Facial Blood Supply and Lymphatics Quiz

Facial Blood Supply

• The face is supplied by branches of the internal and external carotid arteries.
• The internal carotid artery travels near the superior orbital fissure and supplies the medial periorbital and scalp tissues of the anterior forehead
• The external carotid artery terminates into two branches: superficial temporal artery and the internal maxillary artery
• The superficial temporal artery courses deep to facial muscles and anastomoses with the supraorbital and supratrochlear arteries
• The internal maxillary artery courses medially

Facial Lymphatics

• The lymphatic drainage of the face follows patterns critical for spread of disease.
• The forehead, lateral temporal, frontal, and periorbital regions drain into periparotid or intraparotid lymph nodes and then drain into the upper jugular chain
• The medial midface region drains into the submandibular nodes
• The lower face drains into the submental nodes
• The jugular chain serves as a secondary lymph node for both midface and lower face regions

Cutaneous Sensory Innervation of the Face

• Facial skin from the chin to the scalp vertex is innervated by three branches of the trigeminal nerve
• The ophthalmic division (V1) supplies the skin over the forehead, glabella, and upper dorsum of the nose.
• The maxillary division (V2) supplies the skin over the cheek, lower eyelid, lateral nose, and upper lip
• The mandibular division (V3) supplies the skin of the lower lip, chin, and temporal region

Muscles of Facial Expression

• Orbicularis Oculi: It's the muscle that encircles the eye. It controls eyelid closure and helps to protect the eye
• Corrugator Supercilii: Located on the forehead, it draws eyebrows medially and downward, creating vertical wrinkles above the nose
• Procerus: Located between the eyebrows, it contributes to the frown by drawing down the medial aspect of the eyebrows.
• Levator Labii Superioris Alaeque Nasi: It elevates the upper lip and nostril wing, contributing to the expression of smiling and sniffing
• Levator Labii Superioris: Elevates the upper lip, primarily involved in smiling actions
• Zygomaticus Minor: Elevates the upper lip, contributing to smiling expressions
• Zygomaticus Major: Elevates the lip corners and creates a smiling expression
• Depressor Anguli Oris: It depresses the angle of the mouth, contributing to expressions like sadness or frowning
• Orbicularis Oris: It's the muscle surrounding the mouth. It controls lip closure and plays a vital role in speech and eating
• Mentalis: It lifts the chin and protrudes the lower lip, creating a pouting expression
• Platysma: A broad, sheet-like muscle that extends from the upper chest to the lower chin margin. It contributes to various neck movements and plays a role in facial expressions by pulling the corners of the mouth downwards. It also contributes to platysmal banding with age