Muscles of mastication Introduction Definitions Development Classification Description of individual muscles Muscles of facial expression Introduction Development Classification Description of individual muscles Applied aspects

1. GOOD MORNING

2. MUSCLES OF
MASTICATION
AND FACIAL
EXPRESSION
Presented by
DR APARNA RAMACHANDRAN
MDS FIRST YEAR
DEPARTMENT OF PUBLIC HEALTH
DENTISTRY

3. CONTENTS
Muscles of mastication
• Introduction
• Definitions
• Development
• Classification
 Description of individual
muscles
Muscles of facial expression
• Introduction
• Development
• Classification
• Description of individual
muscles
• Applied aspects
3

4. INTRODUCTION
 Muscles which are required for mastication are known as
muscles of mastication.
 They move the mandible during speech and mastication.
 They develop from the mesoderm of the first branchial
arch, and are supplied by mandibular nerve.
4

5. DEFINITIONS
MASTICATION
 Rhythmic opposition and separation of jaws with the involvement
of teeth, lips, cheek and tongue for chewing of food in order to
prepare it for swallowing and digestion.
MUSCLES
 A band or bundle of fibrous tissue in a human or animal body that
has the ability to contract, producing movement in or maintaining
the position of parts of the body. 5

6. CLASSIFIACTION OF MUSCLES
Depending on striations Depending on function
a) Striated muscle a)Skeletal muscle
b) Non striated muscle b)Smooth muscle
Depending on control c) Cardiac muscle
a) voluntary muscle
b) Involuntary muscle
DEFINITIONS
6

7. MUSCLES OF MASTICATION
• The muscles which are required for mastication are known as the
muscles of mastication.
• These muscles help mainly in the movement of the mandible and
not the maxilla as maxilla is an integral part of the skull and the
mandible being the only movable bone in the skull.
 The muscles of mastication works with temporomandibular joint
to accomplish these movements of the mandible.
7

8. CLASSIFICATION OF MUSCLES OF MASTICATION
Muscles of mastication are classified into primary muscles and
secondary muscles.
8
Primary muscles Secondary muscles
Masseter
Temporalis
Medial
pterygoid
lateral
pterygoid
Digastric
Mylohyoid
Geniohyoid

9. CLASSIFICATION OF MUSCLES OF
MASTICATION
Functionally they are clasified as
9
Jaw elevators Jaw depressors
Masseter
Temporalis
Medial
pterygoid
Digastric
Geniohyoid
Lateral
pterygoid

10. DEVELOPMENT OF MUSCLES OF
MASTICATION
 The muscular system develop from intra
embryonic mesoderm.
 Muscles tissues develop from embryonic cells
called myoblast.
 Muscular component of branchial arch form
many striated muscles in the head and neck
region.
 Muscles of mastication are derived from first
branchial arch that is MANDIBULAR ARCH. 10

11. MASSETER
 Masseter is the most obvious muscle of
mastication.
 It is the most superficially located
muscle.
 The masseter muscle is a broad ,thick ,
rectangular muscle on each side of the
face ,anterior to the parotid salivary
gland.
11

12. MASSETER
ATTACHMENTS
SUPERFICIAL LAYER
ORIGIN - From anterior two thirds of lower
border of zygomatic arch and adjoining
zygomatic process of maxilla. Fibers pass
downwards and backwards at 45 degree.
INSERTION - Into the lower part of lateral
surface of ramus of mandible 12

13. MASSETER
MIDDLE LAYER
ORIGIN- From anterior 2/3 rd of deep
surface and posterior 1/3 rd of lower
border of zygomatic arch.
INSERTION-into the middle part of
ramus.
13

14. MASSETER
DEEP LAYER
ORIGIN - From deep surface of zygomatic
arch.
INSERTION – Into upper part of ramus and
coronoid process of the mandible.
 The three layers are separated posterio
inferiorly by an artery and a nerve.
14

15. ACTIONS OF THE MASSETER
 Elevates the mandible to close the
mouth and to occlude the teeth in
mastication.
 Its activity in the resting position
is minimal
 It has a small effect in side to
side movement ,protraction and
retraction
15

16. RELATIONS OF MASSETER MUSCLE
SUPERFICIAL
 Platysma
 Risorius
 Zygomaticus major
 Parotid gland
 Parotid duct
 Branches of facial nerve
DEEP SURFACE
 Insertion of temporalis and
ramus of the mandible
 Buccinator and buccal
nerve
 Massetric nerve and artery.
16

17. RELATIONS OF MASSETER MUSCLE
NERVE SUPPLY
Massetric nerve ( branch of
anterior division of
mandibular nerve
BLOOD SUPPLY
Maxillary artery(branch of
external carotid artery)
17

18. PALPATION
 The patient is asked to clench their teeth and, using both hands, the
practitioner palpates the masseter muscles on both sides extra
orally, making sure that the patient continues to clench during the
procedure.
 Palpate the origin of the masseter bilaterally along the
zygomatic arch and continue to palpate down the body
of the mandible where the masseter is attached
CLINICAL EXAMINATION
18

19. CLINICAL EXAMINATION
19

20. APPLIED ANATOMY
 Masseter can become enlarged in patients who habitually clench or
grind their teeth and even in those who constantly chew gum.
 This massetric hypertrophy is asymptomatic and soft and is
usually bilateral but can be unilateral also.
 This enlargement may be confused with parotid gland diseases
,dental infections ,maxillofacial neoplasms
20

21. TEMPORALIS
 The Temporalis muscle is a
broad ,fan shaped muscle.
 It is situated on either side of
the head and fills the temporal
fossa
21

22. ATTACHMENTS
ORIGIN- whole of temporal fossa and
deep surface of temporal fascia.
 Fibers converge and descend into
tendon.
 It passes through the gap between the
zygomatic arch and the side of the skull.
INSERTION-
a)Margins and deep surface of coronoid
process
b)Anterior border of ramus of mandible
TEMPORALIS
22

23.  The temporal fascia is a thick aponeurotic
sheet that roofs over the temporal fossa
and covers the temporalis muscle.
 Superiorly the fascia is a single layered
and is attached to superior temporal line.
 Inferiorly, it splits into 2 layers
which are attached to the inner and outer
lips of inner border of the zygomatic arch
TEMPORAL FASCIA
23

24.  The superficial surface of the
temporal fascia receives an
expansion from epicranial
aponeurosis.
 The deep surface of the fascia gives
rise to some fibres of temporalis
muscle.
TEMPORAL FASCIA
24

25. RELATIONS Of TEMPORALIS
SUPERFICIAL
 Skin
 Auricularis anterior
 Temporal fascia
 Superficial temporal vessels
 Auriculotemporal nerve
 Temporal branch of facial nerve
 Zygomatic arch
DEEP SURFACE
 Temporal fossa
 Lateral pterygoid
 Superficial head of medial
pterygoid
 Small part of buccinator
 Maxillary artery
 Deep temporal nerves
 Buccal vessels and nerve25

26. ARTERIAL SUPPLY
The deep temporal artery supplies
the muscle
NERVE SUPPLY
Nerve supply is through trigeminal
nerve
RELATIONS Of TEMPORALIS
26

27. ACTIONS OF TEMPORALIS
• Elevates the mandible, this movement
requires both the upward pull of anterior
fibers and backward pull of the posterior
fibers.
• Posterior fibers draw the mandible
backwards after it has been protruded.
• It also contributes to side to side grinding
movement.
27

28. 28

29. 29

30. PALPATION
 To locate the muscle, make the patient clench
CLINICAL EXAMINATION
30

31.  The lateral pterygoid or external
pterygoid muscle is a muscle of
mastication.
 The muscle has two separate heads of
origin,the superior head and inferior
head.
 The two heads are separated by a slight
interval anteriorly but fuse posteriorly.
LATERAL PTERYGOID
31

32. ATTACHEMENTS
ORIGIN
Upper head- from the infra temporal
surface and crest of greater wing of
sphenoid bone
Lower head – from lateral surface of
lateral pterygoid
LATERAL PTERYGOID
32

33. ATTACHMENTS
INSERTION
Upper head – Pterygoid fovea on the
anterior surface of the neck of the mandible.
Lower head –anterior margin of articular disc
and capsule of temporomandibular joint.
Insertion is posteriolateral and at aslightly
elevated than origin.
LATERAL PTERYGOID
33

34. SUPERFICIAL
 Masseter
 Ramus of mandible
 Tendon of temporalis
 Maxillary artery
RELATIONS OF LATERAL PTERYGOID
34

35. DEEP SURFACE
 Mandibular nerve
 Middle meningial artery
 Spheno mandibular ligament
 Deep head of medial pterygoid
BETWEEN THE TWO HEADS
 The buccal branch of the
mandibular nerve
RELATIONS OF LATERAL PTERYGOID
35

36. Blood supply
Pterygoid branch of second part
of maxillary artery
Nerve supply
Nerve to lateral pterygoid
branch of anterior division of
trigeminal nerve.
RELATIONS OF LATERAL PTERYGOID
36

37. RELATIONS OF LATERAL PTERYGOID
37

38.  Depresses the mandible to open mouth ,along with suprahyoid
muscles
 Left lateral pterygoid and right medial pterygoid turn the chin to
left side as part of grinding movements.
 When the medial and lateral pterygoids of two sides act together
they protrude the mandible
ACTIONS OF LATERALPTERYGOID
38

39. palpation
CLINICAL EXAMINATION
39

40.  Medial pterygoid or internl pterygoid
muscle is another muscle of
mastication.
 It is a thick quadrilateral muscle
which is deeper but similar in form to
superficial masseter.
MEDIAL PTERYGOID MUSCLE
40

41. ATTACHEMENTS
ORIGIN
Superficial head- From tuberosity of
maxilla and adjoining bone.
Deep head - From medial surface of
lateral pterygoid plate and adjoining
process of palatine bone.
MEDIAL PTERYGOID MUSCLE
41

42. ATTACHMENTS
INSERTATION
Roughened area on the medial surface
of the angle and adjoining ramus of the
mandible , below and behind the
mandibular foramen and mylohyoid
groove
MEDIAL PTERYGOID MUSCLE
42

43. SUPERFICIAL
 Lateral pterygoid
 Lingual nerve
 Inferior alveolar nerve
 Maxillary artery
 Sphenomandibular ligament
RELATIONS OF MEDIAL PTERYGOID
43

44. DEEP SURFACE
• Tenser veli palatini muscle
• Superior constrictor of pharynx
• Styloglossus
• Stylopharyangeous muscle
RELATIONS OF MEDIAL PTERYGOID
44

45. BLOOD SUPPLY
Pterygoid branch of the second part
of maxillary artery
NERVE SUPPLY
Branch of the main trunk of
mandibular nerve
RELATIONS OF MEDIAL PTERYGOID
45

46.  Elevates the mandible
 Protrudes the mandible
 Helps in the side to side movement( along with the help
of opposite side lateral pterygoid)
ACTIONS OF MEDIAL PTERYGOID
46

47. CLINICAL IMPLICATION
 Medial pterygoid spasm occurs from repeatedly piercing the
medial pterygoid muscle during inferior alveolar nerve block
 As the muscle is pierced repeatedly by the needle, hemorrhage
occurs in the muscle leading to pain followed by muscle
spasm and trismus.

47
MEDIAL PTERYGOID MUSCLE

48. PALPATION
CLINICAL EXAMINATION
 Gently palpate them on the medial aspect of
the jaw,
 Simultaneously from both inside and outside
the mouth
48

49. PALPATION
CLINICAL EXAMINATION
49

50.  The muscle can only be palpated intraorally.
 It is most commonly involved in the myofacial pain
disfunction syndrome.
 Trismus following inferior alveolar nerve block is mostly
due to involvement of medial pterygoid muscle.
APPLIED ANATOMY
50

51.  This syndrome is the most common disorder affecting the
temporomandibular region.
 It is caused by tension, fatigue, or spasm in the masticatory
muscles .
 Symptoms include bruxism, pain, and tenderness in and around the
masticatory apparatus or referred to other locations in the head and
neck
Myofacial pain dysfunction syndrome
51

52. ETIOLOGY
 Abnormal occlusion
 Prosthetic problems
 Emotional disturbances
 Joint problems
 Orthodontic problems
Myofacial pain dysfunction syndrome
52

53. 53
LASKINS DIAGNOSTIC CRITERIA FOR MPDS

54.  When the nerve that is connected to the muscle becomes iritated
small nodules or contractures form causing the muscle to become
tight and painful.
 These contractures are called trigger points. Which often refers
pain into distant locations
Myofacial pain dysfunction syndrome
54

55. Involvement of various masticatory muscles and their clinical effects
Myofacial pain dysfunction syndrome
55
MUSCLE PAIN REFERS TO CLINICAL EFFECT
TEMPORALIS Temple,.
Maxillary teeth,
TMJ
Restriction of mandibular
opening,ipsilateral deviation of
mandible
MASSETER Temple,Maxillary
molar, TMJ, Ear
Restriction of mandibular
opening,ipsilateral deviation of
mandible
LATERAL
PTERYGOID
TMJ Contralateral deviation of
mandible,protrusion of the
condyle,acute malocclusion
MEDIAL PTERYGOID TMJ, Tongue Restriction of mandibular
movements,contralateral deviation of
mandible

56. TREATMENT
 Physiotherapy and Myotherapeutic exercises
 Transcutaneous Electronic Nerve Stimulation
 Pharmacotherapy
 Biofeedback
 Anaesthasia
Myofacial pain dysfunction syndrome
56

57. 57
PRIOR TO THE PROCEDURE,
 Use hot compresses to masseter and temporalis areas 10 to 20
minutes two to three times daily for 2 days
 Use a minor tranquilizer or skeletal-muscle relaxant (eg,
lorazepam, 1 mg; cyclobenzaprine, 10 mg) on the night before and
at day of the procedure.
 Start a non-steroidal anti-inflammatory analgesic the day of the
procedure.
Managing masticator muscle disorder patients
requiring dental treatment

58. 58
DURING THE PROCEDURE
 Use a child-sized surgical rubber mouth prop to support the
patient’s comfortable opening; remove periodically to reduce
joint stiffness.
 Consider intravenous sedation and/or inhalation analgesia.
 Provide frequent rest periods to avoid prolonged opening.
 Apply moist heat to masticatory muscles during rest breaks
 Gently massage masticatory muscles during rest breaks.
 Perform the procedure in the morning, when reserve is likely to
be greatest.

59. 59
AFTER THE PROCEDURE
 Extend the use of muscle relaxant and NSAID
medication as necessary.
 Apply cold compresses to the TMJ and muscle areas
during the 24 hours after the procedure

60. 60

61. The 4 primary muscles of mastication are in turn supported or
supplemented by few secondary muscles known as
SUPRAHYOID GROUP of muscles they are
• DIGASTRIC
• MYLOHYOID
• GENIOHYOID
SECONDARY MUSCLES OF MASTICATION
61

62. DIGASTRIC MUSCLE
ORIGIN
Anterior belly from digastric fossa of
mandible.
Posterior belly from mastoid notch of
temporal bone.
INSERTION
Both heads meet at the intermediate tendon
which perforates stylohyoid and is held by a
fibrous pulley to the hyoid bone 62

63. NERVE SUPPLY
 The anterior belly is innervated by the
mylohyoid nerve, branch of the
mandibular division of trigeminal
nerve.
 The posterior belly is innervated by
the the posterior digastric nerve,
branch of facial nerve.
INNERVATION OF THE DIGASTRIC MUSCLE
63

64. ACTIONS OF DIGASTRIC MUSCLE
 It depresses mandible when mouth is
opened widely or against resistance ; its
action is secondary to lateral pterygoid.
 It elevates hyoid bone.
DIGASTRIC MUSCLE
64

65.  The mylohyoid is an anterior
suprahyoid muscle that is deep
to the digastric muscle.
 It is flat and triangular in
shape and form the floor of the
mouth.
MYLOHYOID MUSCLE
65

66. ORIGIN - Mylohyoid line of mandible
INSERTION – Body of hyoid bone
MYLOHYOID MUSCLE
66

67. ACTIONS OF MYLOHYOID
 Depression of the mandible.
 Elevates hyoid bone.
 Elevates the floor of the mouth and tongue during
deglution.
MYLOHYOID MUSCLE
67

68. NERVE SUPPLY
The muscle is innervated by the
mylohyoid nerve, a branch of the
mandibular division of the
trigeminal nerve.
INNERVATION OF MYLOHYOID MUSCLE
68

69.  It is a narrow muscle situated
superior to the medial border of
mylohyoid.
GENIOHYOID MUSCLE
69

70. ORIGIN – Genial tubercle of mandible
INSERTION – Body of hyoid
GENIOHYOID MUSCLE
70

71.  Geniohyoid elevates the hyoid
bone and draws it forward ,thus
acting as a partial antagonist to
stylohyoid.
 When the hyoid bone is fixed, it
depresses the mandible
ACTIONS OF GENIOHYOID
71

72. NERVE SUPPLY
The muscle is supplied by
first cervical
nerve,conducted by the 12th
cranial nerve ie hypoglossal
nerve.
INNERVATION OF GENIOHYOID
72

73. MUSCLES OF FACIAL
EXPRESSION
73

74.  The facial muscles are a group of
striated skeletal muscles innervated
by the facial nerve which control
facial expression.
 These muscles are also called
mimetic muscles.
 They develop from the second
pharyngeal arch
INTRODUCTION
74

75.  The facial musculature is fairly unique. They include the only
somatic muscles in the body attached on one side to bone and the
other to skin; thus facial movements are specialized for
expression.
 Morphologically, they represent remanants of the Panniculus
Carnosus, a continuous subcutaneous muscle sheet seen in some
animals.
INTRODUCTION
75

76.  The muscles of facial expression is formed from the second
branchial arch or the facial arch.
 Each pharyngeal arch consists of mesenchymal tissue, covered
on outside by surface ectoderm and on inside by epithelium of
endodermal origin.
 The mesoderm of the arches give rise to musculature of face
and neck
 The mesoderm of the arches give rise to musculature of face
 and neck.
DEVELOPMENT
76

77. The facial nerve, the nerve of 2nd arch supplies all
these muscles.
nerve, the nerve of 2nd arch supplies all these
muscles.
 The mesoderm of the arches give rise to musculature of face
 and neck.
DEVELOPMENT
 The facial nerve, the nerve of 2nd arch supplies all these
muscles.
77

78. TOPOGRAPHICAL CLASSIFICATION
78

79. 79

80.  Functionally,most of these muscles may be regarded
primarily as regulators of the 3 openings situated on the
face.
1. Palpebral fissures
2. Nostrils
3. Oral fissures
CLASSIFICATION
80

81. OPENING SPHINCTER DILATORS
Palpebral fissure Orbicularis oculi 1)Levator palpebrae
superioris
2)occipitofrontalis-
frontalis part
Oral fissure Orbicularis oris All the muscles around
the mouth,except the
orbicularis oris and
mentalis
Nostrils Compressor naris 1) Dilator naris
2) Depressor septi
3) Medial slip of levator
labii superioris
alaequae nasi
FUNCTIONAL GROUP OF FACIAL MUSCLES
81

82. PLATYSMA
 Covers lateral and anterior region
of the neck
 origin: Fascia covering upper parts
of pectoralis major and deltoid
 insertion:Lower border of the
mandible or to the lower lip or
skin and subcutaneoustissue of the
lower face. 82

83. ARTERIAL SUPPLY
 Submental branch of facial artery
 Suprascapular artery from the thyrocervical trunk of the
subclavian artery.
NERVE SUPPLY
 Cervical branch of the facial nerve
PLATYSMA
83

84. ACTIONS
 Tenses the skin producing vertical
skin ridges.
 Facilitates venous flow in the neck
by keeping skin and fascia fairly taut
between mandible and clavicle.
 Depresses mandible.
PLATYSMA
84

85. OCCIPITOFRONTALIS
 Consists of 2 occipital and 2 frontal parts connected by epicranial
aponeurosis.
MUSCLES OF SCALP
85

86. ORIGIN
Occipital part – lateral 2/3rd highest nuchal line of occipital bone
and mastoid part of temporal bone.
Frontal part – no bony attachments of its own , fibers blend with
adjacent muscles.
INSERTION
Into epicranial aponeurosis.
OCCIPITOFRONTALIS
86

87. BLOOD SUPPLY
 Superficial temporal artery
 Ophthalmic artery
 Posterior auricular artery
 Occipital artery
NERVE SUPPLY
 Occipital part – posterior auricular branch of facial nerve
 Frontal part – temporal branch of facial nerve
OCCIPITOFRONTALLIS
87

88. ACTIONS
FRONTAL PART
 Acting from above – raise the eyebrows and skin over the root of
the nose.
 Acting from below – draw the scalp forward , throwing the
forehead into transverse wrinkles.
OCCIPITAL PART
 Draws the scalp backwards
 Acting alternatively – move the entire scalp backwards and
forwards.
OCCIPITOFRONTALLIS
88

89. EPICRANIAL APONEUROSIS
 Common tendon of
occipitofrontalis muscle.
 Consists mostly of Sagittal fibers.
 There is no sharp boundary, it thins out
gradually & above the Zygomatic arch it
fuses with superficial fascia.
 Galea is loosely fixed to
periosteum but tightly
adherent to skin.
89

90. TEMPOROPARAIETALIS
 Lies between the frontal parts of
occipitofrontalis and anterior and
superior auricular muscles.
 ORIGIN – Fascia superior to the
ear.
 INSERTION-Lateral border of
the galea aponeurotica.
90

91. TEMPOROPARAIETALIS
.
BLOOD SUPPLY
 Superficial temporal
 Opthalmic
 Posterior auricular
 Occipital arteries
NERVE SUPPLY
 Posterior auricular branch of
facial nerve
 The temporal branch of
facial nerve
91

92. .
TEMPOROPARAIETALIS
ACTIONS
 Elevates the ear
 Fixes the galea aponeurotica
92

93. ORBICULARIS OCCULI
 The muscle has 3 parts
a) Orbital part –on and around the orbit
b) Palpebral part- in the lids
c) Lacrimal part- lateral and deep to the
lacrimal sac
MUSCLES OF EYE LID
93

94. ORBICULARIS OCULI
MUSCLE ORIGIN INSERTION
Orbital part Medial part of
the medial
palpebral
ligamet and
adjoining bone
Concentric
rings return to
the point of
origin
Palpebral part Lateral part of
medial
palpebral
ligament
Lateral
palpebral
raphe
Lacrimal part Lacrimal
fascia and
Upper and
lower eyelids 94

95. ORBICULARIS OCULI
BLOOD SUPPLY
 Supplied by superficial
temporal,maxillary and
facial artery
NERVE SUPPLY
 Temporal and zygomatic
branch of facial nerve.
95

96. ACTIONS
 Closing of eyelids
 Drainage of tears
 Dilates the lacrimal sac ; directs lacrimal puncta into lacus
lacrimalis ;supports the lower lid.
 Protects eye from bright light
ORBICULARIS OCULI
96

97.  It is a pyramidal muscle
 Located at the medial end of
eyebrow.
 It lies between the frontalis and
orbicularis oculi muscles.
CORRUGATOR SUPERCILI
97

98. ORIGIN
 Medial end of superciliary arch
INSERTION
 Skin of mid eye brow
CORRUGATOR SUPERCILI
98

99. BLOOD SUPPLY
 Superficial temporal
 opthalmic arteries
NERVE SUPPLY
 Temporal branch of facial nerve.
CORRUGATOR SUPERCILI
99

100. LEVATOR PALPEBRAE SUPERIORIS
 It is a triangular shaped muscle.
 It broadens and decreases in thickness
(becomes thinner) and becomes the levator
aponeurosis.
 The superior tarsal muscle a smooth muscle,
is attached to the levator palpebrae
superioris
100

101. LEVATOR PALPEBRAE SUPERIORIS
ORIGIN
It originates from the lesser wing of
the sphenoid bone, just above the
optic foramen.
INSERTION
It inserts on the skin of the upper
eyelid, as well as the superior tarsal
plate
101

102. LEVATOR PALPEBRAE SUPERIORIS
BLOOD SUPPLY
 Directly by ophthalmic
artery
 Indirectly by superiororbital
branch of ophthalmic artery.
NERVE SUPPLY
Innervation is through the
occulomotor nerve. 102

103. ACTIONS
 It elevates the upper eye lid.
CLINICAL SIGNIFICANCE
 Damage to this muscle or its innervation can cause ptosis, which
is drooping of the eyelid.
 Lesions in CN III can cause ptosis, because without stimulation
from the oculomotor nerve the levator palpebrae cannot oppose
the force of gravity, and the eyelid droops.
LEVATOR PALPEBRAE SUPERIORIS
103

104. LEVATOR PALPEBRAE SUPERIORIS
 Ptosis can also result from damage to the adjoining
superior tarsal muscle or its sympathetic innervation.
 Such damage to the sympathetic supply occurs in
Horner's syndrome and presents as a partial ptosis.
104

105. PROCERUS
 The procerus muscle (or pyramidalis nasi) is a small
pyramidal slip of muscle deep to the superior orbital
nerve, artery and vein.
MUSCLES OF NOSE
105

106. ORIGIN
 Facial aponeurosis covering lower
part of nasal bone and upper part of
lateral nasal cartilage.
INSERTION
 Skin over lower part of forehead
between the eyebrows.
PROCERUS
106

107. BLOOD SUPPLY
 Branches from facial
artery.
NERVE SUPPLY
 Temporal and lower
zygomatic branches of
facial nerve
PROCERUS
107

108. ACTIONS
 Depresses medial end of eyebrow
 Creates transverse wrinkles over the bridge of nose
APPLIED ANATOMY
 It is targeted in the anti-wrinkle treatment of injected
botulinum toxin for cosmetic purposes.
PROCERUS
108

109.  Nasalis muscle is also
known as compressor nari.
 It is a sphinctor like
muscle.
 Consists of transverse and
alar parts.
NASALIS
109

110. ORIGIN
 Tranverse part- from maxilla just
lateral
to the nasal notch
 Alar part – from maxilla below and
medial to the transverse part.
INSERTION
 Nasal cartilages.
NASALIS
110

111. BLOOD SUPPLY
Alar part
 Angular artery and lateral nasal artery,
branches of facial artery
Transverse part
 Dorsal nasal artery and Anterior
ethmoidal artery. Branches of
ophthalmic artery
NASALIS
111

112. NERVE SUPPLY
 Zygomatic branch of facial
nerve.
NASALIS
112

113. ACTIONS
 Transverse- compresses the nasal aperture.
 Alar –widens the anterior nasal aperture.
 Helps in deep inspiration
NASALIS
113

114.  The Depressor septi nasi or depressor septiis
is a facial muscle located in the lower nose
region.
 It may be absent or rudimentary in some
people.
 It lies between the mucous membrane and
muscular structure of the lip.
DEPRESSOR SEPTI
114

115. ORIGIN
 Incisive fossa of maxilla
INSERTION
 Into the nasal septum and back
part of the alar part of nasalis
muscle.
DEPRESSOR SEPTI
115

116. BLOOD SUPPLY
 The depressor septi nasi is
supplied by the superior
labial branch of the facial
artery.
DEPRESSOR SEPTI
116

117. NERVE SUPPLY
 The depressor septi nasi
receives nerve supply from the
buccal branch of the facial
nerve (CN VII).
DEPRESSOR SEPTI
117

118. ACTIONS
 The depressor septi is a direct antagonist of the other muscles of
the nose, drawing the ala of the nose downward, and thereby
constricting the aperture of the nares.
DEPRESSOR SEPTI
118

119. ORBICULARIS ORIS
 The orbicularis oris muscle is a complex of muscles in the lips that
encircles the mouth.
 The muscle was considered as a sphincter or circular until recently.
 But it is actually composed of four independent quadrants that
interlace and give only an appearance of circularity.
119
MUSCLES AROUND THE MOUTH

120. ORIGIN
Near midline on anterior surface of
maxilla and mandible and modiolus
at angle of mouth.
INSERTION
Mucous membrane of lips.
120
ORBICULARIS ORIS

121. BLOOD SUPPLY
 Superior and inferior labial
branches of facial artery
 Mental and infraorbital
branches of maxillary artery
 Transverse facial branch of
superficial temporal
artery 121
ORBICULARIS ORIS

122. NERVE SUPPLY
 Zygomatic branches of the facial
nerve in the area of the upper lip.
 Buccal branches of the facial nerve
in the area of the labial angle.
 Marginal mandibular branch of the
facial nerve in the area of the
lower lip
122
ORBICULARIS ORIS

123. ACTIONS
 Compresses and protrudes the lips.
 Restricts distension while blowing.
123
ORBICULARIS ORIS

124. ORIGIN
 Muscle originates from the frontal
process of the maxilla.
INSERTION
 Muscle inserts into the skin of the
lateral part of the nostril and skin of
the upper lip.
124
LEVATOR LABI SUPERIORIS ALAEQUE NASI

125. NERVE SUPPLY
 The muscle is innervated by the
zygomatic branches of the facial
nerve (CN VII).
BLOOD SUPPLY
 Arterial blood is supplied via the
facial artery and the infraorbital
branch of the maxillary artery.
125
LEVATOR LABI SUPERIORIS ALAEQUE NASI

126. ACTIONS
 Contractions of the muscle,
Dilates the nostril.
Elevates the wing of the nose and the upper lip.
126
LEVATOR LABI SUPERIORIS ALAEQUE NASI

127.  The zygomaticus major muscle) is a
paired facial muscle that extends
between the zygomatic bone and the
corner of the mouth.
 The zygomaticus major may be
involved in the formation of cheek
dimples in some individuals.
127
ZYGOMATICUS MAJOR

128. ORIGIN
 Temporal process of zygomatic bone.
INSERTION
 It inserts into the skin of the angle of the
mouth, blending with fibers of levator anguli
oris,orbicularis oris.
ACTION
 Lift the angle of the mouth upwards and
laterally.
128
ZYGOMATICUS MAJOR

129. BLOOD SUPPLY
 Superior labial branch
of facial artery.
NERVE SUPPLY
 Zygomatic and buccal
branch of facial nerve
129
ZYGOMATICUS MAJOR

130. ORIGIN
 Originates from the lateral surface of the
zygomatic bone.
INSERTION
 Inserts into the skin of the lateral part of
the upper lip and extends to the nasolabial
sulcus.
ACTIONS
 pulls the upper lip backward, upward and
outward. 130
ZYGOMATICUS MINOR

131. BLOOD SUPPLY
 Superior labial branch
of facial artery.
NERVE SUPPLY
 Buccal branch of facial
nerve
131
ZYGOMATICUS MINOR

132. ORIGIN
 It originates from the infra-orbital
margin of the maxilla.
INSERTION
 Muscle inserts into the skin of the
upper lip
ACTION
 Lifts the upper lip.
132
LEVATOR LABII SUPERIORIS

133. BLOOD SUPPLY
 Facial artery
 Infraorbital branch of the
maxillary artery.
NERVE SUPPLY
 Buccal branch of the facial nerve
(CN VII).
133
LEVATOR LABII SUPERIORIS

134. ORIGIN
 It rises from the canine fossa on the
anterior surface of the maxilla right
below the infraorbital foramen.
INSERTION
 Inserts into the skin of the angle of
the mouth.
ACTION
 Lifts the angle of the mouth
134
LEVATOR ANGULI ORIS

135. BLOOD SUPPLY
 Superior labial branch
of facial artery.
NERVE SUPPLY
 Buccal branch of facial
nerve
135
LEVATOR ANGULI ORIS

136. BLOOD SUPPLY
 Superior labial branch
of facial artery.
NERVE SUPPLY
 Buccal branch of facial
nerve
136
LEVATOR ANGULI ORIS

137. ORIGIN
 Originates from the oblique line of
mandible
INSERTION
 Inserts into the angle of mouth
ACTIONS
 Pulls the angle of mouth upwards.
137
DEPRESSOR ANGULI ORIS

138. BLOOD SUPPLY
 Inferior labial branch of
facial artery.
NERVE SUPPLY
 Marginal mandibular
branch of facial nerve
138
DEPRESSOR ANGULI ORIS

139. ORIGIN
 Originates from the oblique line of
mandible
INSERTION
 Into skin of lower lip
ACTIONS
 pulls the lower lip downward and
forward.
139
DEPRESSOR LABII INFERIORIS

140. BLOOD SUPPLY
 Inferior labial branch of
facial artery.
NERVE SUPPLY
 Marginal mandibular
branch of facial nerve
140
DEPRESSOR LABII INFERIORIS

141.  The mentalis is a paired central muscle of
the lower lip, situated at the tip of the
chin.
ORIGIN
 Originates from the incisive fossa on the
alveolar process of the mandible.
INSERTION
 The fibers of the mentalis radiate and
insert into the skin of the chin.
141
MENTALIS

142. ACTIONS
 Contraction of the muscle causes upward – inward movement of
the soft tissue complex of the chin, which raises the central
portion of the lips in turn .
APPLIED ANATOMY
 Geniospasm is a genetic movement disorder of the mentalis
muscle.
 In cases of lip incompetence,the muscle contraction can bring
about strained and temporary oral competence.
142
MENTALIS

143. BLOOD SUPPLY
 Inferior labial branch of facial
artery.
 Mental branch of maxillary
artery
NERVE SUPPLY
 Buccal branch of the facial
nerve
143
MENTALIS

144. ORIGIN
 It originates from the masseteric fascia.
INSERTION
 It inserts into the skin of the angle of the
mouth.
ACTIONS
 pulls the angle of the mouth laterally.
144
RISORIOUS

145. BLOOD SUPPLY
 Superior labial branch
of facial artery.
NERVE SUPPLY
 Buccal branch of facial
nerve
145
RISORIOUS

146.  The buccinator is a facial muscle that participates in forming
the anterior part of the cheek and the lateral wall of the oral
vestibule.
 It is a thin and quadrilateral muscle .
 It occupies the interval between the maxilla and mandible.
 It is covered by the buccopharyngeal fascia.
146
BUCCINATOR

147. ORIGIN
 It originates from the alveolar processes of
maxilla and mandible and the
pterygomandibular raphae
INSERTION
 It inserts in to the angle of the mouth
ACTIONS
 Upon contraction the buccinator pulls the
angle of the mouth laterally, presses the
cheeks to the teeth, thus decreasing the
oral vestibule. 147
BUCCINATOR

148. BLOOD SUPPLY
 Buccal branch of maxillary
artery
 Facial artery
NERVE SUPPLY
 Buccal branch of facial nerve
148
BUCCINATOR

149. The auricular muscles (or extrinsic muscles) are the three muscles
surrounding the auricula or outer ear:
1. Auricularis anterior – Protractor of outer ear
2. Auricularis superior – Elevator of outer ear
3. Auricularis posterior – Retractor of outer ear
In humans these posesses very little function.
149
MUSCLES OF AURICLE

150. 150
AURICULARIS
ANTERIOR
AURICULARIS
SUPERIOR
AURICULARIS
POSTERIOR

151. MUSCLE ORIGIN INSERTION ACTION
Auricularis
superior
Above the ear in a
broad line from
aponeurotic tendon of
scalp
Medial Surface of
articular cartilage
Elevates the
outer ear
Auricular
anterior
Aponeurotic
tendon of the scalp
in the temporal
region
Cartilage of outer
ear at its anterior
border & medial
surface above
auditory passage
Protracts the
outer ear
Auricular
posterior
Medial surface of
cartilaginous outer
ear
Medial surface of
cartilaginous
outer ear
Retracts the
outer ear
151

152. 152
FACIAL EXPRESSIONS AND MUSCLES
PRODUCING THEM
EXPRESSIONS MUSCLES
SMILING,LAUGHING ZYGOMATICUS MAJOR
SADNESS LEVATOR LABII
SUPERIORIS,LEVATOR
ANGULI ORIS
GRIEF DEPRESSOR ANGULI ORIS
ANGER DILATOR
NARIS,DEPRESSOR NARIS
FROWNING CORRUGATOR SUPERCILI
,PROCERUS

153. 153
EXPRESSIONS MUSCLES
HORROR,TEROR,FRIGHT PLATYSMA
SURPRISE FRONTALIS
DOUBT MENTALIS
GRINNING RISORIUS
CONTEMPT ZYGOMATICUS MINOR
CLOSING THE MOUTH ORBICULARIS ORIS
WHISTLING BUCCINATOR,ORBICU;ARIS
ORIS

154. APPLIED ASPECTS
154

155.  The relation of apices to the origins of
buccinators muscle determines whether the
infection exists intra orally in the buccal
vestibule or expands deeply into buccal
space.
 Molar infections exiting superiorly to the
maxillary origin of the muscle or inferiorly
to the mandibular origin enter the buccal
space 155
SIGNIFICANCE IN INFECTION

156.  Myositis occurs from extracting infected tooth usually
the 3rd molars
 Infection from the periapical area or from pericoronal
area passes to the deeper structures and into the muscles
causing myositis.
156
SIGNIFICANCE IN INFECTION

157.  Charles Bell in 1821 first described
Bell’s Palsy.
 It is an acute, benign neurological
disorder, characterized by sudden,
isolated peripheral facial nerve paralysis
 It is a Lower Motor Neuron Disorder.
 It has a female prediliction.
157
BELLS PALSY

158. ETIOLOGY
 The exact cause of bell’s palsy is unknown.
 Risk factors include, 1) Diabetes
2) Recent upper respiratory tract infection
3) pregnancy
 viral etiology – Epstein bar virus
Varicella zoster
158
BELL’S PALSY

159.  Sudden onset, patient gives a history of occurrence on awakeningearly
in the morning.
 Unilateral involvement of entire side of face
 Inability to smile, close the eye or wink on affected side
 Whistling is impossible
 Corner of the mouth droops down with drooling Saliva
 Inability to wrinkle the forehead or elevate upper or lower lip
 BELLS sign-in attempt to close the eyelid, eyeball rolls upwards so the
pupil is covered and only the white sclera is visible.
159
CLINICAL FEATURES

160.  FRONTALIS
 ORBICULARIS ORIS
 BUCCINATOR
 ORBICULARIS OCULI
 PLATYSMA
 OCCIPITALIS
 ANTERIOR AND POSTERIOR AURICULAR MUSCLE
160
FACIAL MUSCLES INVOLVED

161.  It is an extremely rare congenital neurological
disorder which is characterized by facial paralysis
and the inability to move the eyes from side to
side.
 Most people with Möbius syndrome are born with
complete facial paralysis and cannot close their
eyes or form facial expressions.
 Limb and chest wall abnormalities sometimes
occur with the syndrome.
161
MOBIUS SYNDROME

162.  Tetanus is a clinical diagnosis characterized
by a triad of muscle rigidity,muscle spasms
and autonomic instability.
 Clostridium tetani spores enter into the
body through any abrasions on the skin.
 Release tetanospasmin (potent neurotoxin)
162
TETANUS

163.  Early symptoms of tetanus include neck stiffness, sore
throat, dysphagia and trismus.
 Spasm extending to the facial muscles causes the typical
facial expression, ‘risus sardonicus’.
 Truncal spasm causes opisthotonus.
163
TETANUS

164. TREATMENT
• Active and Passive immunization
• Antimicrobial therapy
• Surgical wound care
• Anticonvulsants if required
164
TETANUS

165.  Failure of muscle relaxation after the cessation
of voluntary contraction is called myotonia.
 Weakness of muscles including mucles of
jaw , face, neck and levators of eyelids.
 First occurs in, limbs Ptosis of eyelids,
atrophy of masseter and sternocleidomastoid,
weakness of facial muscles.
165
DYSTROPHIC MYOTONIA

166.  Defined as involuntary,unconscious an excessive grinding,tapping
or clenching of teeth.
 Can be of two types 1) Nocturnal bruxism
2)Diurnal bruxism / bruxomania
Causes
 Local causes: Mild occlusal disturbances
 Systemic causes: Gastrointestinal disturbances
 Psychological causes: Emotional tension, etc
 Occupational causes: watchmakers 166
BRUXISM

167.  Involves excessive muscle use leading to Hypertrophy of the Masseter
muscle and facial muscles
 Leads to a characteristic square jaw.
TREATMENT
 Psychotherapy
 Biofeedback using EMG
 Splints like night gaurds
167
BRUXISM

168.  The facial musculature is fairly unique. They include the only
somatic muscles in the body attached on one side to bone and the
other to skin; thus facial movements are specialized for
expression.
 The face is also one of the few places in the body where some
muscles are not attached to any bone at all.
 The facial muscles are capable of performing 7000 expressions.
according to Coleman.
168
CONCLUSION

169.  Knowing a through anatomy of the facial muscles and its relation
to the adjacent structures will help a clinician to diagnose
pathologies relating to them.
 It also help him/her practise in caution while performing dental
treatment.
169
CONCLUSION

170.  BD Chaurasia’s; Human Anatomy, 5th edition.
 Atlas of human Anatomy, 8th edition- Frank H Netter
 Illustrated anatomy of head and neck , 3rd edition
 Grays’s anatomy,38 th edition
 Grants atlas of antomy ,12th edition
 Text book of oral medicine- anil govindrai ghom, 3rd edition
170
REFERENCES

171. 171