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Plantigrade- flat
Pronograde - projectile
FACE
Extent
• Above
– Hair line of scalp
• Below
– Chin and base of mandible
• Each side
– Auricle
Forehead – common area for scalp and face
Skin
• Highly vascular
– Plastic surgery gives excellent
results
• Sebaceous and sweat glands
– Activities control by sex
hormones
– Acne in adults
• Due to inflammation of sebaceous
glands
Skin …. Contd.,
• Thick, elastic and gives
attachment to muscles
– Wounds tends to gape
– And profuse bleeding
• Lax
– Permits rapid spread of
oedema
Superficial fascia
• Contains
– Facial muscles
– Vessels and nerves
– Variable amount of fat
• Fat is
– Abundant in cheek
– Absent in eyelids
Deep fascia
• Absent
• Except parotid fascia
Facial skeleton (14)
• Unpaired bones
– Mandible
– Vomer
• Paired bones
– Maxilla
– Nasal
– Lacrimal
– Palatine
– Zygomatic
– Inferior nasal concha
Muscles
• Morphologically remnants of
– Panniculus carnosus
• Embryologically –
– Derived from mesoderm of
• II-branchial arch
• Functionally
– To close and open
• 3 main orifices
Muscles of Nose (3)
• Nasalis
– 2 parts
• Compressor naris
• Dilator naris
• Depressor septi Nasi
• Procerus
Nasalis
• 2 parts
– Compressor naris
• O
– Ant surface of maxilla
» Lat to nasal notch
• I
– Opposite side muscles meet
along the bridge
• A
– Compresses ant nasal opening
– Dilator naris
• O
– Just inferior to origin of com
naris
• I
– Ala of nose
• A
– Dilates the ant nasal opening
Depressor
septi nasi
• O
– Ant surface of maxilla
• Incisive fossa (below nasal
notch)
– I
• Inferior part of nasal septum
– A
• Widening nasal opening
Procerus
• O
– Nasal bone
• I
– Skin between eyebrows
• A
– Frowning
Muscles of Mouth
1+10
• Orbicularis oris
• Levator labii superioris
alaeque nasi
• Levator labi superioris
• Levator anguli oris
• Zygomaticus major
• Zygomaticus minor
• Risorius
• Depressor labii inferioris
• Depressor anguli oris
• Mentalis
• Buccinator
• Muscles of mouth
– Can be divided into
• 2 groups
– One sphincter & 10 elevators
• Elevators can be divided into
– 3 subgroups
» Muscles acting on upper lip
» Muscles acting on lower lip
» Muscles acting at the angle
Muscles acting on upper lip
• Levator labii superioris
alaeque nasi
• Levator labii superioris
• Zygomaticus minor
• O
– Superior part of frontal process of maxilla
• I
– Divides into 2 parts
• Nasal
– Skin & cartilage of ala
• Labial
– Upper lip (into orbicularis oris)
• A
– Medial part
• Dilates nose
– Lateral part elevates upper lip
Levator labii superioris alaque nasi
Levator labii
superioris
• O
– Infraorbital margin of
maxilla
• Above infraorbital foramen
• I
– Skin of upper lip
• A
– Elevates upper lip
Zygomaticus minor
• O
– Outer surface of zygomatic
bone
• Zygomaticomaxillary suture
• I
– Skin of upper lip lateral part
• A
– Elevates upper lip
Muscles acting on angle of mouth
• Levator anguli oris
• Zygomaticus major
• Risorius
• Depressor anguli oris
Levator anguli oris
• O
– Canine fossa of maxilla
• Below infraorbital foramen
• I
– Angle of mouth
• A
– Raises angle of mouth
Zygomaticus major
• Smiling muscle
• O
– Zygomatic bone
• Anterior to zygomaticotemporal
suture
• I
– Angle of mouth
• A
– Elevates angle of mouth laterally
Risorius
• Grinning muscle
• O
– Parotid fascia
• I
– Angle of mouth
• A
– Pulls the angle of mouth
downwards & laterally
Depressor anguli oris
• O
– Posterior part of
• Oblique line of mandible
• I
– Angle of mouth
• A
– Pulls angle of mouth downwards &
laterally
Muscles acting on lower lip
• Depressor labii inferioris
• Mentalis
Depressor labii inferioris
• O
– Oblique line of mandible
• Near symphysis menti
• I
– Skin of lower lip
• A
– Depressor of lower lip
Mentalis
• O
– Incisive fossa of mandible
• I
– Skin of chin
• A
– Draws lower lip downwards
Muscles around oral cavity
• Orbicularis oris
• Buccinator
Orbicularis oris
• Sphincter
• Encircles oral fissure
• Has 2 parts
– Extrinsic & intrinsic (Deep)
• O
– Incisive fossa of
• Maxilla & mandible
• I
– Surround the orifice and
attach angle of mouth
– Skin of lips
• A
– Closure of lips
– Compressor of lips
(mastication)
– Protrusion of lips
Buccinator
• Muscle of cheek
• O
– Alveolar process of
• Maxilla & mandible
– At Third molar tooth
– Ant surface of
pterygomandibular raphe
– Post part of
• Oblique line of mandible
• I
Insertion of Buccinator
• All fibres converge at angle
of mouth
• Upper fibers
– Passes into upper lip
– Meet with opposite side
• Lower fibres
– Passes into lower lip
– Meet with opposite side
• Middle fibres
– Decussate at angle
– Lower part goes to upper lip
– Upper part reaches lower lip
Buccinator
• Action
– Compresses cheek
– Helps in
• Chewing
• Blowing
• Sucking
• Relations
– Covered by
• Buccopharyngeal fascia
• Buccal pad of fat
– Deep Relations
• Mucous membrane and
• Pharyngobasilar fascia
• Structures piercing
– Parotid duct
Buccinator - Superficial relations
• Muscles
– Zygomaticus major
– Zygomaticus minor
– Risorius
Buccinator - Superficial relations
• Vessels
– Deep facial vein
– Anterior facial vein
– Facial artery & vein
• Nerves
– Upper & lower buccal of
VII
Buccinator - Superficial relations
• Lymph nodes
– Facial lymph nodes
Muscles around orbit
• Orbicularis oculi
– Sphincter of orbit
– Surrounds palpebral
fissure
– Has 3 parts
• Palpebral
• Orbital
• Lacrimal
Orbicularis oculi
• Orbital part
– O
• Medial palpebral ligament
• Frontal process of maxilla
• Nasal process of frontal bone
– I
• Encircles orbit
– A
• Locks eyelid
Orbicularis oculi
• Palpebral part
– O
• Medial palpebral ligament
– I
• Lateral palpebral raphae
– A
• Closes the eyelids gently
• Blinking & sleeping
Orbicularis oculi
• Lacrimal part
– O
• Posterior Lacrimal crest
• Lateral surface of lacrimal bone
– I
• Divides into upper & lower parts
• Attached to tarsal plates
• Lateral palpebral raphe
Orbicularis oculi
• Nerve supply
– Branches from facial
• Zygomatic
• Temporal
Zygomatic Branch
Temporal Branch
Corrugator supercilii
• Muscle of frowning
• O
– Medial part of superciliary
arch
• I
– Skin above supra orbital
margin
• A
– Draws eyebrow medially
Arteries of face
• Facial artery
• Superficial temporal
• Opthalmic artery
Facial branches of facial artery
• Inferior labial
• Superior labial
• Lateral nasal
• Angular
Superficial temporal branch
• Transverse facial
Facial branches from Maxillary
• Mental artery
• Buccal artery
• Infra orbital
Facial branches of opthalmic
• Supratrochlear
• Supraorbital
Veins
• Facial vein
– Formation
• By Union of
– Supra trochlear
– Supra orbital
• Pierces
– Deep fascia below
mandible
• Joins with
– Anterior division of
• Retromandibular v
– Forms
• Common facial vein
Facial vein
• Communications
– With cavernous vein
• Through – angular vein &
superior opthalmic vein
– With pterygoid venous
plexus
• Through – deep facial vein
Dangerous area of face
• Upper lip and lower part of
nose –
– lying between the angular
vein and deep vein of face
• Facial vein is devoid of
valves
• Rests on facial muscles
• Movements of facial
muscles facilitate spread of
emboli
Nerve supply of face
• Sensory
– Trigeminal nerve
• Except area over angle of
mandible
– Supplied by
» Great auricular nerve
(C2, 3)
Sensory nerves
• Opthalmic (5)
– Lacrimal
– Supra orbital
– Supra trochlear
– Infra trochlear
– External nasal
Sensory nerves
• Maxillary (3)
- a) Zygomatico temporal
- b) Zygomatico facial
- c) Infra orbital
Zygomaticotemporal
Zygomaticofacial
Infraorbital nerve
Sensory nerves
• Mandibular (3)
- Buccal
- Auriculo temporal
- Mental
Auriculo temporal
Buccal
Mental
Motor
• Facial
– Temporal
– Zygomatic
– Buccal
– Marginal mandibular
– Cervical
Temporal
Zygomatic
Upper Buccal
Lower Buccal
Marginal mandibular
Cervical
Supranuclear palsy
• Upper motor neurons
– Occlusion of blood supply to
motor area
– Or Internal capsule area
• Results
– Contralateral side lower
facial muscles paralysed
• Upper muscle has bilateral
control of motor cortex
Bell’s palsy
• Lower motor neuron
• Lesion in peripheral part of
facial nerve
– Near stylomastoid foramen
• Paralysis of ipsilateral side
Face

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Face

  • 2. Extent • Above – Hair line of scalp • Below – Chin and base of mandible • Each side – Auricle Forehead – common area for scalp and face
  • 3. Skin • Highly vascular – Plastic surgery gives excellent results • Sebaceous and sweat glands – Activities control by sex hormones – Acne in adults • Due to inflammation of sebaceous glands
  • 4. Skin …. Contd., • Thick, elastic and gives attachment to muscles – Wounds tends to gape – And profuse bleeding • Lax – Permits rapid spread of oedema
  • 5. Superficial fascia • Contains – Facial muscles – Vessels and nerves – Variable amount of fat • Fat is – Abundant in cheek – Absent in eyelids
  • 6. Deep fascia • Absent • Except parotid fascia
  • 7. Facial skeleton (14) • Unpaired bones – Mandible – Vomer • Paired bones – Maxilla – Nasal – Lacrimal – Palatine – Zygomatic – Inferior nasal concha
  • 8. Muscles • Morphologically remnants of – Panniculus carnosus • Embryologically – – Derived from mesoderm of • II-branchial arch • Functionally – To close and open • 3 main orifices
  • 9. Muscles of Nose (3) • Nasalis – 2 parts • Compressor naris • Dilator naris • Depressor septi Nasi • Procerus
  • 10. Nasalis • 2 parts – Compressor naris • O – Ant surface of maxilla » Lat to nasal notch • I – Opposite side muscles meet along the bridge • A – Compresses ant nasal opening – Dilator naris • O – Just inferior to origin of com naris • I – Ala of nose • A – Dilates the ant nasal opening
  • 11. Depressor septi nasi • O – Ant surface of maxilla • Incisive fossa (below nasal notch) – I • Inferior part of nasal septum – A • Widening nasal opening
  • 12. Procerus • O – Nasal bone • I – Skin between eyebrows • A – Frowning
  • 13. Muscles of Mouth 1+10 • Orbicularis oris • Levator labii superioris alaeque nasi • Levator labi superioris • Levator anguli oris • Zygomaticus major • Zygomaticus minor • Risorius • Depressor labii inferioris • Depressor anguli oris • Mentalis • Buccinator • Muscles of mouth – Can be divided into • 2 groups – One sphincter & 10 elevators • Elevators can be divided into – 3 subgroups » Muscles acting on upper lip » Muscles acting on lower lip » Muscles acting at the angle
  • 14. Muscles acting on upper lip • Levator labii superioris alaeque nasi • Levator labii superioris • Zygomaticus minor
  • 15. • O – Superior part of frontal process of maxilla • I – Divides into 2 parts • Nasal – Skin & cartilage of ala • Labial – Upper lip (into orbicularis oris) • A – Medial part • Dilates nose – Lateral part elevates upper lip Levator labii superioris alaque nasi
  • 16. Levator labii superioris • O – Infraorbital margin of maxilla • Above infraorbital foramen • I – Skin of upper lip • A – Elevates upper lip
  • 17. Zygomaticus minor • O – Outer surface of zygomatic bone • Zygomaticomaxillary suture • I – Skin of upper lip lateral part • A – Elevates upper lip
  • 18. Muscles acting on angle of mouth • Levator anguli oris • Zygomaticus major • Risorius • Depressor anguli oris
  • 19. Levator anguli oris • O – Canine fossa of maxilla • Below infraorbital foramen • I – Angle of mouth • A – Raises angle of mouth
  • 20. Zygomaticus major • Smiling muscle • O – Zygomatic bone • Anterior to zygomaticotemporal suture • I – Angle of mouth • A – Elevates angle of mouth laterally
  • 21. Risorius • Grinning muscle • O – Parotid fascia • I – Angle of mouth • A – Pulls the angle of mouth downwards & laterally
  • 22. Depressor anguli oris • O – Posterior part of • Oblique line of mandible • I – Angle of mouth • A – Pulls angle of mouth downwards & laterally
  • 23. Muscles acting on lower lip • Depressor labii inferioris • Mentalis
  • 24. Depressor labii inferioris • O – Oblique line of mandible • Near symphysis menti • I – Skin of lower lip • A – Depressor of lower lip
  • 25. Mentalis • O – Incisive fossa of mandible • I – Skin of chin • A – Draws lower lip downwards
  • 26. Muscles around oral cavity • Orbicularis oris • Buccinator
  • 27. Orbicularis oris • Sphincter • Encircles oral fissure • Has 2 parts – Extrinsic & intrinsic (Deep) • O – Incisive fossa of • Maxilla & mandible • I – Surround the orifice and attach angle of mouth – Skin of lips • A – Closure of lips – Compressor of lips (mastication) – Protrusion of lips
  • 28. Buccinator • Muscle of cheek • O – Alveolar process of • Maxilla & mandible – At Third molar tooth – Ant surface of pterygomandibular raphe – Post part of • Oblique line of mandible • I
  • 29. Insertion of Buccinator • All fibres converge at angle of mouth • Upper fibers – Passes into upper lip – Meet with opposite side • Lower fibres – Passes into lower lip – Meet with opposite side • Middle fibres – Decussate at angle – Lower part goes to upper lip – Upper part reaches lower lip
  • 30. Buccinator • Action – Compresses cheek – Helps in • Chewing • Blowing • Sucking • Relations – Covered by • Buccopharyngeal fascia • Buccal pad of fat – Deep Relations • Mucous membrane and • Pharyngobasilar fascia • Structures piercing – Parotid duct
  • 31. Buccinator - Superficial relations • Muscles – Zygomaticus major – Zygomaticus minor – Risorius
  • 32. Buccinator - Superficial relations • Vessels – Deep facial vein – Anterior facial vein – Facial artery & vein • Nerves – Upper & lower buccal of VII
  • 33. Buccinator - Superficial relations • Lymph nodes – Facial lymph nodes
  • 34. Muscles around orbit • Orbicularis oculi – Sphincter of orbit – Surrounds palpebral fissure – Has 3 parts • Palpebral • Orbital • Lacrimal
  • 35. Orbicularis oculi • Orbital part – O • Medial palpebral ligament • Frontal process of maxilla • Nasal process of frontal bone – I • Encircles orbit – A • Locks eyelid
  • 36. Orbicularis oculi • Palpebral part – O • Medial palpebral ligament – I • Lateral palpebral raphae – A • Closes the eyelids gently • Blinking & sleeping
  • 37. Orbicularis oculi • Lacrimal part – O • Posterior Lacrimal crest • Lateral surface of lacrimal bone – I • Divides into upper & lower parts • Attached to tarsal plates • Lateral palpebral raphe
  • 38. Orbicularis oculi • Nerve supply – Branches from facial • Zygomatic • Temporal Zygomatic Branch Temporal Branch
  • 39. Corrugator supercilii • Muscle of frowning • O – Medial part of superciliary arch • I – Skin above supra orbital margin • A – Draws eyebrow medially
  • 40. Arteries of face • Facial artery • Superficial temporal • Opthalmic artery
  • 41. Facial branches of facial artery • Inferior labial • Superior labial • Lateral nasal • Angular
  • 42. Superficial temporal branch • Transverse facial
  • 43. Facial branches from Maxillary • Mental artery • Buccal artery • Infra orbital
  • 44. Facial branches of opthalmic • Supratrochlear • Supraorbital
  • 45. Veins • Facial vein – Formation • By Union of – Supra trochlear – Supra orbital • Pierces – Deep fascia below mandible • Joins with – Anterior division of • Retromandibular v – Forms • Common facial vein
  • 46. Facial vein • Communications – With cavernous vein • Through – angular vein & superior opthalmic vein – With pterygoid venous plexus • Through – deep facial vein
  • 47. Dangerous area of face • Upper lip and lower part of nose – – lying between the angular vein and deep vein of face • Facial vein is devoid of valves • Rests on facial muscles • Movements of facial muscles facilitate spread of emboli
  • 48. Nerve supply of face • Sensory – Trigeminal nerve • Except area over angle of mandible – Supplied by » Great auricular nerve (C2, 3)
  • 49. Sensory nerves • Opthalmic (5) – Lacrimal – Supra orbital – Supra trochlear – Infra trochlear – External nasal
  • 50. Sensory nerves • Maxillary (3) - a) Zygomatico temporal - b) Zygomatico facial - c) Infra orbital Zygomaticotemporal Zygomaticofacial Infraorbital nerve
  • 51. Sensory nerves • Mandibular (3) - Buccal - Auriculo temporal - Mental Auriculo temporal Buccal Mental
  • 52. Motor • Facial – Temporal – Zygomatic – Buccal – Marginal mandibular – Cervical Temporal Zygomatic Upper Buccal Lower Buccal Marginal mandibular Cervical
  • 53. Supranuclear palsy • Upper motor neurons – Occlusion of blood supply to motor area – Or Internal capsule area • Results – Contralateral side lower facial muscles paralysed • Upper muscle has bilateral control of motor cortex
  • 54. Bell’s palsy • Lower motor neuron • Lesion in peripheral part of facial nerve – Near stylomastoid foramen • Paralysis of ipsilateral side