anatomy of face, facial muscles

1. FACE
Presented by: Dr. Chitransha

2. The face is the front aspect of
the head possessing eyes, nose
and mouth.

3. The forehead is common to both
the face and the scalp.
SUPERIORLY
• up to
the
hair
line
INFERIORLY
• chin and
base of the
mandible
LATERALY
• auricle

5. FACE
Layers of the face:
1- Skin: it is thick, has rich blood
supply (rapid healing)
2- Superficial fascia: contains muscles,
vessels and nerves of the face.
No deep fascia in most of the face (to
allow for facial expression)

6. Skin of the face is thick, elastic, and
very vascular.
It contains large number of sweat
and sebaceous glands.
The sweat glands- regulate the
body temperature
sebaceous glands - oily

7. Skin
Very vascular Blushing
Wounds bleed
profusely but heal
rapidly

8. The skin of face is lax except on
the nose where it is firmly
attached to the underlying
cartilages and provides insertion
to the muscles of facial
expressions.
BOILS

9. Superficial Fascia
muscles of facial expression
vessels and nerves- Ms& skin
variable amount of fat

10. The fat is absent in the eyelids & well-
developed in cheeks forming buccal pad
of fat, which provides rounded contour
to cheeks.
The buccal pads of fat are very
prominent in infants in whom they help
in suckling the milk and are called
suctorial pad of fat.

11. Deep Fascia
Absent in face except over the
parotid gland and masseter muscle,
k/n as parotidomasseteric fascia.
The absence of deep fascia in the
face is essential for the facial
expression.

12. MUSCLES OF FACIAL
EXPRESSION
The muscles of facial expression
are embedded in the superficial
fascia.

13. Characteristic Features of the
Muscles
1. They lie in superficial fascia and
inserted into the skin.
2. Morphologically, they represent the
remnant of (panniculus carnosus), of
lower animals.
Skeletal muscle in superficial fascia

14. 3. Embryologically, they develop
from mesoderm of 2nd
pharyngeal arch, hence supplied
by facial nerve.
4. Functionally, they perform all
important functions of non-verbal
communication in addition to
closing and opening the orifices in
the region of the face.

15. Location and Function
The facial muscles are arranged
in groups
Eye
 around the orifices of mouth
nose as sphincters and dilators
of these orifices.

16. As mentioned earlier, they produce
different types of facial expressions. To
perform fine movements of facial
expressions the facial muscles have small
motor units.
Orbicularis oculi, orbicularis oris, and
buccinator

20. Muscles Around the Orifice
of the Eye
These include:
 Orbicularis oculi.
 Corrugator supercilii.
 Frontalis.
 Levator palpebrae superioris.

22. “
”
Orbicularis oculi
It consists of three parts—
orbital, palpebral, and lacrimal.

23. Orbital part
Origin
• medial palpebral ligament, frontal
process of maxilla and adjoining part
of the frontal bone.
Insertion
• without interrupting returning to
their point of origin.
Action
• closes the eye tightly to protect the
eye from bright light, injury. also used
in winking

24. Palpebral part
Arises from medial palpebral ligament
and sweeps laterally over the upper and
lower eyelids
inserted into the lateral palpebral
ligament.
It closes the eyelids gently as in sleep
or in blinking.

26. Lacrimal part
It arises from posterior lacrimal crest
and lacrimal fascia that passes laterally
in front of tarsal plates of both eyelids to
be inserted into the lateral palpebral
raphe.
It dilates the lacrimal sac by exerting
traction on the lacrimal fascia, thus
helping in the drainage of lacrimal
fluid.

28. Action- Contraction of entire
muscle draws the skin of
forehead, temple & cheek
towards the medial angle of eye.

29. Corrugator supercilii
It arises from the medial end of the
superciliary arch of frontal bone, passes
laterally and upwards to be inserted into
the subcutaneous tissue of the eyebrow
above the middle of the supraorbital
margin.
It drags the eyebrow medially and
downwards & protect the eye from
bright light, produces vertical wrinkles
on the forehead as in frowning, an

31. act
Origin- medial end of
superciliary arch
Insertion- subcutaneous
tissue of eyebrow
Action- vertical wrinkles
on the forehead

32. Frontalis
Origin- Skin of forehead, subcutaneous
tissue of eyebrow & root of the nose.
Action- Alternate contraction move the
entire scalp backward and forward.
Acting from above frontal bellies raise
the eyebrows as in surprise, horror,
fright).
Acting from below produces transverse
wrinkle into forehead.

34. Levator palpebrae superioris
It is not a muscle of the face but
one of the orbital muscles.
It is an antagonist to the
sphincteric action of palpebral
part of orbicularis oculi.
It elevates the upper eyelid.

36. Facial muscles
Thin, flat muscles,
connected to the dermis
of the skin Innervated
by the facial nerve.
blend into each other.

37. Muscles Around the Nasal
Cavity
1. Procerus.
2. Nasalis.
3. Depressor septi.

39. Procerus
It arises from fascia covering
the nasal bone, passes upwards
to be inserted into the skin of the
eyebrows.
It produces transverse wrinkles
across the bridge (root) of the
nose as in frowning.

40. Nasalis
It consists of two parts: transverse part
called compressor naris and alar part
called dilator naris.
1. Compressor naris arises form maxilla
close to the nasal notch, passes upwards
and medially to form an aponeurosis
across the bridge of nose where it
becomes continuous with its counterpart
on the opposite side.
It compresses the nasal aperture.

43. 2. Dilator naris arises from from
the margin of the nasal notch of
maxilla, and inserted into the lateral
part of the ala of the nose.
It dilates the anterior nasal apertures
as in deep inspiration. It also
expresses the anger (sign of omega).

44. Depressor septi
It arises from the incisive fossa
of the maxilla and is inserted into
the lower mobile part of the
nasal septum.
It dilation of anterior nasal
aperture, also active in anger.

45. Nose muscles
- Nasalis - compresses/dilates
nose
-Depressor Septi - depresses tip
-Procerus- produce transverse
wrinkles across the bridge of
nose.

47. Muscles Around the Mouth
The muscles around the mouth
are responsible for the movement
of lips and cheek. These include:
1. Orbicularis oris: Acts as
sphincter.
2. Nine muscles converging
around the mouth act as
dilator.

48. Nine Muscles Converging Around
the Mouth
1. Levator labii superioris alaeque
nasi.
2. Levator labii superioris.
3. Levator anguli oris.
4. Zygomaticus minor.
5. Zygomaticus major.
6. Depressor labii inferioris.

49. 7. Depressor anguli oris.
8. Risorius.
9. Buccinator

51. Orbicularis Oris
This complex muscle surrounds the
oral orifice and forms the greater
part of the lips.
It has extrinsic and intrinsic parts.
Extrinsic part arrange in 3
groups.
1. Deepest
2. Intermediate
3. superficial

53. Deepest part: incisivus superior muscle
from insicive fossa of maxilla &
mandible.
Intermediate part: buccinator muscle.
The fibres of buccinator converge
towards the modiolus.

54.  The uppermost and lowermost
fibres pass straight into their
respective lips, whereas the
middle fibres decussate, so that
the upper fibres pass into the
lower lip, and lower into the
upper lip.

56. Superficial: interlacing fibres of the
muscles which converge around the
mouth for their insertion into the lips,
viz. levator anguli oris, depressor
anguli oris.
Intrinsic part : skin to mucous
membrane of lips.

57. ACTIONS
Closes the lip.
Deep fibres compresses the lips
against the teeth help in mastication.
Superficial fibres protrudes the lips.
Also helps in speech.

58. Nerve supply
Buccal branch of the facial nerve.

60. Buccinator (Bugler’s
muscle/trumpeter’s muscle)
muscle of the cheek, thin &
quadrilateral in shape.
Origin: arises from the following 4 sites:
Outer surface of the alveolar process
of maxilla & mandible opposite three
molar teeth.

61. Pterygomaxillary raphe.
Pterygomandibular raphe.

63. INSERTION
After reaching angle of mouth
arrange in 3 groups.
Upper- into upper lip
lower – lower lip
Intermediate- chiasmaticus
dicussation. Upper goes into
lower lip & lower fibres into
upper lip.

64. Nerve supply: Buccal branches of
facial nerve.
Actions:
It flattens the cheek against the gum
and teeth, and thus prevents the
accumulation of food in the vestibule
of mouth during mastication.

65. It is responsible for blowing the
cheek and expelling the air
between the lips from inflated
vestibule as in blowing the
trumpet (hence the name
trumpeter’s muscle).

66. Emotional
expression
Presenting features Facial
muscles
Surprise/horro
r/fright
Transverse wrinkles of
the forehead
Frontalis
Frowning •Vertical wrinkles of
the forehead
• Transverse wrinkle
across the root of
nose
Corrugator
supercilii
Procerus
Anger Dilation of the anterior
nasal aperture
• Depression of lower
mobile part of the
nasal septum
Dilator naris
• Depressor
septi

67. Nerve supply of the face
13 nerves: 1 motor & rest are
sensory.

68. Nerve 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

69. Sensory Nerve Supply
The upper 1/3rd of face (develop from
frontonasal process) is supplied by
ophthalmic division, middle 3rd of face
(develop from maxillary processes) is
supplied by maxillary division and
lower 3rd of face (develop from
mandibular processes) is supplied by
mandibular division of the trigeminal
nerve.

72. Motor Nerve Supply
Here divides into 5 terminal branches which emerge in the
face radiating through the anterior border of the parotid
gland and supply the muscles of facial expression.
enters the parotid gland.
the facial nerve wind around the lateral aspect
of styloid process
After coming out of cranial cavity through
stylomastoid foramen,

75. Nerve supply of the face

76. Facial 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

77. Nerve supply
Forehead
- Frontalis – temporal
- Procerus – temporal,
zygomatic, buccal
- Corrugator supercilii –
temporal, zygomatic,
buccal
- Orbicularis oculi –
temporal, zygomatic

78. Nerve supply
Nose
- Nasalis – zygomatic,
BUCCAL
- Depressor Septi Nasi
– BUCCAL
- Levator labii
superioris alaeque
nasi – BUCCAL

79. Arterial supply
The face is supplied by
branches of the external
carotid and the internal
carotid artery
- Two main branches of the
ECA: Facial artery and
superficial temporal artery
- Main branches of the
internal carotid that supplies
the medial upper face and
scalp is the ophthalmic
artery

80. - 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

81. Arterial blood supply
The face is the highly vascular region
and is supplied by the
1. Facial artery- chief artery of the
face.
2. Transverse facial artery.
3. Arteries that accompany the
cutaneous nerves.

83. Facial Artery
It arises from ECA in the neck at the
level of greater cornu of the hyoid
bone, and after a looped course in
the submandibular region, it enters
the face by winding around the lower
border of the mandible at the
anteroinferior angle of the masseter
by piercing the investing layer of
deep cervical fascia.

84. In the face, the artery passes
tortuously, first upwards and
forwards to a point 1.25 cm lateral
to the angle of the mouth and then
ascends along the side of the nose to
the medial angle of the eye where it
ends by anastomosing with the
dorsal nasal branch of ophthalmic
artery. The terminal part of facial
artery is called angular artery.

85. Branches of the Facial Artery in
the Face
In the face it gives three sets of named
branches, viz.
1.Inferior labial artery, to supply the
lower lip.
2.Superior labial artery, to supply the
upper lip.
3.Lateral nasal artery, to supply the
ala and dorsum of the nose.

86. All these branches arise
anteriorly.
4.Muscular branches, are small,
unnamed and arise from the
posterior aspect of the artery

87. Venous drainage of scalp and face

88. Venous drainage of scalp and face
Supratrochlear 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

89. LYMPHATIC DRAINAGE
The face is divided into three lymphatic
territories, viz.
Upper area—comprising greater part
of the forehead, lateral halves of the
eyelids including conjunctiva, parotid
area, and adjoining part of the cheek.
Lymph from upper territory is drained
into preauricular or superficial parotid
LN.

90. Middle area —comprising central
part of the forehead, medial halves
of the eyelids, external nose, upper
Lip, lateral part of lower lip, medial
part of cheek, and greater part of the
lower jaw.
 Lymph from middle territory is
drained into submandibular lymph
nodes.

91. Lower territory—comprising
central part of the lower lip
and chin.
Lymph from lower territory is
drained into submental lymph
nodes.

94. Dangerous area of the face
The facial vein and its communications are
devoid of valves in their lumens.
Since facial vein rests directly on the
muscles of facial expression, the movements
of these muscles may facilitate the spread of
septic emboli from infected area of the lower
part of the nose, upper lip, and adjoining
part of the cheek in retrograde direction
through deep facial vein, pterygoid venous
plexus, and emissary vein into the cavernous
sinus leading to meningitis and cavernous

95. facial vein
Pterygoid venous
plexus
Cavernous sinus
Emissary veins
Deep facial V. Sup.oph.V.

97. Bell’s palsy
It is lower motor neuron type
paralysis of facial muscles due to
compression of facial nerve in the
facial canal near stylomastoid
foramen.
The exact etiology is not known
but it is probably due to viral
infection.

98. Characteristic Features
Facial asymmetry (affected side is drawn
to the healthy side)—due to unopposed
action of muscles of normal side.
Loss of horizontal wrinkles on
forehead—due to paralysis of
occipitofrontalis muscle.
Widening of palpebral fissure and
inability to close the eye—due to
paralysis of orbicularis oculi.

99. Tears flow down from the eye
(epiphora)—due to paralysis of the lower
part of the orbicularis oculi.
Sagging of the angle of the mouth
towards the affected side and inability of
the angle of the mouth to move upwards
and laterally during laughing—due to
paralysis of zygomaticus major.

100. Loss of nasolabial furrow—due to
paralysis of levator labii 7. Acsuperioris
alaeque nasi.
Acumulation of food into the vestibule of
the mouth—due to paralysis of buccinator
muscle.
Dribbling of saliva from the angle of the
mouth—due to paralysis of orbicularis
oris.

101. Loss of resistance when one
presses cheek with inflated
vestibule and air leaks out from
between the lips—due to
paralysis of buccinator muscle.

103. Trigeminal neuralgia (tic
douloureux)
It is a clinical condition characterized
by sudden paroxysmal attacks of
lancinating pain lasting from few hours
to several days, confined to distribution
of one or more divisions of trigeminal
nerve.
It commonly starts in the maxillary
territory and more frequently on the
right side.

104. Herpes zoster ophthalmicus
It is a viral infection involving the
ophthalmic nerve.
It presents as severe pain and edema
in the ophthalmic territory and is
characterized by the appearance of
vesicles along the course of cutaneous
branches of the ophthalmic nerve.