Face and lacrimal apparatus anatomy

FACEFACE
Dr. Siraj A Shirbadgi Associate Prof
BMCH CTA

- It extends from lower border of mandible to the hair- It extends from lower border of mandible to the hair
line (forehead is common for face and scalp)line (forehead is common for face and scalp)
- It extends laterally to the ear auricle- It extends laterally to the ear auricle
Layers of the face:Layers of the face:
1- skin:1- skin: it is thick, has rich blood supply (rapid healing)it is thick, has rich blood supply (rapid healing)
2- superficial fascia :2- superficial fascia : contains ms, vessels and nerves ofcontains ms, vessels and nerves of
the facethe face
No deep fascia in most of the face (to allow for facialNo deep fascia in most of the face (to allow for facial
expression)expression)
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Skin of the face
•Very vascular,rich in
sweat& sebaceous glands .
•Receives the insertion
of facial muscles .
Superficial fascia
Contains :-
Facial muscles ,vessels &
nerves & fat .
Deep fascia ABSENT except ………
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Facial musclesFacial muscles
Thin, flat muscles, connected to the
dermis of the skin
Innervated by the facial nerve
Considerable individual variation
Often blend into each other
Relaxed skin tension lines run
perpendicular to the direction of muscle
fibers
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Forehead musclesForehead muscles
- Frontalis – elevates brow
- Procerus – depresses brow
- Corrugator Supercilii – depresses
brow
- Orbicularis Oculi – closes eye,
depresses brow
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Nose musclesNose muscles
- Nasalis - compresses/dilates nose
- Depressor Septi Nasi - depresses tip
- Levator labii superioris alaeque nasi -
dilates nostrils and elevates upper lip
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Lip musclesLip muscles
Divided into 3 groups:
- Group 1 (insert into modiolus)
- Orbicularis oris – closes mouth
- Buccinator – presses lips and cheeks
against the teeth
- Risorius – draws commissure laterally
- Levator anguli oris – elevates
commissure
- Depressor anguli oris – depresses and
moves laterally commissure
- Zygomaticus major – elevates and
moves laterally commissure
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Group 2 (insert into upper lip)
- Levator labii superioris –
elevates the upper lip
- Levator labii superioris
alaeque nasi – dilates
nostrils and elevates
upper lip
- Zygomaticus minor -
elevates and pulls
commissure laterally;
contributor to nasolabial
fold
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Group 3 (insert into lower lip)
- Depressor labii inferioris –
depresses and pulls lip
slightly laterally
- Mentalis – elevates lower lip
- Platysma - depresses lower
lip
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Nerve supply of the faceNerve supply of the face
By facial N. which supplies all
muscles of the face except lev.
Palp. Sup. (by oculomotor(
sensory motor
By branches of trigeminal nerve
except the skin covering the angle
of mandible (supplied by great
auricular nerve(
Ophthalmic div. Maxillary div. Mandibular div.
1-supratrrochlear
2-supraorbital
3-palpebral br. of lacrimal
4-infratrochlear
5-external nasal
1-zygomaticofacial
2-zygomaticotemporal
3-infraorbital
1-mental
2-buccal
3-auriculotemporal
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Nerve supply of the faceNerve supply of the face
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Facial nerveFacial nerve
Innervates muscles of facial
expression
- Exits stylomastoid foramen and
crosses parotid gland, where divides
into five major branches:
- Temporal
- Zygomatic
- Buccal
- Marginal Mandibular
- Cervical
- Posterior auricular branch arises
proximal to parotid
There is significant variability in the
course and arborization of this nerve
from patient to patient
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Nerve supplyNerve supply
Forehead
- Frontalis – temporal
- Procerus – temporal,
zygomatic, buccal
- Corrugator supercilii –
temporal, zygomatic,
buccal
- Orbicularis oculi – temporal,
zygomatic
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Nose
- Nasalis – zygomatic,
BUCCAL
- Depressor Septi Nasi –
BUCCAL
alaeque nasi – BUCCAL
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Lips Group 1
- Orbicularis oris – BUCCAL,
MARGINAL MANDIBULAR
- Buccinator – BUCCAL,
zygomatic
- Risorius – BUCCAL
- Levator anguli oris – BUCCAL,
zygomatic
- Depressor anguli oris –
BUCCAL, MARGINAL
MANDIBULAR
- Zygomaticus major –
ZYGOMATIC, BUCCAL
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Group 2 (insert into upper lip)
- Levator labii superioris –
BUCCAL
alaeque nasi – BUCCAL
- Zygomaticus minor -- BUCCAL
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Group 3 (insert into lower lip(
- Depressor labii inferioris –
buccal, MARGINAL
MANDIBULAR
- Mentalis – MARGINAL
MANDIBULAR
- Platysma – marginal
mandibular, CERVICAL
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Sensory supplySensory supply
Sensory innervation to the face is
provided by the branches of the
Trigeminal Nerve
- V1 (Ophthalmic Division(
-- Supraorbital
-- Supratrochlear
-- Palpebral branch of lacrimal
nerve
-- Infratrochlear nerve
-- External nasal branch of anterior
ethmoidal nerve
- V2 (Maxillary Division(
-- Infraorbital
-- Zygomaticofacial
-- Zygomaticotemporal
- V3 (Mandibular Division(
-- Mental
-- Buccal
-- Auriculotemporal
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Sensory supplySensory supply
Sensory branches of the trigeminal nerve
course superficially are prone to damage.
- However, most of the resulting sensory
dysfunction is not debilitating because of
collateral sprouting of nearby sensory nerves.
- Sensation to the posterior scalp and superior
neck is provided by branches of C2 and C3
- Knowledge of sensory nerve anatomy is useful
for regional anesthesia/nerve blocks.
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Arterial supplyArterial supply
The face is supplied by branches
of the
external carotid and the internal
carotid
artery
- Two main branches of the
external carotid:
- Facial artery and superficial
temporal artery
- Main branches of the internal
carotid that
supplies the medial upper face
and scalp is the ophthalmic artery
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Arterial blood supplyArterial blood supply
-Mainly by facial artery
-It is a tortuous artery
-It gives the following
branches in the face
1-inferior labial
2-superior labial
3-nasal
Facial artery
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Venous drainage of scalp and faceVenous drainage of scalp and face
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Venous drainage of scalp and faceVenous drainage of scalp and face
Supratrochlear V + Supraorbital VSupratrochlear V + Supraorbital V
Anterior facial V
Maxillary V Sup. Temporal V+
Retromandibular V
Anterior
division
Posterior
division
Common facial vein
+
Post. Auricular V
EJV
IJV
Subclavian V
*Occipital veins drain into suboccipital plexus of veins
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Supratrochlear V.
Supra-orbital V.
facial vein
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Retro-
Mandibular V.
Ext.jugular V.
Post.auricular
V.
C.Facial V.
Superficial
Temporal V.
Maxillary V.
Int.jugular V.
Facial Vs.
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Superficial
Temporal V.
Maxillary V.
Retro-
Mandibular V.
Post.auricular
V.
Facial vein
Posterior
devision
Anterior
devision
++
Common facial
vein
=
External
Jugular vein
=
I.J.V.
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Supratrochlear V.
Supraorbital V.
facial V.
To sup.ophthalmic V.
Cavernous
sinus
Deep Facial V.Pterygoid venous
plexus
EmissaryVs.
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Cavernous
Sinus
Pterygoid
Venous Plexus
Facial V.
Sup.Ophth.
V.
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facial vein
Pterygoid venous
plexus
Cavernous sinus
Emissary veins
Deep facial V. Sup.oph.V.
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Parotid L.N.
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Lymph drainage of the faceLymph drainage of the face
Lat.part of theLat.part of the
face……..parotid lymph nodesface……..parotid lymph nodes
..
Medial part of the face…Medial part of the face…
submandibular lymph nodes .submandibular lymph nodes .
Central part of lower lip &Central part of lower lip &
chin…………submental lymphchin…………submental lymphDr. Siraj A Shirbadgi Associate Prof
BMCH CTA

Anatomy and diseases ofAnatomy and diseases of
lacrimal apparatuslacrimal apparatus
The lacrimal apparatus consists ofThe lacrimal apparatus consists of
-lacrimal gland-lacrimal gland
-lacrimal passages-lacrimal passages
Lacrimal gland –consists of 2 partsLacrimal gland –consists of 2 parts
A-orbital lobe situated in a fossa in outerA-orbital lobe situated in a fossa in outer
part of the orbital roof.part of the orbital roof.
B-palpebral lobe situated in the outer partB-palpebral lobe situated in the outer part
above the superior fornix.above the superior fornix.

Anatomy and diseases of lacrimal apparatusAnatomy and diseases of lacrimal apparatus
The lacrimal apparatus consists ofThe lacrimal apparatus consists of
-lacrimal gland-lacrimal gland
-lacrimal passages-lacrimal passages
Lacrimal gland –consists of 2 partsLacrimal gland –consists of 2 parts
a)orbital lobe situated in a fossa in outer parta)orbital lobe situated in a fossa in outer part
of the orbital roof.of the orbital roof.
b)palpebral lobe situated in the outer partb)palpebral lobe situated in the outer part
above the superior fornix.above the superior fornix.
The ducts of the gland open in to the external part of
the .superior fornix
In structure the lacrimal gland resemble the salivary
glands.
The ducts of the gland open in to the external part of
the .superior fornix
In structure the lacrimal gland resemble the salivary
glands.

Lacrimal passages –consist ofLacrimal passages –consist of
a) lacrimal puncta:a) lacrimal puncta: one in each lid and situatedone in each lid and situated
near the posterior border of the margin 6 mmnear the posterior border of the margin 6 mm
from The medial canthus.from The medial canthus.
b) Canaliculi :b) Canaliculi : one in each eyelid-it commencesone in each eyelid-it commences
at the punctum and carries tears to the lacrimalat the punctum and carries tears to the lacrimal
sac.sac.
c) Lacrimal sac :c) Lacrimal sac : lies in the lacrimal fossalies in the lacrimal fossa
formed by the lacrimal bone and frontal processformed by the lacrimal bone and frontal process
of maxilla.It is covered by lacrimal foscia.of maxilla.It is covered by lacrimal foscia.
Anterior to the lacrimal foscia is the medialAnterior to the lacrimal foscia is the medial
palpebral ligament.The upper part of the sac ispalpebral ligament.The upper part of the sac is
known as the fundus.The lower end narrows as itknown as the fundus.The lower end narrows as it
open into the nasolacrimal duct.open into the nasolacrimal duct.Dr. Siraj A Shirbadgi Associate Prof
BMCH CTA

d)Naso lacrimal duct:d)Naso lacrimal duct: It is 3-4 in length andIt is 3-4 in length and
opens into the inferior meatus of the nose. Itopens into the inferior meatus of the nose. It
is directed downwards,slightly outwards andis directed downwards,slightly outwards and
backwards.backwards.
The tears which are secreted by the lacrimalThe tears which are secreted by the lacrimal
glands into the conjunctival sac are drainedglands into the conjunctival sac are drained
by the lacrimal passage into the nose.by the lacrimal passage into the nose.
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THANKS
FOR
YOUR
ATTENTIO
N
BMCH CTA

Face and lacrimal apparatus anatomy

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