Face mfe

THE FACE AND THE SCALP

The Face

The face is that part of the head visible in a frontal view, that is, anterior to the external ears.

Boundaries:1. Superior - Hairline2. Inferior - Lower border of the mandible

Regions of the Face

1. Forehead2. Temporal3. Orbital4. External nose

5. Zygomatic6. Oral 7. Cheeks8. Mental9. External ear

FEATURES OF THE FACE

Lips

- Surround the mouth, or entrance to the oral cavity.

- Separated from the cheek by nasolabial groove.

- Philtrum extends superiorly from at the columnella, the fleshy partition between the nostrils to the vermillion border inferiorly

- Lower lip is separated from the chin by the labiomental groove.

- Upper and lower lip meets at the angle of the mouth.

Layers of the Lips:

1. Skin - thin and hairless, allowing the redness of the underlying capillary bed to show through.

2. Superficial Fascia - loosely arranged and contains some fats.

3. Muscle - orbicularis oris

3. Submucous Tissue - contains blood vessels and labial mucous glands which opens to the vestibule of the mouth.

4. Mucous membrane - coats the intraoral vestibule of the lips and then reflects from the upper and lower lips to the attached gingiva. This is called the vestibular or mucolabial fold.

External Ear- Contains a single elastic

cartilage which provides support to the external ear.

- Skin is tightly bound to the cartilage with no intervening subcutaneous layer.

- Skin and cartilage is thrown into several folds.

Cheeks (Buccae):

- Form the lateral movable walls of the oral cavity.- Mucosa of the cheeks ends in the mucobuccal fold

superiorly and inferiorly.- Buccal fat pad is lies superficial to the buccinator

muscle.- Parotid duct opens intraorally thru the mucosa of

the cheeks at the occlusal level of the second maxillary molar.

Layers of the Cheeks:

1. Skin,2. Superficial fascia containing the

fat of Bichot, zygomatic major, risorius, platysma, the parotid duct, and the branches of the facial and trigeminal nerves.

3. Muscular layer – Buccinator muscle

4. Submucous layer containing mucous buccal glands,

5. Mucous membrane

External Nose- The framework is

composed of the nasal bones, septal cartilage, lateral cartilages, and alar cartilages.

- Skin of the nose is continues beyond the external nares into the vestibule of the nose, with nasal hairs to filter larger particles of dusts in the air.

Eyelids (Palpebrae)Form a curtain for the ocular globe or the eyeball.

External features:1. Palpebral fissure - transverse

eliptical opening between the upper and lower eyelid.

2. Palpebral commissure - the lateral and medial junctions of the upper and lower eyelids.

3. Superior palpebral margins - covers the superior 1/5s of the iris when the lids are open.

4. Inferior palpebral margins - cuts across the lower border of the iris when the lids are open.

5. Cilia or eyelashes - project from the palpebral margins intwo or three irregular rows.

6. Plica semilunaris - a cresent fold at the medial angle of the eye that separates the white of the eye from the medial, reddish-colored lacrimal lake.

External features:7. Lacrimal lake - small, raised,

triangular are bordered by the plica semilunaris; a raised, reddish area within the lake is the caruncle.

8. Superior and inferior papillae - are small, raised bumps at the junction of the ciliated hairless margins of the lids; at the apex of which is the lacrimal punctum.

9. Conjuctivum - mucous membrane inner lining of the lid.

The Scalp

The Scalp

The scalp extends from the supraorbital margins back to the superior nuchal line posteriorly. Laterally, the scalp extends up to the temporal fossae.

The Five Layers of the Scalp

The Five Layers of the Scalp

Skin a layer of thin skin containing numerous hair follicles, sweat glands, and sebaceous glands

Connective tissueA thick, dense, subcutaneous connective tissue

is anchored firmly to the skin above and the membranous layer below.

AponeurosisIs formed by the galea aponeurotica.

Loose Connective TissueAllows freedom of movement of the superficial three

layers over the top of the skull

PeriosteumFirmly anchored to the underlying bone.

The Musculature of the Head

THE TWO GROUPS OF THE MUSCLES OF THE HEAD

1. Craniofacial muscles

- related mainly to the orbital margins and eyelids, the external nose and nostrils, the lips, the cheeks and mouth, the pinna, scalp, and cervical skin. These are collectively referred to as the muscles of facial expression.

Common Characteristics of the Muscles of Facial Expression

• All are inserted into the skin of the face;

• All are supplied by the muscular branches of the facial nerve

2. Masticatory muscles-- concerned primarily with the

movements of the temporomandibular joint.

The Craniofacial Muscles

• They are grouped as:1. epicranial2. circumorbital and palpebral3. nasal4. buccolabial

1. The Epicranial Muscles

The epicranius is made up of two main parts:

1. Occipitofrontalis2. Temporo-parietalis

The Muscles of the Scalp

Muscle Origin Insertion

Action Cranial Nerve

Frontalis Aponuerosis of the scalp

Skin of the forehead

Pulls the scalp up and back

VII – temporal branches

Occipitalis Lateral 2/3s of the superior nuchal line, mastoid process

Skin of the occipital area

Pulls the scalp backward and forward

VII – posterior auricular branches

2. Circumorbital and Palpebral Muscles

This group of muscle if composed of the

following:1. orbicularis oculi,

2. corrugator supercilii, 3. and levator palpebrae superioris.



Orbital part Bone of the upper medial orbital margin

Medial palpebral ligament

Closes eyes forcefully

VII – temporal and zyomatic branches

Palpebral part

Medial palpebral ligament

Fibers arch laterally thru lids and interdigitate laterally in a raphe

Closes the eye gently


Lacrimal part

Lacrimal bone behind the lacrimal sac

Medial aspects of the lid

Squeezes lubricating tears against the eyeball




Corrugator supercilii

Medial aspect of the supraorbital margin

Skin underlying the eyebrow

Vertical wrinkling of the bridge of the nose as in frowning

VII - temporal branches

3. Nasal Muscles

The nasal muscle group is composed of the following muscles:

1. Procerus2. Nasalis - compressor

nares- dilator nares

3. Depressor septi

Muscle Origin Insertion Action Cranial Nerve

Depressor septi

Medial fibers of dilator naris muscle

Mobile part of the nasal septum

Draw the septum downwards to narrow the nostrils

VII – Superior buccal branches



Procerus Nasal bone and lateral nasal cartilages

Skin of glabella

Transverse wrinkling of the bridge of the nose

VII –Temporal and zygomatic branches

Nasalis Compressor Nares

Canine eminence of the maxilla

Midline aponeurosis overlying nasal cartilages

Compresses the nostrils

VII – Zygomatic and buccal branches

Dilator Nares

Nasal notch of the maxilla

Skin of margin of nostril

Dilates or flares the nostrils

VII – Zygomatic and buccal branches

4. Buccolabial Muscles

I. Elevators, retractors, and evertors of the upper lip

II. Depressors, retractors, and evertors of the lower lip

III. A compound sphincter

I. elevators, retractors, and evertors of the upper lip :

levator labii superioris alaque nasi,

levator labii superioris,

zygomaticus major and minor,

levator anguli oris,

and risorius

II. Depressors, retractors, and evertors of the lower lip

depressor labii inferioris,

depressor anguli oris, and

mentalis

III. A compound sphincter

orbicularis oris,

accessory muscles to the orbicularis oris

incisivus superior, and

incisivus inferior


Levator labii superioris alaque nasi

Frontal process of the maxilla

One slip goes to the ala of the nose the other to the orbicularis oris

Elevate the ala of the nose and the upper lip

VII – zygomatic and buccal branches

Zygomaticus major

Zygomatic bone

Angle of the mouth

Draws the angle of the mouth up and back as in smiling or laughing


Zygomaticus minor

Zygomatic bone medial to the zygomaticus major muscle

Skin on the nasolabial groove

Deepen the nasolbial groove as in sorrow



Levator labii superioris

3 heads:Angular head: frontal process of the maxillaInfraorbital head: inferior margin of the orbitZygomatic head: zygomatic bone

Alar cartilacge and skin of the nose

Upper lip

Nasolabial groove and upper lip

Elevates the upper lip and flares the nostrils

Gives the expression of sadness

Contraction of the whole muscle gives the expression of disdain or doubt

VII - zygomatic and buccal branches


Levator anguli oris or caninus

Canine fossa of the maxilla below the infraorbital foramen

Angle of the mouth

Elevates the angle of the mouth (muscle of happiness)


Mentalis Incissive fossa of the mandible

Skin of the chin

Elevate the chin. It also causes trembling of the chin. It wrinkles the skin of the chin as in disdain or doubt.

VII – mandibular branches


Risorius Superficial fascia over the parotid fascia

Skin and mucosa of the angle of the mouth

Draw the anglef the mouth laterally, giving an expression of strain or tenseness


Depressor labii inferioris

Oblique line of the mandible

Lower lip Depresses the lower lip as in “irony”

VII – mandibular branches

Depressor anguli oris or Triangularis

Oblique line of the mandible

Angle of the mouth

Depresses the angle of the mouth

VII – buccal and mandibular branches


BuccinatorOr Bugler’s or Trumpeter’s muscle

Pterygmandibular raphe, buccal alveolar processes of maxilla and mandible

The fibers are directed towards the angle of the mouth blending with he upper or lower portions of the orbicularis oris muscle

Draw the angle of the mouth laterally and to press the cheeks against the teeth while chewing. Useful in mastication, swallowing, whistling, sucking, and blowing

VII - buccal branches


Orbicularis oris

Extrinsic fibers: From insertions of circumoral muscles

Intrinsic fibers:From the incisive fossae of the mandible and maxilla

Pass around the mouth within the lips as a sphincter

Pass obliquely forward and insert into the skin of the lip

Compresses the lips against the anterior teeth, closes the mouth, and protrudes the lips

VII - zygomatic, buccal and mandibular branches


Platysma-thin, sub-cutaneous quadrilateral muscular sheet covering the upper part of the chest, side of the neck and lower part of the face

Skin and superficial fascia of the pectoral and deltoid regions

The fibers are directed upward and forward to be inserted into the lower border of the mandible

Retract and depress the angle of the mouth

VII - cervical branch

Muscles of the External EarMuscle Origin Insertion Action Cranial

Nerve

Anterior auricular

Aponeurosis of the scalp, temporal fascia

Anterior medial aspect of the helix of the auricle

Pulls the ear forward


Posterior auricular

Superior lateral aspect of mastoid process

Inferior medial aspect of auricle

Pulls the ear backward

VII - Posterior auricular branches

Superior auricular

Aponeurosis of the scalp, temporal fascia

Superior medial aspect of auricle

Pulls ear superiorly


The Facial Nerve

The facial nerve arises as two distinct trunks from the lower border of the pons:

1. the smaller of the two trunks is the nervus intermedius ( a sensory and parasympathetic root)

2. the larger root is the motor root

The Course of the

Facial Nerve

From the lower border of the pons varolli, the two roots of the facial nerve approach and enter the internal acoustic meatus. The meatus leads to the petrous temporal bone and joins the facial canal. The facial nerve runs laterally within the facial canal, turns sharply at the genu (knee) to run posteriorly, and then drops inferiorly to exit thru the stylomastoid foramen at the base of the skull. The nerve enters the substance of the parotid gland and then breaks up into 5 sets of muscular branches. The genu of the nerve contains the sensory geniculate ganglion.

Schematic Diagram

Pons varolii internal auditory meatus

petrous temporal facial canal

genu to run posteriorly stylomastoid foramen

parotid gland five muscular branches.

Branches of the Facial Nerve

1. The greater petrosal nerve

2. The nerve to the stapedius muscle

3. The chorda tympani nerve

4. The posterior auricular nerve

5. The facial branches (motor)

Branches of the Facial Nerve1. The greater petrosal nerve- arises from the genu of the facial nerve within the facial

canal. - contains mainly taste fibers to the palatal mucosa and- parasympathetic fibers to the lacrimal gland, the mucosa of

the palate, nasopharynx and the nasal cavity.


2. The nerve to the stapedius muscle

- arises within the facial canal and is motor to the stapedius muscle of the middle ear.

Branches of the Facial Nerve3. The chorda

tympani nerve - arises from the descending portion of the facial nerve within the facial canal. - leaves the skull thru the petrotympanic fissure - Taste fibers are distributed to the anterior two thirds of the tongue via the lingual nerve.

The Chorda Tympani


4. The posterior auricular nerve arises from the stylomastoid foramen and communicates with the great auricular and lesser occipital nerves. It has 2 branches:

1. auricular branch which supplies the auricularis posterior and intrinsic muscles on the cranial aspect of the auricle, and

2. occipital branch which supplies the occipital belly of the occipitofrontalis.


5. Facial branches (motor) arise within the parotid gland as five main groups. These are:

a. Temporalb. Zygomaticc. Buccald. Mandibular, ande. Cervical

These branches innervate the muscles of facial expression and platysma.

Motor Branches of the Facial Nerve

1. Temporal 2. Zygomatic3. Buccal4. Mandibular 5. Cervical


1. Temporal branches- travel superiorly and anteriorly to supply the facial muscles situated above the zygomatic arch, including the orbit and the forehead.

They innervate:1. the anterior and superior auricular

muscles, 2. the frontalis muscle, and 3. the superior portion of the orbicularis

oculis muscle.


2. Zygomatic branches- runs transversely across the face to supply the facial muscles in the zygomatic, orbital, and infraorbital areas. They supply:

1. the inferior portion of the orbicularis oculis muscle, 2. the superior portions of the zygomaticus major,

levator labii superioris, levator anguli oris, nasalis, and orbicularis oris muscles.


3. Buccal branches- supplies the muscles of the cheek and circumoral muscles. They innervate:

1. the buccinator, and 2. the inferior portions of

the zygomaticus major, levator labii superioris, levator anguli oris, nasalis, and

orbicularis oris muscles.


4. Mandibular branches- supplies the muscles of the chin and the lower lip. Specifically they pass to:

1. the depressor anguli oris, 2. depressor labii inferioris, and to 3. the mentalis muscles.


5. Cervical branches- descend to the neck to supply:

1. the platysma, 2. posterior belly of the digastric, 3. stylohyoid muscles

Cranial Nerve Test

Lesions of the facial nerve may cause:(1) paralysis of facial muscles,(2) loss of taste sensation from the

anterior two thirds of the tongue,(3) decreased salivation.

Face mfe

Health & Medicine

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