Hi, I am Dr Komal Ghiya, a pediatric dentist by profession and I am here to upload some of my own presentations regarding dentistry for educational purposed for all the dental students, both undergraduates and postgraduates as well as dentists. I hope you like the presentation. All the best!

1. Muscles of facial expression
and muscles of tongue
By DR KOMAL GHIYA
MDS PEDODONTICS AND
PREVENTIVE DENTISTRY
1

2. CONTENTS
 Classification of facial muscles
 Origin , insertion , action ,nerev supply
of facial muscles
 Clinical co-relation
 Common facial expressions
 Examination of facial muscles
 Muscles of tongue
 Clinical co-relation
2

3. CLASSIFICATION
 muscles of scalp – occipitofrontalis
 muscles of eyelid –
1. orbicularis oculi
2. corrugators supercilli
3. levator palpebrae superioris
Human anatomy-B.D.Chaurasia-volume
3 -4th edition
3

4.  muscles of nose –
1. procerus
2. compressor naris
3. dilator naris
 muscles around mouth –
1. orbicularis oris
2. levator labii superioris alaeque nasi
3. zygomaticus major
Human anatomy-B.D.Chaurasia-volume
3 -4th edition
4

5. 4. levator labii superioris
5. levator anguli oris
6. zygomaticus minor
7. depressor anguli oris
8. depressor labii inferioris
9. mentalis
10.risorius
11.Buccinators
 muscle of neck – platysma
Human anatomy-B.D.Chaurasia-volume
3 -4th edition
5

6. 6

7.  Functionally these muscles regulate 3
openings on the face : oral , palpebral
,nasal
 Each opening has
1. Single sphincter – circular
2. Many dilators - radial
Grays anatomy-36th edition
7

8. Muscle of scalp (occipitofrontalis)
 Origin -
 Occipital belly –
highest nuchal line
of occipital bone
 Frontal belly –skin
and superficial
fascia of eyebrows
 Insertion –
epicranial
aponeurosis
Last’s anatomy-10th edition 8

9.  Nerve supply – posterior auricular
branch to occipitalis and temporal
branches to frontalis
 Action – moves the scalp on skull and
raises eyebrows
Last’s anatomy-10th edition
9

10. Clinical co-relation
 Epicranial
aponeurosis lies
between the 2
muscles and
between them is the
SUBAPONEUROTIC
SPACE
 Bleeding beneath
the aponeurosis
appears as ‘black
eye’ due to blood
tracking down this
space into eyelids.
Human anatomy-B.D.Chaurasia-volume
3 -4th edition
10

11. MUSCLES OF EYELID
 Orbicularis oculi (sphincter)
– palpebral and orbital part
 Origin –medial palpebral
ligament , frontal and
maxillary bones
 Insertion – tissue of eyelid
 Nerve supply – temporal
and zygomatic branch of
facial nerve
 Action – both parts contract
together and close the
eyelids forcibly ,dilates
lacrimal sac
Human anatomy-B.D.Chaurasia-volume
3 -4th edition
11

12.  DILATORS of eyes
 Corrugator supercilii – extends from
supercilliary arch to eyebrows
Action – wrinkles on forehead
(frowning)
 Levator palpebrae superioris –
supplied by occulomotor nerve and
action is elevating upper lid
Last’s anatomy-10th edition
12

13. MUSCLES OF NOSE
 NASALIS
(sphincter)
 Origin – frontal
process of maxilla
 Insertion-bridge of
nose
 Nerve supply –
buccal branch
 Action –
compresses nasal
cartilages Last’s anatomy-10th edition
13

14. Dilators of nose
 Dilator naris –
extends from maxilla
to ala of nose
Action – widens the
nasal septum
 Procerus – extends
from nasal bone to
skin between
eyebrows
Action – wrinkles skin
of nose
Last’s anatomy-10th edition
14

15. MUSCLES OF LIPS AND
CHEEK
 ORBICULARIS ORIS (sphincter)
Origin – maxilla,mandible and skin
Insertion – encircles oral orifice
Nerve supply – buccal and marginal
mandibular branch
Action – compresses lips together (lips
pursed up as in whistling expression)
Last’s anatomy-10th edition
15

16. Clinical co-relation
 Damage to the nerve during surgical
approach to submandibular gland
causes asymmetry of mouth when
speaking or smiling (due to damage to
this muscle)
Human anatomy-B.D.Chaurasia-volume
3 -4th edition
16

17. 17

18. Dilators – all together open lips
into widest possible circle
 Levator labii superioris alaque nasi
 Levatoe labii superioris
 Levator anguli oris
 Depressor anguli oris
 Zygomaticus major and minor
 Risorius (pulls corner of mouth
laterally)
 Mentalis (elevates skin of chin –
dimples)
Last’s anatomy-10th edition
18

19.  All originate from bones and fascia
around oral aperture and insert into
substance of lips
 Supplied by buccal and marginal
mandibular branches of facial nerve
Last’s anatomy-10th edition
19

20.  BUCCINATOR – considered an
accessory muscle of mastication
Origin – outer surface of alveolar
margins of maxilla and mandible and
pterygomandibular ligament.
Insertion – upper and lower lips
Grays anatomy-36th edition
20

21. Grays anatomy-36th edition
21

22.  Nerve supply – buccal branch o facial
nerve
 Action – compresses cheeks and lips
against teeth.
when the cheeks are puffed out
muscle is relaxed and muscle
contracts in forcible expulsion of air
from mouth (blowing a trumpet)
Human anatomy-B.D.Chaurasia-volume
3 -4th edition
22

23.  Buccal pad of fat lies on outer surface
of buccinator and is prominent in
infants giving them CHUBBY
CHEEKS
 Muscle is pierced by parotid duct
opposite upper 3rd molar tooth
Human anatomy-B.D.Chaurasia-volume
3 -4th edition
23

24. Importance of buccal pad of
fat
 Reliable flap for reconstruction of
small to medium size of defects like
oro-antral fistula , palatal defects ,
buccal mucosa; defects.
 Procedure - incision through
vestibular mucosa in molar region
membrane 1cm below opening of
parotid duct
Textbook of oral and maxillo-facial
surgery – Kruger -6th edition
24

25. Textbook of oral and maxillo-facial
surgery – Kruger -6th edition
25

26. Platysma
 Origin – deep fascia
over pectoralis major
and deltoid
 Insertion – body of
mandible and angle of
mouth
 Nerve supply –
cervical branch of
facial nerve
 Action – depresses the
mandible
Human anatomy-B.D.Chaurasia-volume
3 -4th edition
26

27. Examination of the muscles
 Orbicularis oculi – tight closure of eyes
 Orbicularis oris – whistling and pursing
the mouth
 Dilators of mouth – showing the teeth
 Buccinator – puffing mouth and then
blowing
Human anatomy-B.D.Chaurasia-volume
3 -4th edition
27

28.  Platysma – forcibly pulling of angles of
mouth downwards and backwards.
The platysma contracts along with
risorius
 Frontalis – ask patient to look upwards
and look for horizontal wrinkles of
forehead
 Corrugator supercilli –frowning and
making vertical wrinkles of forehead
Human anatomy-B.D.Chaurasia-volume
3 -4th edition
28

29. Common facial expressions
1. SMILING AND
LAUGHING –
zygomaticus
major
2. SADNESS-
levator labii
superioris and
levator anguli oris
3. GRIEF –
depressor anguli
oris
4. ANGER – dilator
1. HORROR -
platysma
2. SURPRISE –
frontalis
3. DOUBT – mentalis
4. GRINNING – risorius
5. CONTEMPT-
zygomaticus minor
6. CLOSING THE
MOUTH – orbicularis
oris
7. FROWNING –
corrugators supercilii
and procerus
Human anatomy-B.D.Chaurasia-volume
3 -4th edition
29

30. CLINICAL CO-RELATION
 BELL’S PALSY
 Treatment
a. Physiotherapy
b. Medication –
prednisolone
c. Nerve
decompression
d. Nerve grafting
Oral pathology-Shafer-6th edition
30

31.  Melkerson rosenthal syndrome- facial
paralysis , fissured tongue and
swelling involving lips.
Oral pathology-Shafer-6th edition
31

32. MYASTHENIA GRAVIS
 Acquired autoimmune disorder due to
antibodies directed towards acetylcholine
receptor at neuromuscular junction of
muscle
 Muscles of mastication and facial
expression involved leading to weakness
and fatigabiliy
Oral pathology-Shafer-6th edition
32

33.  Features
1. Difficulty in
mastication
2. Dropping of jaw
3. Diplopia ,
ptosis,sorrowed
appearance of
face
4. Exhaustion,loss
of weight
 Treatment
1. Physostigmine(
anticholinestere
rase)
Oral pathology-Shafer-6th edition
33

34. MUSCLES OF TONGUE
 A middle fibrous septum divides
tongue into right and left halves. Each
half contains 4 intrinsic and 4 extrinsic
muscles.
 Classified as intrinsic and extrinsic
muscles of tongue
Human anatomy-B.D.Chaurasia-volume
3 -4th edition
34

35. • Genioglossus
• Hyoglossus
• Styloglossus
• Palatoglossus
EXTRINSIC
MUSCLES
• superior longitudinal
• inferior longitudinal
• transverse
• vertical
INTRINSIC
MUSCLES
Human anatomy-B.D.Chaurasia-volume
3 -4th edition
35

36. DEVELOPMENT
 They are derived from occipital
myotomes which are supplied by the
hypoglossal nerve.
Human anatomy-B.D.Chaurasia-volume
3 -4th edition
36

37.  The intrinsic muscles alter the SHAPE
of tongue
 The extrinsic muscles alter the
POSITION of tongue
Human anatomy-B.D.Chaurasia-volume
3 -4th edition
37

38. STYLOGLOSSUS
 Origin – tip and
anterior surface of
styloid process and
stylohyoid ligament
 Insertion – side of
tongue ,intermingling
with fibres of
hyoglossus
 Nerve supply –
hypoglossal nerve
 Action – during
swallowing it pulls the
tongue upwards and
backwards Human anatomy-B.D.Chaurasia-volume
3 -4th edition
38

39. HYOGLOSSUS
 Origin – greater
cornua and body of
hyoid bone
 Insertion – side of
tongue between
styloglossus and
inerior longitudinal
muscle of tongue
 Nerve supply –
hypoglossal nerve
 Action –depresses
tongue and make
dorsum convex
retracts the
protruded tongue Human anatomy-B.D.Chaurasia-volume
3 -4th edition
39

40. GENIOGLOSSUS
 Fan shaped muscle and forms main bulk
of tongue
 Origin—upper genial tubercle of
mandible
 Fibres – fan out and are divided into
upper,middle and lower fibres
 Insertion – upper fibres into tip of tongue
Middle fibres into dorsum
Lower fibres into hyoid bone
Human anatomy-B.D.Chaurasia-volume
3 -4th edition
40

41.  Action –
1. upper fibres retract
the tip
2. middle fibres
depress the tongue
3. lower fibres pull
posterior part of
tongue and so
protrude the tongue
from mouth
 Nerve supply –
hypoglossal nerve
Human anatomy-B.D.Chaurasia-volume
3 -4th edition
41

42. PALATOGLOSSUS
 Origin – oral surface of
palatine aponeurosis
 Insertion – side of
tongue at junction of
oral and pharyngeal
parts
 Action – puls up the
root of tongue and
closes the
oropharyngeal isthmus
 Nerve supply – cranial
root of accessory
nerve through
pharyngeal plexus
Human anatomy-B.D.Chaurasia-volume
3 -4th edition
42

43. INTRINSIC MUSCLES
Human anatomy-B.D.Chaurasia-volume
3 -4th edition
43

44. INTRINSIC MUSCLES
 Occupy upper part of tongue and
attached to fibrous septum
1. SUPERIOR LONGITUDINAL –
shortens tongue and makes dorsum
concave
2. INFERIOR LONGITUDINAL – lies
between genioglossus and
hyoglossus. Shortens the tongue and
makes dorsum convex
Human anatomy-B.D.Chaurasia-volume
3 -4th edition
44

45. 3. TRANSVERSE – extends between
septum to margins. It makes tongue
narrow and elongated
4. VERTICALIS – at the borders of
tongue. It makes the tongue broad
and flattened.
Human anatomy-B.D.Chaurasia-volume
3 -4th edition
45

46. CLINICAL CO-RELATION
 Injury to hypoglossal nerve makes its
own half of tongue immobile
 Examination by asking patient to put
out the tongue – it will deviate to
affected side due to unopposed action
of normal side.
Oral pathology-Shafer-6th edition
46

47.  The attachment of genioglossus
muscle to genial tubercles prevents
tongue from falling back and
obstructing respiration .If genioglossus
muscle is paralysed - the tongue will
fall back on the oropharynx and block
the air passage .
Oral pathology-Shafer-6th edition
47

48. REFERENCES
 Grays anatomy-36th edition
 Last’s anatomy-10th edition
 Textbook of oral and maxillofacial
surgery –Neelima Malik – 2nd edition
 Cunningham’s manual of practical
anatomy-G.J.Romanes – volume 3
 Burket’s oral medicine – 11th edition
48

49.  Human anatomy-B.D.Chaurasia-volume
3 -4th edition
 Handbook of Local Anaesthesia-
Stanley.F.Malamed-5th edition
 Clinical Anatomy-Richard .S.Snell-7th
edition
 Oral pathology-Shafer-6th edition
 Textbook of oral and maxillo-facial
surgery – Kruger -6th edition
 Recent developments in bell’s palsy –N
Julian Holland, Graeme m Weiner. BMJ
2004:329;553-557
49

50.  Facial palsy :etiology,outcome and
management in children-Andreass
Christoph Jenke.European journal of
pediatric neurology.2011,vol 15(3)209-
213
50