Head and Neck

Face

Dr. Mohamed El Fiky

Face

Scalp

Hair line

chin

Muscles of the Face General Characters of the Muscles of the Face

1- They are the muscles of Expression

2- They are all developed from the 2nd pharyngeal arch

3- They are all supplied by the Facial nerve

Facial Nerve

4- They act as closers and openers of facial orifices

5- They surround the facial openings

6- They originate from bone or other muscle, pass in the superficial fascia and attach to the facial skin or other facial muscle

7- They are Classified into groups

Corrugator Supercilli

Orbicularis Occuli

Levator Palpebrae Superioris

1- Muscles of the Eyelids 2- Muscles of the Nose:

1- Procerus 2- Dilator naris 3- Compressor naris 4- Depressor septi

7- They are Classified into groups 3- Muscles of the mouth:

1- Orbicularis oris 2- Levator labii superioris alaequae nasi 3- Levator labii superioris 4- Levator anguli oris 5- Zygomaticus major 6- Zygomaticus minor 7- Depressor anguli oris 8- Depressor labii inferioris 9- Mentalis 10- Resorius 11- Buccinator

1

2 2 3 3

4 4 5 6

5

6

7 7 8 8 9 9

10 10 11

11 11

7- They are Classified into groups

4- Muscles of the Ear

Auricularis Muscles

5- Muscles of the Scalp

Occipitofrontalis

5- Muscles of the Neck

Platysma

Cranial nerves

1- Olfactory

2-Optic

3- Oculomtor

4- Trochlear

5- Trigeminal

6- Abducent

7- Facial

8-Vestibulochlear

9-Gloosopgrayngeal

10- Vagus

11- Accessory

12- Hypoglossal .

Major muscles 1- Orbicularis Occuli : it is formed of three parts :

A- orbital part B palpebral part C- lacrimal part

A- Orobital part : * Origin : It arises from the nasal part of the frontal bone,

from the frontal process of the maxilla and upper border of medial palpebral lig.

* insertion : lower border of medial palpebral ligament * Action : tight closure of the eye

B- Palpebral part : * Origin : arises from the the medial palpebral ligament,

forms a series of concentric curves. * insertion : inserted into the lateral palpebral raphe at the outer

canthus (corner) of eye. * Action : The palpebral portion acts involuntarily, closing the lids

gently, as in sleep or in blinking;

1- Orbicularis Occuli : (continue )

C. Lacrimal part : Origin : It arises from the posterior crest and adjacent part of the orbital surface of the

of the lacrimal bone, and passing behind the lacrimal sac . * insertion : into the superior and inferior tarsi and wall of lacrimal sac * Action : dilate lacrimal sac

Orbital part

Palpebral part

upper tarsal plate

Lower tarsal plate

Medial palpebral ligament

Lateral palpebral ligament

Lacrimal part

Facial Nerve

Temporal Branch

Zygomatic Branch

Nerve supply of Orbicularis Occuli

2- Buccinator : * Origin : - upper fibers from maxilla above three molar

- lower fibers : from the mandible below three molar - ptergomandibular raphe which separates it from the constrictor pharyngis superior .

* Insertion : - upper fibers : to the upper lip - lower fibers : lower lip - Middle fibers decussate lower ascend to upper lib & lower descend to the lower limb

* Action : Aids in holding the cheek to the teeth and prevent accumulation of food in the vestibule of the mouth during chewing

* Nerve supply : facial nerve ( upper & lower buccal branches )

bccinator

Buccinator

Pterygomandibular ligament

Superior constrictor of pharynx

Buccinator

Superior constrictor

Pterygomandibular ligament

Relations of Buccinator : 1- Deep Relations of Buccinator :

Mucous membrane and pharyngobasilar fascia

2- Superficial Relations of Buccinator 1- Buccal bad of fat

2- Parotid duct

Mucous membrane and pharyngobasilar fascia

Buccal bad of fat

Parotid duct

3- Nerves a- Buccal branch of facial nerve B- Buccal branch of mandibular nerve

Relations of Buccinator ( continue) : Upper Buccal of Facial

Lower Buccal of Facial

Buccal branch of mandibular nerve

Upper Buccal of Facial

Lower Buccal of Facial

4- Vessels a- Facial artery and vein b- Deep facial vein c- Buccal artery

Facial Artery

Anterior Facial Vein

Deep Facial Vein

Buccal Artery

Facial Lymph Nodes

5- Lymph Nodes (Facial)

Zygomaticus minor

Resorius

Zygomaticus major

Buccopharyngeal fascia

6- Muscles a- Zygomaticus major and minor b- Resorius 7- Fascia (Buccopharyngeal)

Upper Buccal of Facial

Lower Buccal of Facial

Nerve Supply of Buccinator

3- Orbicularis Oris

Orbicularis Oris

Lower Buccal of Facial

Mandibular Buccal of Facial

Nerve Supply of Orbicularis Oris

Nerve Supply of the Face 1- Sensory Nerve Supply :

Trigeminal nerve :

•  Ophthalmic

•  Maxillary

* Mandibular

1- Supraorbital nerve

2-Supratrochlear nerve

3-Lacrimal nerve

4-Infratrochlear nerve

5-External nasal nerve

a- Branches of ophthalmic division of Trigeminal Nerve

3-Infraorbital nerve

1- Zygomaticotemporal nerve

2-Zygomaticofacial nerve

Labial

Nasal Palpebral

b- Branches of maxillary division of Trigeminal Nerve

3-Mental nerve

1-Auriculotemporal nerve

2-Buccal nerve

c- Branches of mandibular division of Trigeminal Nerve

Great Auricular Nerve

d- Great auricular nerve (C2, 3) of Cervical Plexus

Motor Nerves of the Face ( facial nerve ) : Orgin : from the pons Type : mixed nerve motor , sensory and containig parasympathetic . Course in the face : after the facial nerve comes out from the stylomandibular foramen it inter the parotid gland superficial to external carotid artery and posterior facial vein and with in the parotid gland the nerve gives five terminal branches . Branches : A- befor it inter the parotid gland ( distal to the stylomastoid foramen : 1- postetrior auricular to the occiptal belly of occiptofrontalis muscle and muscles around ear 2- Branch to posterior belly of digasteric and stylohyoid muscle

Temporal Branch

Zygomatic Branch

Upper Buccal Branch

Lower Buccal Branch

Mandibular Branch

Cervical Branch

Facial Palsy :

Blood Supply of the Face A- Arteries of the Face

1- Facial Artery : Origin : branch from external carotid Course : arise from external carotid and inter the digasteric triangle in the neck and run between submandibular gland and mandible then inter the face in front of masseter muscle and terminate by giving angular artery .

Branches : A- In the neck (cervical ) : 1- Ascending paltine artery . 2- Tonsilar artery 3- Submental artery 4- Glandular branches

B- In the face (facial) : 1- inferior labial 2- superior labial 3- lateral nasal 4- Angular ( the terminal branch )

Facial Artery

Antro-inferior angle of

Masseter

Lower Border of The Mandible

Angular Artery

Supraorbital Artery

Supratrochlear Artery

Inferior Labial Branch

Superior Labial Branch

Septal Branch

Lateral Nasal Branch

1- Facial Artery

Superficial Temporal Artery

Transverse Facial Artery

Zygomatico-orbital Artery

2- Superficial Temporal Artery

3- Other Smaller Arteries that accompany the branches of Trigeminal Nerve

B- Veins of the Scalp and Face

Facial vein: biggest vein in the face Beginning: at the medial angle of the eye by the union of

supra-orbital and supratrochear veins. * Runs downwards and backwards behind the facial artery. * Leaves the face to enter the neck by piercing the deep fascia at the antero-Inferior angle of the masseter. *Ends in the neck by joining the anterior division of

retromandibular (Posterior facial) vein to form the common facial vein which ends in the Internal jugular vein.

Tributaries: corresponding to the branches of facial artery. Communications: (1) With the superior ophthalmic veins: at the medial angle of the eye. (2) With the pterygoid plexus of veins: through the deep facial vein Which passes backwards deep to the ramus of the mandible.

* The facial vein communicates through these two connections with

the cavernous sinus.

Dangerous Area of the Face

This includes the upper lip and the lower part of the nose. It is drained b y t h e f a c i a l v e i n , w h i c h communicates with the cavernous sinus. Infections of this area can therefore, spread in retrograde direction and cause thrombosis of the cavernous sinus.

Submental lymph nodes

Submandibular lymph nodes

Superficial parotid or Preauricular lymph nodes

Lymph Drainage of the Face