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Anatomy of the face
The document outlines the anatomy of the face, detailing the sensory and motor nerve supplies, primarily the trigeminal and facial nerves. It describes various structures including muscles of facial expression, blood supply, and lymphatic drainage, as well as conditions such as Bell's palsy and Horner's syndrome. Additionally, it provides insights into the anatomy of the eyelid and scalp, and highlights the implications of injuries and surgical approaches to the face.
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Anatomy of the face
- 2. MOB TCD Anatomy ofthe Face Professor Emeritus Moira O’Brien FRCPI, FFSEM, FFSEM (UK), FTCD Trinity College Dublin
- 3. MOB TCD Face • Sensorysupply of face is trigeminal • 5th cranial nerve • C2 • Motor supply • Muscles of facial expression • Facial nerve 7th cranial
- 4. MOB TCD Sensory NerveSupply • • • • • Trigeminal Ophthalmic Maxillary Mandibular Cervical plexus
- 5. MOB TCD Terminal Branchesof 5th • Supraorbital • Infraorbital damaged in blow out fracture of orbit • Lateral • Mental; dentures, fracture of mandible • Trigeminal neuralgia
- 6. MOB TCD Sensory TrigeminalNerve • • • • • • • • • Ophthalmic V Supraorbital Supratrochlear Maxillary V Infraorbital Zygomaticofacial Mandibular V Mental Buccal
- 7. MOB TCD Fractured Zygoma •View from above shows depression • Lateral X-ray view should be done
- 8. MOB TCD Great Auricular •C2 from cervical plexus • Skin over angle of mandible
- 9. MOB TCD Scalp • • • • • • • • • Skin Subcutaneous Epicranial aponeurosis Threefused together Loose areolar tissue Periosteum Occipito-frontalis Attached posteriorly No anterior attachment
- 10. MOB TCD Scalp • Occipitalportion of occipitofrontals and epicranial aponeurosis attached to bone posterior • Frontal no bony attachment • Scalp wounds cause black eyes • Occipital belly • Posterior auricular of facial nerve • Frontal belly by temporal of facial nerve
- 11. MOB TCD Blood andNerve Supply of Scalp • Supraorbital vessels and nerve • Scalp as far as vertex • Posterior scalp • Greater occipital C2 • Occipital and posterior auricular vessels • Zygomatico temporal • Greater auricular
- 12. MOB TCD Eyelid • • • • Skin Orbicularis oculi Palpebralportion Orbital septum and tarsal plates, mebonium glands • Medial palpebral ligament anchors tarsal plates to anterior lacrimal crest • Conjunctival sac
- 13. MOB TCD Levator PalpebraeSuperiores • • • • Arises from back of roof of orbit Inserted into skin of upper eyelid The superior tarsal plate Superior fornix of conjunctiva
- 14. MOB TCD Levator PalpebraeSuperiores • Elevates upper eyelid • Voluntary muscle supplied by 3rd oculomotor nerve • Smooth muscle • Sympathetic T1 • Superior cervical ganglion
- 15. MOB TCD Lacrimal Apparatus • • • • • • • Lacrimalgland Conjunctival sac Puncta Cananiculi Nasolacrimal sac Nasolacrimal duct Inferior meatus nose
- 16. MOB TCD Horner's Syndrome • • • • • • • Ptosis Droopingeyelid Meiosis Constricted pupil Anhydrosis Lack of sweating Enopthalmos
- 17. MOB TCD Muscles ofFacial Expression • Muscles of second branchial arch • Nerve second arch is facial nerve • Inserted into skin of face • Buccal pad of fat • No deep fascia in face • Except around parotid • Parotid duct
- 18. MOB TCD Orbicularis Oculi •Orbital closes eyelid tightly, buries eyelashes • Makes conjunctival sac smaller • Finer palpebral portion in eyelid • Anterior to tarsal plate • Closes eye in blinking and sleep • No action on conjunctival sac
- 19. MOB TCD Muscles ofFacial Expression • • • • • • • Occipito frontalis Orbicularis oculi Orbicularis oris Buccinator Platysma Skin of face Incisions
- 20. MOB TCD Muscles ofFacial Expression • Orbicularis oris • Intrinsic: origin and insertion inside, only alters shape • Extrinsic: origin outside, alters position
- 21. MOB TCD Muscles ofFacial Expression • Incisions in the face evert edges • Platysma • Inserted into lower border of mandible • Posterior fibres form risorius
- 22. MOB TCD Buccinator • Buccinator7th nerve • Accessory muscle of mastication • Outer aspect of maxilla and mandible • Related to molar teeth • Pterygomandibular raphe • Action keeps food out of vestibule • Sucking • Blowing trumpet
- 23. MOB TCD Facial Nerve Motornerve to: • Posterior auricular to occipital belly • Posterior belly of digastric Enters parotid and divides into branches • Temporal • Zygomatic • Buccal • Mandibular • Cervical
- 24. MOB TCD Facial Nerve •Stroke • Upper motor neurone of facial • Forehead is spared • Can wrinkle forehead • Bilaterally innervated • All muscles of one side paralysed if it is a lower motor neurone e.g. Bell’s palsy
- 25. MOB TCD Bell’s Palsy •Lower motor neurone of facial nerve • Forehead and all the muscles on the side of lesion are affected
- 26.
- 27. MOB TCD Corneal Reflex •Afferent (sensory) cilary branches nasocilary of ophthalmic of 5th • Efferent (motor) • Zygomatic branch of facial 7th • Last reflex to go
- 28. MOB TCD Blood Supplyand Pulses in Face Internal carotid • Supraorbital artery • Branch of ophthalmic External carotid • Superficial temporal artery • Facial artery
- 29. MOB TCD Venous Drainageof Face • Supraorbital and anterior facial • Communicate superior ophthalmic veins which drain into cavernous sinus • Deep facial vein • Superficial temporal • Retromandibular • Common facial
- 30. MOB TCD Emissary VeinsCavernous Sinus • • • • • • Superior ophthalmic veins Anterior facial Deep facial Pterygoid plexus Danger area of face Parietal emissary veins from scalp to superior sagittal sinus
- 31. MOB TCD Lymph Glands •Submental • Submandibular • Buccal and mandibular • Preauricural • Occipital
- 32. “BMJ Publishing GroupLimited (“BMJ Group”) 2012. All rights reserved.”