This document summarizes the anatomy of the face, including: - The skin of the face is thick, elastic and highly vascular. It allows for rapid spread of edema. - The facial skeleton contains 14 bones including the mandible, maxilla, nasal and zygomatic bones. - Facial muscles originate from the mesoderm and function to open and close the 3 main orifices of the face. They include muscles of the nose, mouth and around the orbit.

1. Plantigrade- flat
Pronograde - projectile
FACE

2. Extent
• Above
– Hair line of scalp
• Below
– Chin and base of mandible
• Each side
– Auricle
Forehead – common area for scalp and face

3. Skin
• Highly vascular
– Plastic surgery gives excellent
results
• Sebaceous and sweat glands
– Activities control by sex
hormones
– Acne in adults
• Due to inflammation of sebaceous
glands

4. Skin …. Contd.,
• Thick, elastic and gives
attachment to muscles
– Wounds tends to gape
– And profuse bleeding
• Lax
– Permits rapid spread of
oedema

5. Superficial fascia
• Contains
– Facial muscles
– Vessels and nerves
– Variable amount of fat
• Fat is
– Abundant in cheek
– Absent in eyelids

6. Deep fascia
• Absent
• Except parotid fascia

7. Facial skeleton (14)
• Unpaired bones
– Mandible
– Vomer
• Paired bones
– Maxilla
– Nasal
– Lacrimal
– Palatine
– Zygomatic
– Inferior nasal concha

8. Muscles
• Morphologically remnants of
– Panniculus carnosus
• Embryologically –
– Derived from mesoderm of
• II-branchial arch
• Functionally
– To close and open
• 3 main orifices

9. Muscles of Nose (3)
• Nasalis
– 2 parts
• Compressor naris
• Dilator naris
• Depressor septi Nasi
• Procerus

10. Nasalis
• 2 parts
– Compressor naris
• O
– Ant surface of maxilla
» Lat to nasal notch
• I
– Opposite side muscles meet
along the bridge
• A
– Compresses ant nasal opening
– Dilator naris
• O
– Just inferior to origin of com
naris
• I
– Ala of nose
• A
– Dilates the ant nasal opening

11. Depressor
septi nasi
• O
– Ant surface of maxilla
• Incisive fossa (below nasal
notch)
– I
• Inferior part of nasal septum
– A
• Widening nasal opening

12. Procerus
• O
– Nasal bone
• I
– Skin between eyebrows
• A
– Frowning

13. Muscles of Mouth
1+10
• Orbicularis oris
• Levator labii superioris
alaeque nasi
• Levator labi superioris
• Levator anguli oris
• Zygomaticus major
• Zygomaticus minor
• Risorius
• Depressor labii inferioris
• Depressor anguli oris
• Mentalis
• Buccinator
• Muscles of mouth
– Can be divided into
• 2 groups
– One sphincter & 10 elevators
• Elevators can be divided into
– 3 subgroups
» Muscles acting on upper lip
» Muscles acting on lower lip
» Muscles acting at the angle

14. Muscles acting on upper lip
• Levator labii superioris
alaeque nasi
• Levator labii superioris
• Zygomaticus minor

15. • O
– Superior part of frontal process of maxilla
• I
– Divides into 2 parts
• Nasal
– Skin & cartilage of ala
• Labial
– Upper lip (into orbicularis oris)
• A
– Medial part
• Dilates nose
– Lateral part elevates upper lip
Levator labii superioris alaque nasi

16. Levator labii
superioris
• O
– Infraorbital margin of
maxilla
• Above infraorbital foramen
• I
– Skin of upper lip
• A
– Elevates upper lip

17. Zygomaticus minor
• O
– Outer surface of zygomatic
bone
• Zygomaticomaxillary suture
• I
– Skin of upper lip lateral part
• A
– Elevates upper lip

18. Muscles acting on angle of mouth
• Levator anguli oris
• Zygomaticus major
• Risorius
• Depressor anguli oris

19. Levator anguli oris
• O
– Canine fossa of maxilla
• Below infraorbital foramen
• I
– Angle of mouth
• A
– Raises angle of mouth

20. Zygomaticus major
• Smiling muscle
• O
– Zygomatic bone
• Anterior to zygomaticotemporal
suture
• I
– Angle of mouth
• A
– Elevates angle of mouth laterally

21. Risorius
• Grinning muscle
• O
– Parotid fascia
• I
– Angle of mouth
• A
– Pulls the angle of mouth
downwards & laterally

22. Depressor anguli oris
• O
– Posterior part of
• Oblique line of mandible
• I
– Angle of mouth
• A
– Pulls angle of mouth downwards &
laterally

23. Muscles acting on lower lip
• Depressor labii inferioris
• Mentalis

24. Depressor labii inferioris
• O
– Oblique line of mandible
• Near symphysis menti
• I
– Skin of lower lip
• A
– Depressor of lower lip

25. Mentalis
• O
– Incisive fossa of mandible
• I
– Skin of chin
• A
– Draws lower lip downwards

26. Muscles around oral cavity
• Orbicularis oris
• Buccinator

27. Orbicularis oris
• Sphincter
• Encircles oral fissure
• Has 2 parts
– Extrinsic & intrinsic (Deep)
• O
– Incisive fossa of
• Maxilla & mandible
• I
– Surround the orifice and
attach angle of mouth
– Skin of lips
• A
– Closure of lips
– Compressor of lips
(mastication)
– Protrusion of lips

28. Buccinator
• Muscle of cheek
• O
– Alveolar process of
• Maxilla & mandible
– At Third molar tooth
– Ant surface of
pterygomandibular raphe
– Post part of
• Oblique line of mandible
• I

29. Insertion of Buccinator
• All fibres converge at angle
of mouth
• Upper fibers
– Passes into upper lip
– Meet with opposite side
• Lower fibres
– Passes into lower lip
– Meet with opposite side
• Middle fibres
– Decussate at angle
– Lower part goes to upper lip
– Upper part reaches lower lip

30. Buccinator
• Action
– Compresses cheek
– Helps in
• Chewing
• Blowing
• Sucking
• Relations
– Covered by
• Buccopharyngeal fascia
• Buccal pad of fat
– Deep Relations
• Mucous membrane and
• Pharyngobasilar fascia
• Structures piercing
– Parotid duct

31. Buccinator - Superficial relations
• Muscles
– Zygomaticus major
– Zygomaticus minor
– Risorius

32. Buccinator - Superficial relations
• Vessels
– Deep facial vein
– Anterior facial vein
– Facial artery & vein
• Nerves
– Upper & lower buccal of
VII

33. Buccinator - Superficial relations
• Lymph nodes
– Facial lymph nodes

34. Muscles around orbit
• Orbicularis oculi
– Sphincter of orbit
– Surrounds palpebral
fissure
– Has 3 parts
• Palpebral
• Orbital
• Lacrimal

35. Orbicularis oculi
• Orbital part
– O
• Medial palpebral ligament
• Frontal process of maxilla
• Nasal process of frontal bone
– I
• Encircles orbit
– A
• Locks eyelid

36. Orbicularis oculi
• Palpebral part
– O
• Medial palpebral ligament
– I
• Lateral palpebral raphae
– A
• Closes the eyelids gently
• Blinking & sleeping

37. Orbicularis oculi
• Lacrimal part
– O
• Posterior Lacrimal crest
• Lateral surface of lacrimal bone
– I
• Divides into upper & lower parts
• Attached to tarsal plates
• Lateral palpebral raphe

38. Orbicularis oculi
• Nerve supply
– Branches from facial
• Zygomatic
• Temporal
Zygomatic Branch
Temporal Branch

39. Corrugator supercilii
• Muscle of frowning
• O
– Medial part of superciliary
arch
• I
– Skin above supra orbital
margin
• A
– Draws eyebrow medially

40. Arteries of face
• Facial artery
• Superficial temporal
• Opthalmic artery

41. Facial branches of facial artery
• Inferior labial
• Superior labial
• Lateral nasal
• Angular

42. Superficial temporal branch
• Transverse facial

43. Facial branches from Maxillary
• Mental artery
• Buccal artery
• Infra orbital

44. Facial branches of opthalmic
• Supratrochlear
• Supraorbital

45. Veins
• Facial vein
– Formation
• By Union of
– Supra trochlear
– Supra orbital
• Pierces
– Deep fascia below
mandible
• Joins with
– Anterior division of
• Retromandibular v
– Forms
• Common facial vein

46. Facial vein
• Communications
– With cavernous vein
• Through – angular vein &
superior opthalmic vein
– With pterygoid venous
plexus
• Through – deep facial vein

47. Dangerous area of face
• Upper lip and lower part of
nose –
– lying between the angular
vein and deep vein of face
• Facial vein is devoid of
valves
• Rests on facial muscles
• Movements of facial
muscles facilitate spread of
emboli

48. Nerve supply of face
• Sensory
– Trigeminal nerve
• Except area over angle of
mandible
– Supplied by
» Great auricular nerve
(C2, 3)

49. Sensory nerves
• Opthalmic (5)
– Lacrimal
– Supra orbital
– Supra trochlear
– Infra trochlear
– External nasal

50. Sensory nerves
• Maxillary (3)
- a) Zygomatico temporal
- b) Zygomatico facial
- c) Infra orbital
Zygomaticotemporal
Zygomaticofacial
Infraorbital nerve

51. Sensory nerves
• Mandibular (3)
- Buccal
- Auriculo temporal
- Mental
Auriculo temporal
Buccal
Mental

52. Motor
• Facial
– Temporal
– Zygomatic
– Buccal
– Marginal mandibular
– Cervical
Temporal
Zygomatic
Upper Buccal
Lower Buccal
Marginal mandibular
Cervical

53. Supranuclear palsy
• Upper motor neurons
– Occlusion of blood supply to
motor area
– Or Internal capsule area
• Results
– Contralateral side lower
facial muscles paralysed
• Upper muscle has bilateral
control of motor cortex

54. Bell’s palsy
• Lower motor neuron
• Lesion in peripheral part of
facial nerve
– Near stylomastoid foramen
• Paralysis of ipsilateral side