This is very useful ppt for beginners, all valuable and basic information has been conered plz go through all the PPT slides

1. Dr. Ahmed Fathalla Ibrahim

2. FACIAL INFECTION
• DANGEROUS AREA OF FACE
1. A triangular area bounded with an apex opposite
the medial angles of eyes & nose and a base
formed by the upper lip
2. It is drained by facial vein
3. It has important communications with cavernous
sinus:
supraorbital & superior ophthalmic veins
Facial vein Cavernous sinus
deep facial vein pterygoid plexus of veins emmissary veins

3. FACIAL INFECTION
• DANGEROUS AREA OF FACE
• Infection of this area may lead to:
1. Thrombosis of facial vein
2. Infection may be transmitted to
cavernous sinus leading to cavernous
sinus thrombosis

4. TRIGEMINAL NERVE
• Supplies the skin of the face EXCEPT
the area over the angle of mandible &
parotid gland
• Is represented by 3 divisions:
1. Ophthalmic
2. Maxillary
3. Mandibular

5. TRIGEMINAL NERVE

6. TRIGEMINAL NERVE
• OPHTHALMIC:
1. Supratrochlear:
forehead + medial part
of upper eyelid
2. Supraorbital: same
3. Palpebral branch of
lacrimal: lateral part of
upper eyelid
4. Infratrochlear: upper
part of nose
5. External nasal: lower
part of nose

7. TRIGEMINAL NERVE
• MAXILLARY:
1. Infraorbital: divides
into: a) palpebral
for lower eyelid,
b) nasal for ala of
nose, c) labial for
upper lip
2. Zygomaticofacial:
upper part of cheek

8. TRIGEMINAL NERVE
• MANDIBULAR:
1. Buccal: lower part
of cheek
2. Mental: lower lip &
chin

9. TRIGEMINAL NEURALGIA
• Inflammatory condition affecting one or
more of the three divisions of trigeminal
nerve
• Gives rise to severe pain in the area of
distribution of the affected nerve
• Surgical treatment may involve:
1. Alcohol injection of the trigeminal ganglion
2. Section of the central root of the nerve or of
the appropriate division

10. FACIAL NERVE

11. FACIAL NERVE
• Extracranial course:
1. The nerve leaves the cranial cavity through stylomastoid
foramen
2. The nerve enters the parotid gland & divides into 5 terminal
motor branches that emerge from the gland
• Extracranial distribution:
• After emergence from stylomastoid foramen:
1. Posterior auricular: to occipital belly of occipitofrontalis
muscle
2. Muscular branch to posterior belly of digastric
3. Muscular branch to stylohyoid
• After emergence from parotid gland:
1. Temporal: to orbicularis oculi, frontal belly of
occipitofrontalis muscles
2. Zygomatic: to orbicularis oculi muscle
3. Buccal: to buccinator, muscles of upper lip & nose
4. Mandibular: to muscles of lower lip
5. Cervical: to platysma

12. FACIAL NERVE INJURY
• UPPER MOTOR NEURONE LESION
(SUPRANUCLEAR LESION): e.g. lesion in
pyramidal tracts: paralysis of muscles on the
lower quadrant of face opposite to the side of
lesion (the patient can close his eye but
cannot expose his teeth on the affected side)
• LOWER MOTOR NEURONE LESION
(NUCLEAR OR INFRANUCLEAR LESION):
e.g. Bell’s palsy: paralysis of all muscles of
face on same side of lesion (the patient
cannot close his eye and cannot expose his
teeth on the affected side)

13. ARTERIES OF FACE

14. FACIAL ARTERY
• ORIGIN: A branch of external carotid in the neck
• COURSE IN FACE:
1. Curves around the lower border of mandible (pulse
can be felt)
2. Ascends: lateral to lips & nose,
anterior to facial vein
3. Runs a tortuous course
• TERMINATION: at the medial angle of eye, where it
anastomoses with branches of ophthalmic artery
• BRANCHES IN FACE:
1. Inferior labial
2. Superior labial
3. Lateral nasal

15. SUPERFICIAL TEMPORAL
ARTERY
• ORIGIN: One of the 2 terminal branches of
external carotid artery in the parotid gland
• COURSE:
1. Ascends in front of auricle (pulse can be
felt)
2. Accompanies the auriculotemporal nerve
• BRANCHES:
1. Transverse facial: arises inside the parotid
gland & runs transversally above parotid
duct
2. anterior & posterior branches: supply the
scalp