it has been
elevated in swallowing & in vocal
movements
THYRO-
HYOID (lies
deep to
sternohyoid)
Oblique line of
thyroid cartilage
Lower body of body &
greater cornua of hyoid
bone
C1 through
hypoglossal
nerve
Depresses hyoid bone
Elevates larynx when the hyoid is fixed
by suprahyoid muscles
OMO-
HYOID
Upper border of
scapula near the
suprascapular
notch
Adjoining part of
suprascapular
ligament
Lower border of body of
hyoid bone lateral to
sternohyoid
Superior
belly by
superior
root of ansa
cervicalis, &
inferior belly
by ansa
Depresses the hyoid bone following its
elevation during swallowing or in vocal
movements

37. MUSCLE PROXIMAL
ATTACHMENT
DISTAL
ATTACHMENT
NERVE
SUPPLY
ACTIONS
STYLO-
HYOID
Posterior surface of
styloid process
Junction of body &
greater cornua of hyoid
bone
Facial nerve Pulls the hyoid bone upwards &
backward
With other hyoid muscles, it fixes hyoid
bone
MYLO-
HYOID
Mylohyoid line of
mandible
Posterior fibres- body of
hyoid bone
Middle & anterior fibres,
median raphe, between
mandible & hyoid bone
Nerve to
mylohyoid
Elevates floor of mouth in first stage of
deglutition
Helps in depression of mandible, &
elevation of hyoid bone
GENIO-
HYOID
Inferior mental
spine(genial
tubercle)
Anterior surface of body
of hyoid bone
C1 through
hypoglossal
nerve
Elevates hyoid bone
May depress mandible when hyoid is
fixed
HYOGLOS
SUS
Whole length of
greater cornua &
lateral part of body
of hyoid bone
Side of tongue between
styloglossus & inferior
longitudinal muscle of
tongue
Hypoglossal
nerve
Depresses tongue makes dorsum
convex, & retracts the protruded tongue

38. SUPRAHYOID
MUSCLES
MUSCLE ORIGIN INSERTION NERVE
SUPPLY
ACTIONS
ANTERIOR
DIGASTRIC
A depression on
the inner side of
the lower border
of mandible, close
to the symphysis
A tendon which passes
through a tendinuous
pulley attached to the
hyoid bone. The anterior
digastric attaches to the
tendon of the posterior
digastric muscle
Mandibular
branch of
trigeminal
nerve & the
mylohyoid
nerve
Depresses the mandible & elevates the
hyoid bone
POSTERIOR
DIGASTRIC
The inferior
surface of the
skull, from the
mastoid notch on
the medial surface
of the mastoid
process of
temporal bone & a
deep groove
between the
mastoid process &
the styloid process
A tendon which passes
through a tendinuous
pulley attached to the
hyoid bone. The posterior
digastric attaches to the
tendon of anterior
digastric muscle
Facial nerve Depresses the mandible & elevates the
hyoid bone

39. MYOTONIA
LACERATIONS
HEMANGIOMA
MYOSITIS
OSSIFICANS
MPDS
CYSTICERCO
SIS
HEMI
HYPERTROPHY
HEMI FACIAL
MICROSOMIA
APPLIEDASPECT

40. Wounds of the scalp bleed profusely because the vessels are prevented from retracting by the
fibrous fascia. Bleeding can be arrested by applying pressure against the bone.
If any injury occurs to the nerve supplying orbicularis oculi, it will lead to paralysis of that muscle
causing dropping of the lower eyelid called as ECTROPION & spilling of tears called as
EPIPHORA
Antigonial notch accentuates in shortened muscles, seen in condylar #, ankylosis & masseteric
hypertrophy
Wounds of the scalp do not gape unless the epicranial aponeurosis is divided transversely
DIMPLE-Cute birth defect, Occurs because of short zygomaticus major muscle, May disappear
with age
Can be created artificially by splitting or shortening of zygomaticus major muscle
In infranuclear lesions of the facial nerve, known as Bell’s palsy, the whole of the face of the
same side gets paralysed. The face becomes asymmetrical & is drawn up to the normal side.
The affected side is motionless. Wrinkles disappear from the forehead, eye cannot be closed,
any attempt to smile draws the mouth to the normal side
In supranuclear lesions of the facial nerve, usually a part of hemiplegia, only the lower part of
the opposite side of face is paralysed. The upper part with the frontalis & orbicularis oculi
escapes due to its bilateral representation in the cerebral cortex.
APPLIEDASPECT

41. NEUROLOGI
C
Myasthenia
gravis
Multiple
sclerosis
Guillian barre
CONGENITAL
Moebius
syndrome
Myotonic
dystrophy
SYSTEMIC
Sarcoidosis
Amyloidosis
Hyperostosis
INFECTIOUS
Melkerson
rosenthal
ramsay hunt
HIV, TB, EBV,
syphillis,
tetanus
TUMOR
Parotid
Glioma
Meningioma
Facial
neuroma
TOXINS/TRA
UMA
Head trauma
Birth trauma
Temporal
bone trauma
FACIALPARALYSIS

43. FUN FACTS
40% of total
body weight
Smallest muscle in
middle ear
Can’t push, only
pull
Strongest muscle is
masseter
No new fibres
grow, they
just become
thicker
17 muscles to
smile
43 muscles to
frown

44. CONCLUSION

45. ARTICLE – ANATOMY OF MUSCLES OF HEAD & NECK
BOOK - OKESON
BOOK – INDERBEER SINGH OF HUMAN EMBRYOLOGY
BOOK - SNELL
BOOK – GRAY’S ANATOMY
BOOK – B D CHAURASIA
REFERENCES

46. Thank You
By Dr Mansi Mehta
MDS 2019