Upload By : Ahmed Ali Abbas Babylon University College of Dentistry download this file from Website on Google  TheOptimalSmile.wix.com

1. UploadUpload By : Ahmed Ali AbbasBy : Ahmed Ali Abbas
Babylon University College of DentistryBabylon University College of Dentistry
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3. The FaceThe Face
Shape of face depend on:
-facial skeleton
-disposition of soft tissue
-type of face
**Facial growth during child
hood as the paranasal sinus
develop and permanent teeth
erupt.

4. Type of faceType of face
There are two types of face:-
1-Leptoprosopic face
-long , narrow
-protruding maxilla
-retruding mandible
2-Euryprosopic face
-upper part of face is less prominent
-nose is short
-eyes are wide set
-cheek bones are usually more
prominent.

5. Sexual Variation of faceSexual Variation of face
-face show sexual dimorphism although
facial types are similar until the age of 12
year.
-face of female attains its mature form
earlier than the male.
-male face tend to be more protuberant,
bulky and coarse.
-nose of female have a concave to straight
profile.
-supra orbital ridge of male overhang the
face, those of female are at same level as
inferior orbital margin and cheek bones.

6. ****On reflectionOn reflection the skin of the face,the skin of the face,
the following main structures arethe following main structures are
revealedrevealed::
1-muscles of facial expression
2-facial nerve
3-cutane. branches of trigeminal nerve
and great auricular n.
4-parotid gland and duct
5-buccal pad of fat
6-facial L.N.

15. Skin of faceSkin of face::
-Thin
-Vascular
-Movable
-Abundly supplied with
sebaceous and sweat gland
-No deep fascia
-So it especially adaptable for
surgical plastic operation.

16. Muscles of the faceMuscles of the face
*Characterized by subcutaneous location
move the skin and change facial expression.
*Placed around orifice of eye (palpebral
fissure), ear nose and mouth ( oral fissure).
*All muscle of face developed from 2nd
pharyngeal arch which supply by facial
nerve.

21. 2orbicalaris : orbiculais ocul
orbiculais oris
2associated with nose : procerus
compressor nares(in infant(
2associated with nose : zygomaticus minor
Zygomatoe area : zygomaticus major(m.of smiling(
2elevator of upper lip : levator labii superioris
alaeque nasi
Levator labii superioris
2muscle with angle of mouth :levator anguli oris
Depressor angel oris
2muscles with lower lip: risorius
Depressor labii inferioris
2muscle associated with
chin and cheek: Mentalis
buccinator muscle

23. Orbicularis OculiOrbicularis Oculi::
3parts:
1-Orbital part: strongly close of eye
protecting it from dust, bright
light , mingling with fiber of
frontalis muscle.
2-Palpebral part: gently close the eye lid as
in blinking or in sleep to keep
the cornea from drying
3-Lacrimal part: posterior border of lacrimal
fossa to lid , its function to dilate
lacrimal sac so that fluid
discharge from conjunctiva to
lacrimal sac.

24. BuccinatorBuccinator:-:-
*Attached to alveolar process of maxilla,
mandible opposite molar tooth to
ptergomandibular raphe.
*Active in smile.
*Keep check taut, preventing it from folding
and being injured during chewing
*Mingle medially with orbicularis oris
*Aid in mastication
*Used during whistling , sucking and blowing

26. Nerve Supply of the faceNerve Supply of the face
Face have both motor and sensory
*Motor: nerve derived from facial nerve (nerve of
second pharyngeal arch(
*Sensory: innervations is primarly from three
division of trigeminal nerve (CN V( with
exception of small area over angle of
mandible and parotid gland which
supply by great auricular nerve(C2,C3(.
*Motor nerve of the face:-
-facial nerve to muscle of facial expression
-motor root of mandibular nerve to muscle of
mastication

33. Facial nerveFacial nerve:-:-
-leave the skull at stylomastoid foramen
give off posterior auricular nerve
-send fiber to:-
-Stapedius muscle
-Stylohyoid muscle
-Posterior belly of digastric muscle
-Scalp muscles
-Auricular muscle
-Platysma muscle
-Buccinator

34. *Provides secretary fiber to salivary and
sensory (taste( fibers to anterior 2/3 of
tongue.
*Enter parotid isthmus and passes
between superior and deep loops of
gland.
*It is superficial to external carotid artery
and retromandibular vein so may be
injured in operation in parotid region.
*Terminal branches appear at margin of
parotid (antromedial surface of gland(.

35. Five terminal branches of facialFive terminal branches of facial
nervenerve
1-Temporal branch- frontalis- orbicularis
oculi(upper(.
2-Zygomatic branch – orbicularis oculi:(lower(
3-Buccal branch- Buccinator- orbicularis oris.
4-Mandibular- (marginal( passes along lower
border of mandible crossing facial
artery and vein and submundibular
L.N.
5-Cervical branch – platysma

36. Facial Nerve InjuryFacial Nerve Injury
Non-traumatic cause of facial parlay is inflammation of
facial nerve near stylomastoid foramen so patient has;
1-Can not close his eyes and palpebral fissure appear
wider, lacrimal fluids drips on cheeks laterally, drying
of cornea.
2-Patient van not whistle, blow or chew effictualey so
food will accumulate between cheeks and gum so
patient use his finger to remove food due to parlysis
of buccintor muscle.
3-Displacement of corner of mouth , so food and saliva
dripling outside of mouth.

37. Facial Nerve Pulsy has manyFacial Nerve Pulsy has many
causescauses::
1-Idiopathic (Belly pulsy( Exposure to
cold (30 to 50 years(.
2-Complication of surgery in Parotid
gland.
3-Dental manipulation-vaccination.
4-Infection of middle ear.

38. Injury to Branch of facial nervesInjury to Branch of facial nerves
1-By stab wound- gunshots.
2-Injury at birth.
3-Injury of temporal bones.
4-Surgical approach to sub mandibular
gland- resulting in dropping of corner of
mouth.

40. Sensory Nerves of faceSensory Nerves of face
Trigeminal nerve (5(
V1- Ophthalmic nerve:
Forehead – upper eyelid- conjunctiva of
eye- side of nose
5Branches
1-Lacrimal nerve
2-Supraorbital nerve
3-Supratrochler nerve
4-Infratochlear nerve
5-External nasal nerve

43. V2- Maxillary nerve:
Side of nose- lower eyelid-check-upper
lip-lateral side of orbital opening
3Branches
1-Infraorbital nerve
2-Zygomatico facial nerve
3-Zygomatico temporal nerve

46. V3- Mandibular Nerve:
Lower lip- lower part of face- temporal
region –part of auricle
3Branches
1-Mental nerve-inferior alveolar nerve
2-Buccal nerve- Mucous membrane of
check.
3-auriculo temporal nerve-accompany
superficial temporal vessels

47. 11--Facial ArteryFacial Artery::
-from external carotid artery
-winds its way to inferior border of mandible
-interior to massetor so artery lies
superficial deep to platysma
-cross mandible, buccinator, maxilla to
medial canthus of eye
-lies deep to Zygomaticus major, levator
labii superioris.

50. -lies fingerbirth lateral to angle of
mouth.
-give superior,inferior labial arteries
-ascend alongside of nose joined
dorsal nasal branches of ophthalmic
artery.
-terminal branch of facial artery is
called angular artery.

51. 2-Superficial temporal artery:
transverse facial artery.
3-Maxillary artery: mental artery-
buccal artery- infra orbital artery
4-Opthlmic artery: supra orbital
artery- supra trochlear artery- lacrimal
artery – dorsal nasal artery- external
nasal artery

53. Venous drainage of faceVenous drainage of face
*Is formed by union of supra orbital and
supra trochlear.
*Connected to superior ophthalmic vein
which connected facial vein to cavernous
sinus.
*Join anterior division of retro mandibular
vein.
*Drain into internal jugular vein directly or
indirectly.
*Taking a less tortuous but more superficial
course.

54. Lymphatic drainage of faceLymphatic drainage of face::
1-submundibular L.N.- forehead- anterior
part of face.
2-Buccal L.N.
3-Parotid L.N. lateral part of face- lateral
part of eyelid.
4-Submental L.N.-central part of lower lip,
skin of chin.

56. Veins of the faceVeins of the face
Supra temporp v. supratrochele v.
+ +
Maxillary v. supraorbital v.
Angular v.
Retromandibular v. Ant. + Facial v.
Post.
+
Post. Amicular v. common facial v.
Ext. jugular v. int. jugular v.

57. Dangerous Area of faceDangerous Area of face
*Is triangle bounded by lines join root
of nose with angle of mouth.
*Venus drainage from this area enter
angular veins which communicate with
cavernous sinus.
*Therefore boil, carbuncle in this
region produce cavernous sinus
thrombosis.

60. The ScalpThe Scalp
*Consist of five layers of soft tissue
covering calvaria:-
S=skin
C= C.T.
A= Aponeurotic
L= loose C.T. (dangerous area(
P= Pericranium
*Frontalis muscle has no bony
attachments.

65. Nerve of the scalpNerve of the scalp
-Trigeminal nerve
-Cervical plexus C2-C3 ( great auricular, lesser
occipital, greater occipital(
Artery of the scalpArtery of the scalp
1-external carotid artery – occipital – posterior –
auricular – superficial temporal
2-internal carotid artery – supra trochlear- supra
orbital.
Lymphatic Drainage of the scalpLymphatic Drainage of the scalp
-there is no L.N. in the scalp
-superficial ring of L.N. (submental ,
submandibular, parotid, retro auricular and
occipital L.N.

66. QuizQuiz
Q1/ Could you explain the following:
1-In Bells palsy there is decrease of lacrimation
2-Loss of tast in the anterior 2/3 of tongue
3-Painful sensitivity to sound
4-Deviation of the lower jaw and tongue
Q2/ What are the efferent and afferent limbs of cornel blink
reflex (closing of the eyes(
Q3/ Death may result from bilateral severance of which of
the following nerve?
A- Trigeminal nerve
B- Facial nerve
C- Vague nerve
D- Spinal accessory nerve
E- Hypoglossal nerve