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Questions and Answers
What is a characteristic of facial skin?
Which cranial nerve is responsible for the sensory supply of the face?
Where is fat absent in the facial region?
What structure is formed by deep fascia over the parotid gland?
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How do facial muscles primarily function?
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Which muscle is responsible for puffing the mouth and then blowing forcibly, as in whistling?
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What structure extends from the superciliary arches anteriorly to the external occipital protuberance posteriorly?
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Which layer of the scalp is firmly attached to the epicranial aponeurosis through dense fascia?
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What characteristic of the connective tissue layer of the scalp contributes to profuse bleeding during wounds?
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Which of the following lymph glands is NOT associated with the mandible area?
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Which sensory area is NOT supplied by the maxillary division of the trigeminal nerve?
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What symptom is primarily associated with trigeminal neuralgia?
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Which of the following is a motor nerve supply provided by the zygomatic branch?
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Which clinical feature indicates an infranuclear lesion of the facial nerve?
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What is the consequence of a supranuclear lesion of the facial nerve?
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Which part of the face is primarily affected by trigeminal neuralgia?
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Which of the following conditions can lead to headaches as related to the trigeminal nerve?
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Which division of the trigeminal nerve supplies the floor of the oral cavity?
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Which muscle is primarily responsible for closing the eyelids?
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What action is primarily facilitated by the Nasalis muscle?
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Which muscle is commonly referred to as the 'happy muscle' due to its role in smiling?
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Which part of the Occipitofrontalis muscle is responsible for lifting the eyebrow and producing horizontal wrinkles?
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What is the main function of the Buccinator muscle?
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The Orbicularis oris muscle primarily functions to:
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Which muscle pulls the skin of the eyebrow downward and medially?
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What is the primary function of the Risorius muscle?
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What causes subcutaneous hemorrhages to be relatively limited in extent?
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Which layer of the scalp is considered dangerous due to the presence of emissary veins?
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What supplies the scalp anteriorly from the external carotid artery?
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What results from a collection of blood in the loose connective tissue of the scalp?
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Which muscle's action is associated with the frontal belly of the occipitofrontalis?
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What anatomical feature causes the black eye effect due to bleeding?
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Where do lymph vessels in the anterior part of the scalp drain?
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What happens if the aponeurosis of the scalp is cut transversely?
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Study Notes
Boundaries of the Face
- Extends superiorly from the adolescent position of the hairline
- Inferiorly to the chin and the base of the mandible
- On each side to the auricle.
Facial Skin
- Highly vascular
- Rich in sebaceous glands
- Rich in sweat glands
- Laxity of skin facilitates rapid spread of edema
- Boils in the nose and ear are 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.
Superficial Fascia
- Contains facial muscles
- Contains vessels and nerves to muscles and skin
- Variable amount of fat: absent from the eyelids but well-developed in the cheeks
Deep Fascia
- Absent from the face, except over the parotid gland where it forms the parotid fascia, and over the buccinator where it forms the buccopharyngeal fascia.
Facial Muscles
- Subcutaneous muscles
- Inserted into skin, and bring out various facial expressions
- Have small motor units
- Embryologically, they develop from the mesoderm of the second branchial arch, and are, therefore, supplied by the facial nerve.
Functional Groups of Facial Muscles
- Regulators of 3 openings situated on the face
- Palpebral fissures
- Nostrils
- Oral fissure.
Sensory Supply of Face
- Trigeminal 5th cranial nerve
Motor Supply to Muscles of Facial Expression
- Facial nerve 7th cranial
Ophthalmic Nerve (V1)
- Sensory supply: Forehead & scalp, frontal & ethmoidal sinus, upper eyelid & its conjunctiva, cornea & dorsum of nose
Maxillary Nerve (V2)
- Sensory supply: skin and mucous membrane of lower eyelid & its conjunctiva, cheeks & maxillary sinus, nasal cavity & lateral nose, upper lip, upper molar, incisor & canine teeth & associated gingiva & superior palate.
Mandibular Nerve (V3)
- Sensory Supply: floor of oral cavity, external ear, lower lip, chin, anterior 2/3 of the tongue & lower molar, incisor & canine teeth & the associated gingiva
Clinical Anatomy Sensory Innervation of Face
- Sensory distribution of 5th cranial nerve is cause of headache in conditions involving:
- Nose (common cold, boils)
- Paranasal air sinuses (sinusitis)
- Infections and inflammations of teeth and gums
- Refractive errors of the eyes
Trigeminal Neuralgia
- Sudden, severe facial pain.
- Sharp shooting pain or like having an electric shock in the jaw, teeth, or gums.
- Maxillary and mandibular division of the trigeminal nerve are involved
- In most cases, affects just one side of the face, with the pain usually felt in the lower part of the face.
Motor Nerve Supply to Facial Muscles
- Temporal branch of the facial nerve: frontalis, auricular muscles, orbicularis oculi
- Zygomatic branch of the facial nerve: orbicularis oculi (lower eyelid part)
- Buccal branch of the facial nerve: muscles of the cheek and upper lip.
- Mandibular branch of the facial nerve: muscles of the lower lip.
- Cervical branch of the facial nerve: platysma.
Infranuclear Lesion of Facial Nerve
- Occurs at stylomastoid foramen
- Paralysis of upper and lower quarters of face on the same side
- Face is asymmetrical and drawn up to the normal side.
- No motion on affected side
- Wrinkles disappear from the forehead
- Eye cannot be closed leading to keratitis
- When smiling, the mouth draws to the normal side.
- During mastication, food accumulates between the teeth and the cheek.
- Drooling of saliva
Supranuclear Lesion of Facial Nerve
- Only the lower quarter of the opposite side of the face is paralyzed.
Muscles of Facial Expression
- Muscles of the Eyelids/Orbital Openings
- Orbicularis oculi
- Corrugator supercilii
- Levator palpebrae superioris
- Muscles of the Nose
- Procerus
- Compressor naris
- Dilator naris
- Depressor septi
Muscles around the Mouth
- Orbicularis oris
- Buccinator
- Levator labii superioris alaeque nasi
- Zygomaticus major & minor
- Levator labii superioris
- Levator anguli oris
- Depressor anguli oris
- Depressor labii inferioris
- Mentalis
- Risorius
Functions of Facial Muscles
- Dilators of mouth: Showing teeth
- Orbicularis oculi: Tight closure of the eyes
- Buccinator: Puffing the mouth and then blowing forcibly as in whistling
Occipitofrontalis
- One of the muscles of the scalp
- Arises from two distinct parts:
- Occipital part (belly)
- Frontal part (belly)
- The frontal part lifts the eyebrow and the upper eyelid producing horizontal wrinkles on the forehead.
The Orbicularis Oculi
- Constructed of three parts, the palpebral, orbital and lacrimal.
- The palpebral area lies at the centre of this sphincter muscle and forms the eyelids
- Allows us to open and close the eyelids
- Closes eye in blinking and sleep
- Dilates lacrimal sac for the sucking of lacrimal fluid into the lacrimal sac
Corrugator Supercilii
- Small, narrow, pyramidal muscle
- Located at the medial end of the eyebrow, beneath frontalis and just above orbicularis oculi muscle.
- When contracted it pulls the skin of the eyebrow downward and medially.
- Produces vertical wrinkles of the forehead.
Nasalis
- Sphincter-like muscle of the nose
- Function: Compresses the nasal cartilages
- Responsible for "flaring" of the nostrils.
Levator Labii Superioris
- Raises the upper lip
- Involved in movements such as facial expressions, actions of disgust, expressions of sadness, nasal flaring, retching (vomiting) and to show oral content.
- Origin is on the lateral aspect of the nose and extends to the zygomatic bone.
Levator Anguli Oris
- The happy muscle, making the corners of our mouth turn upwards into a smile.
Zygomaticus Major & Minor
- Both muscles are involved in elevating the upper lip to generate a smile.
Risorius
- A very thin and delicate muscle that pulls the lips horizontally creating a large, but insincere smile.
Orbicularis Oris
- The circular muscle around our mouth
- Brings our lips together.
Boundaries of Scalp
- Extends from the superciliary arches anteriorly to the external occipital protuberance and superior nuchal lines posteriorly
- Down to the ears and zygomatic arches laterally
Scalp Layers
- Skin
- Connective tissue
- Aponeurosis
- Loose areolar tissue
- Pericranium
- The first three layers are intimately bound together and move as a unit.
Scalp Skin ('S')
- Thick and hairy
- Firmly attached to the epicranial aponeurosis through dense fascia
- Abundant sebaceous glands
- Sebaceous cysts are common
Scalp Connective Tissue ('C')
- Fibrous and dense, containing blood vessels and nerves
- Binds skin to subjacent aponeurosis
- Wounds bleed profusely as blood vessels are prevented from retraction by fibrous tissue.
- Bleeding is stopped by applying pressure against the bone
- Subcutaneous hemorrhages are not extensive due to dense fascia
- Inflammation causes little swelling but more pain
Scalp Aponeurosis ('A')
- Anteriorly frontal belly and posteriorly occipital belly of occipitofrontalis muscle
- Frontal belly originates from skin of forehead and mingled with orbicularis oculi muscle
- Occipital belly originates from lateral 2/3 of superior nuchal line
- It gaps if cut transversely and should be stitched
Scalp Loose Areolar Tissue ('L')
- Extends anteriorly into the eyelids as frontalis has no bony attachment
- Posteriorly to superior nuchal line
- On each side to superior temporal line
- Bleeding causes generalized swelling of the scalp
- Dangerous layer of the scalp as emissary veins open here and carry any infections inside the brain (venous sinus)
- Bleeding leads to black eye
- Caput succedaneum in newborn
Arterial Supply of Scalp
- In front of the auricle, the scalp is supplied from before backwards by the:
- Supratrochlear: Branches of ophthalmic artery
- Supraorbital: branch of internal carotid artery
- Superficial temporal arteries: branch of the external carotid artery.
- Behind the auricle, the scalp is supplied from before backwards by the:
- Posterior auricular
- Occipital (tortuous) arteries, both of which are branches of the external carotid artery.
Lymphatic Drainage of Scalp
- Lymph vessels in the anterior part of the scalp and forehead drain into the submandibular lymph nodes.
- Drainage from the lateral part of the scalp above the ear is into the superficial parotid (preauricular) nodes.
- Lymph vessels in the part of the scalp above and behind the ear drain into the mastoid nodes.
- Vessels in the back of the scalp drain into the occipital nodes.
Black Eye
- Collection of blood in the layer of loose connective tissue causes generalized swelling of the scalp.
- The blood may extend anteriorly into the root of the nose and into the eyelids (as frontalis muscle has no bony origin) resulting in a black eye.
Lymph Glands
- Submental
- Submandibular
- Buccal and mandibular
- Preauricural
- Occipital
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Description
Explore the intricate structures of the face, including boundaries, skin characteristics, superficial and deep fascia, and facial muscles. This quiz provides an overview of the vital elements that contribute to facial anatomy and its functions in expression and sensation.
