for examination purposes.

1. MUSCLES OF
FACIAL
EXPRESSION
DR.SONAL SUBHANGI
MDS 1ST YEAR
PUBLIC HEALTH DENTISTRY

2. CONTENTS
 INTRODUCTION
 MUSCLES OF SCALP
 MUSCLES OF AURICLE
 MUSCLES OF EYELIDS
 MUSCLES OF NOSE
 MUSCLES AROUND MOUTH
 MUSCLES OF NECK
 BLOOD SUPPLY OF MUSCLES AROUND MOUTH
 VENOUS SUPPLY OF MUSCLES AROUND MOUTH
 NERVE SUPPLY OF MUSCLES AROUND MOUTH
 LYMPHATIC DRAINAGE OF MUSCLES AROUND MOUTH
 APPLIED CLINICAL ANATOMY OF MUSCLES AROUND MOUTH
 REFRENCES

3. INTRODUCTION
THE FACIAL MUSCLES ARE STRIATED MUSCLES THAT ATTACH TO
BONES OF SKULL TO PERFORM IMPORTANT FUNCTIONS FOR DAILY
LIFE INCLUDING MASTICATION AND FACIAL EXPRESSIONS.
• develop from mesoderm of 2nd branchial
arche , therefore supplied by facial nerve.
EMBRYOLOGICALLY
• represent remants of panniculus carnosus.
MORPHOLOGICALLY
• muscles are grouped under the following six
heads.
• 1)MUSCLES OF SCALP
• 2)MUSCLES OF AURICLE
• 3)MUSCLES OF EYELIDS
• 4)MUSCLES OF NOSE
• 5)MUSCLES AROUND MOUTH
• 6)MUSCLES OF NECK
TOPOGRAPHICALLY

4. MUSCLES OF SCALP
 OCCIPITOFRONTALIS

5. MUSCLES OF AURICLE
 AURICULARIS
ANTERIOR
AURICULARIS
SUPERIOR
AURICULARIS
POSTERIOR

6. MUSCLES OF EYELIDS
 ORBICULARIS OCULI
 CORRUGATOR SUPERCILII
 LEVATOR PALPEBRAE SUPERIORIS [an extraocular muscle,
supplied by 3rd cranial nerve.]

7. MUSCLES OF NOSE
 PROCERUS
 COMPRESSOR NARIS
 DILATOR NARIS
 DEPRESSOR SEPTI

8. MUSCLES AROUND MOUTH
 ORBICULARIS ORIS
 LEVATOR LABII SUPERIORIS ALAEQUE NASI
 LEVATOR LABI SUPERIORIS
 LEVATOR ANGULI ORIS
 ZYGOMATICUS MAJOR
 ZIGOMATICUS MINOR
 DEPRESSOR ANGULI ORIS
 DEPRESSOR LABII INFERIORIS
 MENTALIS
 RISORIUS
 BUCCINATOR

9. ORBICULARIS ORIS
Origin Maxilla and mandible
Insertion Skin around the lips
Artery Inferior labial
artery and superior labial artery.
Nerve cranial nerve VII, buccal branch
Actions It is sometimes known as
the kissing muscle because it is
used to pucker the lips.
Clinical significance ;
Babies are occasionally born without one or both sides
of this particular muscle, resulting in a slight droop to
the affected side of the face.

10. LEVATOR LABII SUPERIORIS ALAEQUE NASI
Origin Nasal bone
Insertion Nostril and upper lip
Nerve Buccal branch of facial nerve
Actions Dilates the nostril; elevates the upper
lip and wing of the nose
known as Otto's muscle . A mnemonic to remember its name
is, "Little Ladies Snore All Night. Snore is used because it is the
labial elevator closest to the nose.

11. LEVATOR LABI SUPERIORIS
Origin Medial infra-orbital margin
Insertion Skin and muscle of the upper
lip (labii superioris)
Artery facial artery
Nerve buccal branch of the facial
nerve (C.N. VII)
Actions Elevates the upper lip
The levator labii superioris also called quadratus
labii superioris, is a muscle of the human body used
in facial expression. It is a broad sheet, the origin of
which extends from the side of the nose to
the zygomatic bone.

12. LEVATOR ANGULI ORIS
Origin Maxilla
Insertion Modiolus
Artery Facial artery
Nerve Buccal branches of the facial
nerve
Actions Smile (elevates angle of mouth)
The levator anguli oris (caninus) is a facial muscle of
the mouth arising from the canine fossa, immediately
below the infraorbital foramen. It elevates angle of mouth
medially. Its fibers are inserted into the angle of the
mouth, intermingling with those of
the zygomaticus, triangularis, and orbicularis oris.
Specifically, the levator anguli oris is innervated by
the buccal branches of the facial nerve

13. ZYGOMATICUS MAJOR
Origin anterior of zygomatic
Insertion modiolus of the mouth
Artery facial artery
Nerve zygomatic and buccal branches of
the facial nerve
Actions draws the angle of the mouth upward
laterally
Clinical significance
The zygomaticus major muscle may be used
in reconstructive surgery to replace lost tissue, such as with
injuries to the lips

14. ZIGOMATICUS MINOR
Origin zygomatic bone
Insertion skin of the upper lip
Artery facial artery
Nerve buccal branch
Actions elevates upper lip
The zygomaticus minor muscle is sometimes referred
to as the "zygomatic head" of the levator labii
superioris muscle

15. DEPRESSOR ANGULI ORIS
The depressor anguli oris muscle (triangularis muscle) is a facial
muscle.
Origin tubercle of mandible
Insertion modiolus of mouth
Artery facial artery
Nerve marginal mandibular branch of the facial nerve
Actions depresses angle of mouth ( FURROWING)
Clinical significance ;
1} Damage to the marginal mandibular branch of the facial nerve may
cause paralysis of the depressor anguli oris muscle.[1] This may
contribute to an asymmetrical smile.
2} Underdevelopment (Hypoplasia) or complete absence (Aplasia) of
the depressor anguli oris can occur.[2] Similarly to paralysis, individuals
with these conditions will have an asymmetric smile.

16. DEPRESSOR LABII INFERIORIS
The depressor labii inferioris (or quadratus labii inferioris)
is a facial muscle. It helps to lower the bottom lip.
Clinical significance ;
Resection
The depressor labii inferioris muscle may be resected (cut and
removed) using surgery to correct an asymmetry of the lower
lip when smiling. This asymmetry can be caused by paralysis
of the marginal mandibular branch of the facial nerve on one
side, so the healthy side may be cut to create symmetry. Local
anaesthesia may be used, such as by blocking the mental
nerve. This operation tends to be successful.

17. Origin oblique line of the mandible, between
the symphysis and the mental
foramen
Insertion integument of the lower
lip, Orbicularis oris fibers, its fellow of
the opposite side
Nerve marginal mandibular branch of
the facial nerve
Actions depression of the lower lip
Antagonist orbicularis oris muscle
Origin oblique line of the mandible, between
the symphysis and the mental foramen
Insertion integument of the lower lip, Orbicularis oris fibers, its
fellow of the opposite side
Nerve marginal mandibular branch of the facial nerve
Actions depression of the lower lip.
It is needed to expose the mandibular
(lower) teeth during smiling.
Antagonist orbicularis oris muscle

18. MENTALIS
Origin anterior mandible
Insertion chin
Nerve mandibular branch of facial nerve
Actions elevates and wrinkles skin of chin, protrudes
lower lip
The mentalis muscle is a paired central muscle of the lower lip,
situated at the tip of the chin. It is sometimes referred to as the
"pouting muscle" due to it raising the lower lip and causing
chin wrinkles.
Clinical significances
Geniospasm is a genetic movement disorder of the mentalis
muscle.
The mentalis muscle may be partially paralysed using botulinum
toxin to reduce wrinkling of the skin of the chin.[4] This may be
done for cosmetic purposes.

19. RISORIUS
The risorius muscle is a muscle of facial expression. It
arises from the fascia over the parotid gland, and inserts into
the angle of the mouth. It may be absent or asymmetrical in
some people. It retracts the angle of the mouth during
smiling.
Origin parotid fascia
Insertion modiolus
Artery facial artery
Nerve buccal branch of the facial nerve
Actions draws back angle of mouth

20. BUCCINATOR
Origin from the alveolar
processes of maxilla and mandible, buccinato
r crest and temporomandibular joint
Insertion in the fibers of the orbicularis oris
Artery buccal artery
Nerve buccal branch of the facial nerve (VII cranial
nerve)
Actions The buccinator compresses the cheeks
against the teeth and is used in acts such as
blowing. It is an assistant muscle
of mastication (chewing) and in neonates it is
used to suckle.
The buccinator is a thin quadrilateral muscle occupying the
interval between the maxilla and the mandible at the side of
the face. It forms the anterior part of the cheek or the lateral
wall of the oral cavity.

21. MUSCLES OF NECK
 PLATYSMA

22. BLOOD SUPPLY
■ LOWER AND UPPER LIPS AND MOUTH - inferior & superior labial artery.
■ MAXILLARY REGION – maxillary artery .
■ MUSCLES LOCATED INFERIOR TO THE MANDIBLE – submental artery.
■ FOREHEAD REGION – superficial temporal artery.

23. VENOUS SUPPLY
SUPRATROCHLEAR + SUPRORBITAL VEIN ANGULAR VEIN FACIAL VEIN
INTERNAL JUGULAR VEIN .

24. NERVE SUPPLY
■ MOTOR – facial nerve & mandibular nerve.
■ SENSORY – trigeminal nerve
ophthalmic branch [ forehead region ]
maxillary branch [ maxillary region ]
mandibular branch [ mandible region ]
 CERVICAL SPINAL NERVES .

25. LYMPHATIC DRAINAGE
SUBMENTAL , SUBMANDIBULAR , PREAURICULAR & PAROTID.

26. FEW COMMON FACIAL EXPRESSION MUSCLES PRODUCING
SMILING& LAUGHING ZYGOMATICUS MAJOR
SADNESS LEVATOR LABII SUPERIORIS &
LEVATOR ANGULII ORIS
GRIEF DEPRESSOR ANGULII ORIS
ANGER DILATOR NARIS & DEPRESSOR SEPTI
FROWNING/DISLIKE CORRUGATOR SUPERCILII &
PROCERUS
HORROR, TERROR& FRIGHT PLATYSMA
SUPRISE FRONTALIS
DOUBT MENTALIS
GRINNING RISORIUS
CONTEMPT ZYGOMATICUS MINOR
CLOSINGMOUTH ORBICURALIS ORIS
WHISTLING BUCCINATOR & ORBICULARIS ORIS

27. APPLIED CLINICAL ANATOMY
■ Damage to the facial nerve and problems with the facial muscles can be caused by:
■ Autoimmune disease: Diseases such as Guillain-Barré syndrome or multiple
sclerosis can cause facial palsy over time.
■ Bell’s palsy: When swelling puts pressure on the facial nerve, Bell’s palsy can cause
facial weakness or paralysis on one or both sides of your face. It almost always leads to a
complete inability to wrinkle your forehead. Bell’s palsy happens suddenly but is usually
temporary.
■ Head and neck cancer: In head and neck cancer, a growing tumor can interfere with
facial muscle function over time.
■ Infection: A bacterial or viral infection can cause inflammation of the facial nerve and
problems in the muscles of the face. Examples include ear infections, Lyme disease or
Ramsay-Hunt syndrome.
■ Injury to the head or face: Facial trauma, such as a blow to the head or car accident, can
damage the facial nerve and facial muscles.
■ Stroke: A stroke occurs when a blood vessel in the brain is blocked or bursts. It can cause
sudden facial weakness or paralysis. Other signs may include paralysis on one side of the
body, confusion, memory loss and trouble communicating. A person who has had a stroke
can usually still wrinkle the forehead, unlike with Bell’s palsy.

28. ■ The inability to move facial muscles is a classic symptom of facial nerve paralysis.
Hereby, one can clinically differentiate between a peripheral lesion and central lesion.
■ In peripheral facial lesions the facial muscles are completely paralyzed on the affected
side. When trying to close the lids the eye rotates upwards exposing the sclera (Bell’s
phenomenon).
■ In central facial lesions one can still wrinkle the forehead on both sides.
■ The reason behind this is that the motor branches of the forehead muscles derive from
both the ipsi- and contralateral facial nuclei. In both types of facial nerve
paralysis speech, chewing and facial expression are severely impaired. Depending on
the location of the lesion, the affected patients suffer from additional disturbances of
tear and saliva secretion, hearing or taste.
■ There is a variety of causes for facial nerve paralysis including inflammation (e.g.
herpes zoster infection), stroke, petrous bone fracture and tumors (e.g. vestibular
schwannoma) but in most cases a definite cause cannot be found (idiopathic facial
nerve paralysis, also known as Bell’s palsy). Current studies suggest that infections
with the Herpes simplex virus type 1 and other less harmful viruses are behind Bell’s
palsy.

29. PREVELANCE
A total of 348 088 patients with COVID-19 were identified in this study.
Of these patients, 284 (0.08%) were diagnosed with Bell palsy within 8 weeks of the
initial COVID-19 diagnosis.
One hundred fifty-three of these patients (53.9%) had no history of Bell Palsy, whereas
131 (46.1%) had a history of Bell Palsy .
Overall, 1525 patients (0.44%) had a history of Bell Palsy before receiving the COVID-
19 diagnosis, which translates to an 8.6% Bell Palsy recurrence rate within 8 weeks of
COVID-19 diagnosis.
Tamaki A, Cabrera CI, Li S, et al. Incidence of Bell Palsy in Patients With COVID-19. JAMA Otolaryngol Head Neck Surg. 2021;147(8) :76

30. REFRENCES
■ Standring S . Gray's Anatomy :The Anatomical Basis of Clinical Practice . 42th
Edition.
■ Selvakumari T L . Essentials of Anatomy for Dental Students . 1st Edition.
■ Chaurasia B D & Garg K . B D Chaurasia's Human Anatomy . 9th Edition .
■ Devi V S . Inderbir Singh's Textbook of Anatomy for Dental Students . 7TH
Edition.