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Sensory Innervation of the Face
& Muscles of Facial Expression
08-04-2019
Face
Boundaries
• Extends superiorly to
the hair line, inferiorly
to the chin and base of
mandible, and on each
side to auricle
• Forehead is common to
both scalp and face.
skin
• Very vascular
• Due to rich vascularity
face blush and blanch.
• Wounds of face bleed
profusely but heal rapidly.
• Facial skin is rich in
sebaceous gland and
sweat gland.
• Sebaceous gland keep the
skin oily but also cause acne
in adult.
• Laxity of skin facilitates
rapid spread of
oedema
• Renal oedema appears
first in the eye lids and
face before spreading
to other parts of the
body
• Boils in the nose and ear
acutely painful due to the
fixity of the skin to the
underlying cartilages
• Facial skin is very elastic
and thick because the
facial muscles are inserted
into it. The wounds of the
face therefore tend to
gape
Superficial fascia
• It contains
1. Facial muscles
2. Vessels and nerves
3. Fat
• Deep fascia is absent in face (except parotid
gland and buccinators muscle)
Face
• Muscle of facial
expression lie in
superficial fascia
(subcutaneous).
• Embryologically they
develop from
mesoderm of 2nd
branchial arch,
therefore supplied by
facial nerve.
• No deep fascia is
present in the face.
Bones of the Face
• The facial skeleton
consists of 14 stationary
bones and the mandible.
• These 14 bones form the
basic shape of the
face, and are responsible
for providing attachments
for muscles that make the
jaw move and control
facial expressions.
Bones of the Face
Muscles of the Face
(Muscles of Facial Expression)
• They are in the superficial fascia, with origins
from either bone or fascia, and insertions into the
skin. (subcutaneous muscles)
• these muscles control expressions of the face.
• They act as sphincters and dilators of the orifices
of the face (i.e. the orbits, nose, and mouth).
Muscles of the Face
Muscles of the Face
1. Muscle of scalp
2. Muscles of the
eyelids (Orbital
group)
3. Muscle of auricle
4. Muscles of nose
(Nasal group)
5. Muscles around
mouth (Oral group)
6. Muscles of neck
Muscles of scalp
occipitofrontalis
• Two bellies
• Occipitalis / frontalis
• Both inserted into epicranial aponeurosis
• Occipital belly arises from lateral two thirds
of superior nuchal lines
• Frontalis belly arises from skin of forehead
Action of frontalis : surprise, frightening
Orbital group
• Three muscles are
– Orbicularis oculi
– Corrugator supercili
– Levator palpebrae
superioris
Orbicularis oculi
• 3 parts-
• Orbital part(outer)
– Originate from medial part of medial palpebral ligament and
adjoining bone.
– Insertion- form concentric rings, return to point of origin
Action –closes the lids tightly, wrinkling
• Palpebral part(Inner)
– Originate from lateral part of medial palpebral ligament
– Insert into lateral palpebral raphe
Action-closes the lids gently, blinking
• Lacrimal part(Small)
– Originate from lacrimal fascia& lacrimal bone
– Insert into upper &lower eyelids
Action-dilate lacrimal sac, support lower eye lid
Orbicularis oculi
Orbicularis oculi
Palpebral part Orbital part
Orbicularis oculi
Actions : • Acts as sphincter of the eyelid
• Palpebral part closes the eyelid gently in
sleep or blinking
• Movement-reflexly oriented or voluntarily
mediated
• Contraction of entire muscle-crow feet
appearance
• Lacrimal part –transport lacrimal fluid
Corrugator supercillii
• Origin : superciliary arch
• Insertion: skin of the
eyebrow
• Action: produces vertical
wrinkles of the forehead
in frowning as an
expression of annoyance
26
levator palpabrae superioris
• Origin: lesser wing
of sphenoid bone
• Insertion : upper
eyelid
• Function : lid
elevation
Nasal group
• Three muscles are
associated with the
nasal group:
– Compressor naris
– Dilator naris
– Procerus
– Depressor septi nasi
Compressor naris
• Origin: Frontal process
of the maxilla
• Insertion: Aponeurosis
which crosses the bridge
of the nose
• Action: Compresses the
mobile nasal cartilages
Dilator naris
• Origin : Maxilla bone
• Insertion: Ala of the
nose
• Action: Widens the nasal
aperture (by pulling the
alar laterally) in deep
inspiration; is also a sign
of anger
Procerus
• Origin: nasal bone and
lateral nasal cartilage
• Insertion: skin
between the eyebrows
• Action:
– pulls down the medial
end of the eyebrow
– wrinkles the skin of the
nose transversely in
frowning
Depressor septi
• Origin : maxilla above central incisor
• Insertion : mobile part of nasal septum
• Action : depress the nasal septum,
expression of anger acts along with dilator
naris
Oral group
• The muscles in the oral group move the lips and cheek:
– Orbicularis oris
– Buccinator
– Lower group of oral muscles
• depressor anguli oris
• depressor labii inferioris
• Mentalis
– Upper group of oral muscles
• risorius
• zygomaticus major and zygomaticus minor
• levator labii superioris
• levator labii superioris alaeque nasi
• levator anguli oris
Orbicularis oris
• Origin: from maxilla
above incisor teeth
• Insertion: into skin of
lip.
• Action: closes the
mouth, whistling
Buccinator
• Upper fibers
– Origin- from maxilla opposite molar
teeth
– Insertion-upper lip
• Lower fibers
– Origin-from mandible opposite molar
teeth
– Insertion-lower lip
• Middle fibers
– Origin –from pterigomandibular raphe
– Insertion-decussate before passing to lips
• Action- it aids in mastication by prevent
accumulation of food in vestibule of mouth. It
is used every time air expanding the cheeks is
forcefully expelled
• Action : whistling along with orbicularis oris
Levator labii superioris alaque nasi
o Arises- frontal process of
maxilla near nasal
o Inserted-ala of the nose
by one slip
o To skin of upper lip by
another slip
o Action-elevates and
everts the upper lip and
dilates the nostril
Depressor anguli oris
Arises-posterior part of the
oblique line of the mandible
inserted-angle of mouth
Extends further into the skin of
upper lip upto the midline
Action-draws the angle of
mouth downward and laterally
,expression-sadness , grief
Levator labii superioris
• Arises-lower margin of orbit
Just above the infraorbital foramen
• Inserted-upper lip
• Action-elevates and everts the upper lip increase the
nasolabial furrow, sadness
Zygomaticus major
• Arises-zygomatic bone
• Inserts- angle of
mouth
• Action-draws angle of
mouth upward and
laterally as in laughing
- smiling and laughing
• Spasm- risus
sardonicus
Zygomaticus minor
• Small muscle
• Extending from zygomatic bone to the upper
lip
• Action-elevates and everts the upper lip
increase the nasolabial furrow
Depressor
labii
inferioris
• Muscle attached to lower lip
• Arises-oblique line of mandible
• Quadrilateral sheet
• Inserted into skin of lower lip
Action-it draws the lower lip
downward and laterally
Expression-irony
Levator anguli oris
• Arises-maxilla, below the infra orbital
foramen
• Inserted-angle of mouth
• Intermingle with other muscles
• Extends further into skin of lower lip up to
midline
• Action-raises the angle of mouth
• Accentuates the nasolabial furrow
• Expression of sadness
Risorius
• Arises-parotid fascia, as a continuation of
posterior fibers of platysma
• Insert-angle of mouth
• Action-retract the angle of mouth as in
grinning
Mentalis
• Muscle of chin
• Conical in shape
• Arises-incisive fossa
• Insert-skin of chin
• Action-puckers the chin
• Protrudes the lower lip in
drinking
• Expression of disdain
Muscles of auricle
• Auricularis anterior
• Auricularis posterior
• Auricularis superior
 Functionally unimportant
 Insert into epicranial aponeurosis
Muscles of neck
• They include:
– Platysma
Platysma
• Origin– upper part of
pectoral and deltoid
fascia
• Insertion– base of
mandible, skin of lower
face and lip
• Action– releases pressure
of skin on the subjacent
veins, depress
mandible, pulls angle of
mouth downwards.
Action : terror,
fright, horror
Muscles of the Face
Sensory Nerves of the Face
• The skin of the face is
supplied by the trigeminal
nerve (V), except for the
small area over the angle of
the mandible and the
parotid gland which is
supplied by the great
auricular nerve (C2 and 3).
• The trigeminal nerve (V)
divides into three major
divisions-the ophthalmic
(V1), maxillary (V2), and
mandibular (V3) nerves
Sensory Nerves of the Face
Sensory Nerves of the Face
Testing the Integrity of the Trigeminal
Nerve (temperature & pain)
Motor Nerves of the Face
• Motor supply:
– Facial nerve
• Facial nerve divides into five
terminal branches for
muscles of facial expression:
– Temporal
– Zygomatic
– Buccal
– Marginal mandibular
– Cervical
Frontalis, auricular
muscles, orbicularis
oris
Orbicularis
oculi
Muscles of cheek
and upper lip
Muscles of lower lip
platysma
Applied Anatomy
• Trigeminal neuralgia
– Maxillary and mandibular nerve are involved
– Excruciating pain in the region of distribution of these
nerve
• In infranuclear lesions of facial nerve (eg, bell’s palsy)- whole
face is paralyzed
– c/f
• Affected side is motionless
• Loss of wrinkles
• Eye cannot be closed
• In smiling the mouth is drawn to normal side
• During mastication food accumulates in vestibule of
mouth
bell’s palsy
Facial nerve lesion ( Bell’s palsy )
Arteries of face
1. Facial artery
2. Transverse facial artery
3. Arteries that accompany cutaneous nerves
Facial artery
• Enters the
face by
winding
around the
base of the
mandible
• By piercing
the deep
cervical fascia
at the
anteroinferior
angle of the
masseter
muscle
• Runs upwards and forwards to a point 1.25
cm lateral to the angle of the mouth
• Then it ascends by the side of the nose up to
the medial angle of the eye , terminates by
supplying lacrimal sac, anastomosing with
the dorsal nasal branch of the ophthalmic
artery
• It lies between superficial and deep muscles
of the face
• Branches :
1. Inferior labial
2. Superior labial
3. Lateral nasal
• Posterior muscular branches- small and
unnamed
Anterior branches
Transverse facial artery
• Branch of superficial artery
• After emerging from parotid gland, it runs forwards over th
masseter between the parotid duct and zygomatic arch
• Supplies parotid and its duct , masseter and overlying skin
an ends by anastomosing with neighbouring arteries
Veins of face
• Veins on each side
forms a W-shaped
arrangement
• Facial vein is the largest
• Begins as angular vein
at the medial angle
• Continues as facial vein
• Joins with
retromandibular vein
(ant divi) forms
common facial vein
• Facial vein communicates with cavernous sinus ;
infections from face can spread in a retrograde direction
and can cause thrombosis of the cavernous sinus .
• This is specifically likely to occur in the presence of
infection in the upper lip and in the lower part of the
nose
• This area is called the dangerous area of the face
Lymphatic drainage of face
• Pre-auricular parotid
• Submandibular: strip over the median part of
forehead, external nose, upper lip, lateral
part of lower lip, medial halves of eyelids,
medial part of cheek and greater part of
lower jaw
• Submental: central part of lower lip, chin
Glands
• Labial glands
• Buccal glands
• Molar mucous glands
Anatomy-  Muscles of Facial expression

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Anatomy- Muscles of Facial expression

  • 1. Sensory Innervation of the Face & Muscles of Facial Expression 08-04-2019
  • 2. Face Boundaries • Extends superiorly to the hair line, inferiorly to the chin and base of mandible, and on each side to auricle • Forehead is common to both scalp and face.
  • 3. skin • Very vascular • Due to rich vascularity face blush and blanch. • Wounds of face bleed profusely but heal rapidly. • Facial skin is rich in sebaceous gland and sweat gland. • Sebaceous gland keep the skin oily but also cause acne in adult.
  • 4. • Laxity of skin facilitates rapid spread of oedema • Renal oedema appears first in the eye lids and face before spreading to other parts of the body • Boils in the nose and ear acutely painful due to the fixity of the skin to the underlying cartilages • Facial skin is very elastic and thick because the facial muscles are inserted into it. The wounds of the face therefore tend to gape
  • 5. Superficial fascia • It contains 1. Facial muscles 2. Vessels and nerves 3. Fat • Deep fascia is absent in face (except parotid gland and buccinators muscle)
  • 6. Face • Muscle of facial expression lie in superficial fascia (subcutaneous). • Embryologically they develop from mesoderm of 2nd branchial arch, therefore supplied by facial nerve. • No deep fascia is present in the face.
  • 7. Bones of the Face • The facial skeleton consists of 14 stationary bones and the mandible. • These 14 bones form the basic shape of the face, and are responsible for providing attachments for muscles that make the jaw move and control facial expressions.
  • 9. Muscles of the Face (Muscles of Facial Expression) • They are in the superficial fascia, with origins from either bone or fascia, and insertions into the skin. (subcutaneous muscles) • these muscles control expressions of the face. • They act as sphincters and dilators of the orifices of the face (i.e. the orbits, nose, and mouth).
  • 10.
  • 12. Muscles of the Face 1. Muscle of scalp 2. Muscles of the eyelids (Orbital group) 3. Muscle of auricle 4. Muscles of nose (Nasal group) 5. Muscles around mouth (Oral group) 6. Muscles of neck
  • 13. Muscles of scalp occipitofrontalis • Two bellies • Occipitalis / frontalis • Both inserted into epicranial aponeurosis • Occipital belly arises from lateral two thirds of superior nuchal lines • Frontalis belly arises from skin of forehead
  • 14.
  • 15. Action of frontalis : surprise, frightening
  • 16. Orbital group • Three muscles are – Orbicularis oculi – Corrugator supercili – Levator palpebrae superioris
  • 17. Orbicularis oculi • 3 parts- • Orbital part(outer) – Originate from medial part of medial palpebral ligament and adjoining bone. – Insertion- form concentric rings, return to point of origin Action –closes the lids tightly, wrinkling • Palpebral part(Inner) – Originate from lateral part of medial palpebral ligament – Insert into lateral palpebral raphe Action-closes the lids gently, blinking • Lacrimal part(Small) – Originate from lacrimal fascia& lacrimal bone – Insert into upper &lower eyelids Action-dilate lacrimal sac, support lower eye lid
  • 19.
  • 20.
  • 23. Actions : • Acts as sphincter of the eyelid • Palpebral part closes the eyelid gently in sleep or blinking • Movement-reflexly oriented or voluntarily mediated • Contraction of entire muscle-crow feet appearance • Lacrimal part –transport lacrimal fluid
  • 24. Corrugator supercillii • Origin : superciliary arch • Insertion: skin of the eyebrow • Action: produces vertical wrinkles of the forehead in frowning as an expression of annoyance
  • 25.
  • 26. 26
  • 27. levator palpabrae superioris • Origin: lesser wing of sphenoid bone • Insertion : upper eyelid • Function : lid elevation
  • 28. Nasal group • Three muscles are associated with the nasal group: – Compressor naris – Dilator naris – Procerus – Depressor septi nasi
  • 29. Compressor naris • Origin: Frontal process of the maxilla • Insertion: Aponeurosis which crosses the bridge of the nose • Action: Compresses the mobile nasal cartilages
  • 30. Dilator naris • Origin : Maxilla bone • Insertion: Ala of the nose • Action: Widens the nasal aperture (by pulling the alar laterally) in deep inspiration; is also a sign of anger
  • 31. Procerus • Origin: nasal bone and lateral nasal cartilage • Insertion: skin between the eyebrows • Action: – pulls down the medial end of the eyebrow – wrinkles the skin of the nose transversely in frowning
  • 32.
  • 33.
  • 34.
  • 35.
  • 36. Depressor septi • Origin : maxilla above central incisor • Insertion : mobile part of nasal septum • Action : depress the nasal septum, expression of anger acts along with dilator naris
  • 37. Oral group • The muscles in the oral group move the lips and cheek: – Orbicularis oris – Buccinator – Lower group of oral muscles • depressor anguli oris • depressor labii inferioris • Mentalis – Upper group of oral muscles • risorius • zygomaticus major and zygomaticus minor • levator labii superioris • levator labii superioris alaeque nasi • levator anguli oris
  • 38. Orbicularis oris • Origin: from maxilla above incisor teeth • Insertion: into skin of lip. • Action: closes the mouth, whistling
  • 39. Buccinator • Upper fibers – Origin- from maxilla opposite molar teeth – Insertion-upper lip • Lower fibers – Origin-from mandible opposite molar teeth – Insertion-lower lip • Middle fibers – Origin –from pterigomandibular raphe – Insertion-decussate before passing to lips • Action- it aids in mastication by prevent accumulation of food in vestibule of mouth. It is used every time air expanding the cheeks is forcefully expelled • Action : whistling along with orbicularis oris
  • 40. Levator labii superioris alaque nasi o Arises- frontal process of maxilla near nasal o Inserted-ala of the nose by one slip o To skin of upper lip by another slip o Action-elevates and everts the upper lip and dilates the nostril
  • 41. Depressor anguli oris Arises-posterior part of the oblique line of the mandible inserted-angle of mouth Extends further into the skin of upper lip upto the midline Action-draws the angle of mouth downward and laterally ,expression-sadness , grief
  • 42.
  • 43.
  • 44. Levator labii superioris • Arises-lower margin of orbit Just above the infraorbital foramen • Inserted-upper lip • Action-elevates and everts the upper lip increase the nasolabial furrow, sadness
  • 45. Zygomaticus major • Arises-zygomatic bone • Inserts- angle of mouth • Action-draws angle of mouth upward and laterally as in laughing - smiling and laughing • Spasm- risus sardonicus
  • 46.
  • 47. Zygomaticus minor • Small muscle • Extending from zygomatic bone to the upper lip • Action-elevates and everts the upper lip increase the nasolabial furrow
  • 48.
  • 49. Depressor labii inferioris • Muscle attached to lower lip • Arises-oblique line of mandible • Quadrilateral sheet • Inserted into skin of lower lip Action-it draws the lower lip downward and laterally Expression-irony
  • 50. Levator anguli oris • Arises-maxilla, below the infra orbital foramen • Inserted-angle of mouth • Intermingle with other muscles • Extends further into skin of lower lip up to midline
  • 51. • Action-raises the angle of mouth • Accentuates the nasolabial furrow • Expression of sadness
  • 52. Risorius • Arises-parotid fascia, as a continuation of posterior fibers of platysma • Insert-angle of mouth • Action-retract the angle of mouth as in grinning
  • 53. Mentalis • Muscle of chin • Conical in shape • Arises-incisive fossa • Insert-skin of chin • Action-puckers the chin • Protrudes the lower lip in drinking • Expression of disdain
  • 54.
  • 55. Muscles of auricle • Auricularis anterior • Auricularis posterior • Auricularis superior  Functionally unimportant  Insert into epicranial aponeurosis
  • 56. Muscles of neck • They include: – Platysma
  • 57. Platysma • Origin– upper part of pectoral and deltoid fascia • Insertion– base of mandible, skin of lower face and lip • Action– releases pressure of skin on the subjacent veins, depress mandible, pulls angle of mouth downwards.
  • 60.
  • 61. Sensory Nerves of the Face • The skin of the face is supplied by the trigeminal nerve (V), except for the small area over the angle of the mandible and the parotid gland which is supplied by the great auricular nerve (C2 and 3). • The trigeminal nerve (V) divides into three major divisions-the ophthalmic (V1), maxillary (V2), and mandibular (V3) nerves
  • 62. Sensory Nerves of the Face
  • 63. Sensory Nerves of the Face
  • 64. Testing the Integrity of the Trigeminal Nerve (temperature & pain)
  • 65. Motor Nerves of the Face • Motor supply: – Facial nerve • Facial nerve divides into five terminal branches for muscles of facial expression: – Temporal – Zygomatic – Buccal – Marginal mandibular – Cervical
  • 66. Frontalis, auricular muscles, orbicularis oris Orbicularis oculi Muscles of cheek and upper lip Muscles of lower lip platysma
  • 67. Applied Anatomy • Trigeminal neuralgia – Maxillary and mandibular nerve are involved – Excruciating pain in the region of distribution of these nerve • In infranuclear lesions of facial nerve (eg, bell’s palsy)- whole face is paralyzed – c/f • Affected side is motionless • Loss of wrinkles • Eye cannot be closed • In smiling the mouth is drawn to normal side • During mastication food accumulates in vestibule of mouth
  • 69.
  • 70. Facial nerve lesion ( Bell’s palsy )
  • 71. Arteries of face 1. Facial artery 2. Transverse facial artery 3. Arteries that accompany cutaneous nerves
  • 72. Facial artery • Enters the face by winding around the base of the mandible • By piercing the deep cervical fascia at the anteroinferior angle of the masseter muscle
  • 73.
  • 74. • Runs upwards and forwards to a point 1.25 cm lateral to the angle of the mouth • Then it ascends by the side of the nose up to the medial angle of the eye , terminates by supplying lacrimal sac, anastomosing with the dorsal nasal branch of the ophthalmic artery
  • 75.
  • 76. • It lies between superficial and deep muscles of the face • Branches : 1. Inferior labial 2. Superior labial 3. Lateral nasal • Posterior muscular branches- small and unnamed Anterior branches
  • 77. Transverse facial artery • Branch of superficial artery • After emerging from parotid gland, it runs forwards over th masseter between the parotid duct and zygomatic arch • Supplies parotid and its duct , masseter and overlying skin an ends by anastomosing with neighbouring arteries
  • 78. Veins of face • Veins on each side forms a W-shaped arrangement • Facial vein is the largest • Begins as angular vein at the medial angle • Continues as facial vein • Joins with retromandibular vein (ant divi) forms common facial vein
  • 79. • Facial vein communicates with cavernous sinus ; infections from face can spread in a retrograde direction and can cause thrombosis of the cavernous sinus . • This is specifically likely to occur in the presence of infection in the upper lip and in the lower part of the nose • This area is called the dangerous area of the face
  • 80. Lymphatic drainage of face • Pre-auricular parotid • Submandibular: strip over the median part of forehead, external nose, upper lip, lateral part of lower lip, medial halves of eyelids, medial part of cheek and greater part of lower jaw • Submental: central part of lower lip, chin
  • 81.
  • 82. Glands • Labial glands • Buccal glands • Molar mucous glands