Podcast
Questions and Answers
Selective paralysis of the zygomatic branch of the facial nerve following a deep plane face-lift would MOST specifically impair which expressive function?
Selective paralysis of the zygomatic branch of the facial nerve following a deep plane face-lift would MOST specifically impair which expressive function?
- Elevation and protusion of the upper lip, revealing the maxillary incisors (correct)
- Lateral traction of the oral commisure, crucial for both smiling and expressions of grief
- Eversion of the lower lip and chin, which is essential for expressing doubt and disdain
- Exaggerated grin and forced smile due to unopposed platysma action
A patient presents with acute paralysis of the left orbicularis oculi muscle following a blunt trauma to the lateral aspect of the orbit. Concurrent examination reveals intact function of other facial muscles. This presentation MOST accurately indicates damage to which specific structure?
A patient presents with acute paralysis of the left orbicularis oculi muscle following a blunt trauma to the lateral aspect of the orbit. Concurrent examination reveals intact function of other facial muscles. This presentation MOST accurately indicates damage to which specific structure?
- Marginal mandibular branch of the facial nerve as it crosses the mandible
- Temporal branch of the facial nerve distal to the zygomaticofacial foramen (correct)
- Facial nerve within the parotid gland, proximal to its bifurcation
- Zygomatic branch exclusively, near its origin from the facial nerve
A surgeon performing a rhytidectomy encounters difficulty defining the plane superficial to the platysma muscle. Atypical fibrous adhesions are noted, obscuring the usually distinct separation. This MOST likely indicates aberrant development from which embryological structure?
A surgeon performing a rhytidectomy encounters difficulty defining the plane superficial to the platysma muscle. Atypical fibrous adhesions are noted, obscuring the usually distinct separation. This MOST likely indicates aberrant development from which embryological structure?
- Incomplete delamination of the panniculus carnosus from cervical fascia (correct)
- Incomplete involution of the thyroglossal duct creating fascial tethers
- Persistent hyoid arch mesenchyme disrupting normal fascial planes
- Aberrant migration of neural crest cells altering connective tissue deposition
Following a complicated Le Fort III fracture repair, a patient exhibits a complete loss of sensation in the anterior two-thirds of the hard palate and maxillary gingiva, but retains cutaneous sensation of the cheek. This MOST specifically suggests injury to which nerve?
Following a complicated Le Fort III fracture repair, a patient exhibits a complete loss of sensation in the anterior two-thirds of the hard palate and maxillary gingiva, but retains cutaneous sensation of the cheek. This MOST specifically suggests injury to which nerve?
During a deep dissection in the parotid region, a surgeon inadvertently severs a nerve resulting in the paralysis of the transverse muscles of the nose leading to alar collapse, but spares the anterior nasal dilator. Which nerve has been severed?
During a deep dissection in the parotid region, a surgeon inadvertently severs a nerve resulting in the paralysis of the transverse muscles of the nose leading to alar collapse, but spares the anterior nasal dilator. Which nerve has been severed?
A patient presents with facial asymmetry characterized by unilateral ptosis, miosis, and anhydrosis, along with ipsilateral loss of taste sensation from the anterior two-thirds of the tongue and decreased salivation. This constellation of symptoms MOST likely indicates a lesion affecting which structure?
A patient presents with facial asymmetry characterized by unilateral ptosis, miosis, and anhydrosis, along with ipsilateral loss of taste sensation from the anterior two-thirds of the tongue and decreased salivation. This constellation of symptoms MOST likely indicates a lesion affecting which structure?
A patient with Bell's palsy is noted to have decreased lacrimation in the affected eye. This deficit MOST accurately reflects dysfunction of parasympathetic fibers carried within which nerve?
A patient with Bell's palsy is noted to have decreased lacrimation in the affected eye. This deficit MOST accurately reflects dysfunction of parasympathetic fibers carried within which nerve?
A reconstructive surgeon is elevating a subperiosteal flap over the maxilla during a midface lift procedure. To minimize the risk of injury, the surgeon must be aware that the infraorbital nerve exits the infraorbital foramen and then courses between which two muscles?
A reconstructive surgeon is elevating a subperiosteal flap over the maxilla during a midface lift procedure. To minimize the risk of injury, the surgeon must be aware that the infraorbital nerve exits the infraorbital foramen and then courses between which two muscles?
A patient who underwent a rhinoplasty complains of numbness and tingling of the nasal ala. Which nerve was MOST likely injured?
A patient who underwent a rhinoplasty complains of numbness and tingling of the nasal ala. Which nerve was MOST likely injured?
A patient presents with paralysis limited to the muscles of facial expression in the lower right quadrant of their face. A lesion in which of the following structures is MOST likely responsible for the patient's symptoms?
A patient presents with paralysis limited to the muscles of facial expression in the lower right quadrant of their face. A lesion in which of the following structures is MOST likely responsible for the patient's symptoms?
A surgeon planning a face-lift must understand the layers of the face to avoid nerve damage. Through which layer does the facial nerve travel?
A surgeon planning a face-lift must understand the layers of the face to avoid nerve damage. Through which layer does the facial nerve travel?
A 60-year old patient seeking wrinkle reduction discovers during consultation that they have hollowing in the mid-cheek region. An injection into which compartment would BEST address this condition?
A 60-year old patient seeking wrinkle reduction discovers during consultation that they have hollowing in the mid-cheek region. An injection into which compartment would BEST address this condition?
A patient presents with significant facial asymmetry. Upon examination, you note that the patient is unable to wrinkle the skin of their forehead on the right side yet can fully animate the muscles of the lower face bilaterally. Where is the MOST probable location of the lesion causing this deficit?
A patient presents with significant facial asymmetry. Upon examination, you note that the patient is unable to wrinkle the skin of their forehead on the right side yet can fully animate the muscles of the lower face bilaterally. Where is the MOST probable location of the lesion causing this deficit?
A patient presents with a chief complaint of an inability to puff out their cheeks. Which muscle is MOST likely affected?
A patient presents with a chief complaint of an inability to puff out their cheeks. Which muscle is MOST likely affected?
A 35-year-old woman undergoes surgical removal of a benign mass within the parotid gland. Postoperatively, she exhibits slight drooping at the corner of her mouth and difficulty with smiling. What specific nerve branch was MOST likely affected during the procedure?
A 35-year-old woman undergoes surgical removal of a benign mass within the parotid gland. Postoperatively, she exhibits slight drooping at the corner of her mouth and difficulty with smiling. What specific nerve branch was MOST likely affected during the procedure?
A patient complains after a cosmetic procedure that they can no longer show their upper teeth when smiling and that their upper lip has descended. Which muscle was MOST likely affected during the procedure?
A patient complains after a cosmetic procedure that they can no longer show their upper teeth when smiling and that their upper lip has descended. Which muscle was MOST likely affected during the procedure?
A patient reports a loss of sensation from the anterior two-thirds of the hard palate on one side following a surgical procedure. Which nerve was MOST likely damaged?
A patient reports a loss of sensation from the anterior two-thirds of the hard palate on one side following a surgical procedure. Which nerve was MOST likely damaged?
A novice aesthetic injector attempting to treat marionette lines causes an occlusion of a facial artery. What is the MOST likely artery to cause this?
A novice aesthetic injector attempting to treat marionette lines causes an occlusion of a facial artery. What is the MOST likely artery to cause this?
A surgeon elevating a scalp during a craniofacial procedure notes profuse bleeding from several arteries despite cauterization. Which of the following is MOST likely the source of persistent bleeding?
A surgeon elevating a scalp during a craniofacial procedure notes profuse bleeding from several arteries despite cauterization. Which of the following is MOST likely the source of persistent bleeding?
In a patient undergoing a deep face lift, extreme traction on the SMAS flap could MOST directly compromise blood flow in the:
In a patient undergoing a deep face lift, extreme traction on the SMAS flap could MOST directly compromise blood flow in the:
A patient undergoing treatment with botulinum toxin to alleviate bruxism experiences an unexpected cosmetic side effect: a noticeable flattening of the lower cheek and a more hollowed appearance. Which muscle was MOST likely unintentionally affected by the injection?
A patient undergoing treatment with botulinum toxin to alleviate bruxism experiences an unexpected cosmetic side effect: a noticeable flattening of the lower cheek and a more hollowed appearance. Which muscle was MOST likely unintentionally affected by the injection?
In treating a patient with trigeminal neuralgia, a neurosurgeon elects for a microvascular decompression of the trigeminal nerve at the pons. Which artery is MOST commonly implicated in causing compression in this condition?
In treating a patient with trigeminal neuralgia, a neurosurgeon elects for a microvascular decompression of the trigeminal nerve at the pons. Which artery is MOST commonly implicated in causing compression in this condition?
During a complicated parotidectomy, the surgeon notes damage to a nerve leading to the finding of an elevated and medially rotated scapula on posto-operative physical examination. Which nerve was MOST likely affected intra-operatively, contributing to the signs of a 'winged' scapula?
During a complicated parotidectomy, the surgeon notes damage to a nerve leading to the finding of an elevated and medially rotated scapula on posto-operative physical examination. Which nerve was MOST likely affected intra-operatively, contributing to the signs of a 'winged' scapula?
Which BEST describes the trajectory of the marginal mandibular nerve?
Which BEST describes the trajectory of the marginal mandibular nerve?
What is the MOST LIKELY cause of facial nerve dysfunction in the setting of a deep laceration to the face, passing through the parotid gland?
What is the MOST LIKELY cause of facial nerve dysfunction in the setting of a deep laceration to the face, passing through the parotid gland?
A patient presents with unilateral facial paralysis but can still wrinkle their forehead. Where is the MOST likely location of the lesion?
A patient presents with unilateral facial paralysis but can still wrinkle their forehead. Where is the MOST likely location of the lesion?
After undergoing a facelift, a patient exhibits a widened lower eyelid and scleral show. Which of the following structures was MOST likely disrupted?
After undergoing a facelift, a patient exhibits a widened lower eyelid and scleral show. Which of the following structures was MOST likely disrupted?
Which of the following is responsible for movement of the platysma?
Which of the following is responsible for movement of the platysma?
A patient presents with a unilateral drooping of the mouth and mentions that food often gets trapped between their cheek and gums. Which neural structure is MOST likely to be involved?
A patient presents with a unilateral drooping of the mouth and mentions that food often gets trapped between their cheek and gums. Which neural structure is MOST likely to be involved?
A surgeon must be cautious when injecting the forehead to avoid damaging which artery?
A surgeon must be cautious when injecting the forehead to avoid damaging which artery?
During a face-lift procedure, a surgeon accidentally severs motor function to the orbicularis oculi. What deficit will the patient MOST likely complain of?
During a face-lift procedure, a surgeon accidentally severs motor function to the orbicularis oculi. What deficit will the patient MOST likely complain of?
A patient experiences forehead numbness after a surgical procedure. Which sensory division of the trigeminal nerve is likely affected?
A patient experiences forehead numbness after a surgical procedure. Which sensory division of the trigeminal nerve is likely affected?
A surgeon is concerned about compromising the nerve supply to the frontalis muscle. Which nerve should the surgeon take care to avoid damaging?
A surgeon is concerned about compromising the nerve supply to the frontalis muscle. Which nerve should the surgeon take care to avoid damaging?
Which artery courses alongside the nose, near the medial canthus of the eye, and is often a target for minimizing bleeding during rhinoplasty?
Which artery courses alongside the nose, near the medial canthus of the eye, and is often a target for minimizing bleeding during rhinoplasty?
Which muscle depresses the corner of the mouth, contributing to a frowning expression?
Which muscle depresses the corner of the mouth, contributing to a frowning expression?
During a surgical dissection, a small, easily compressible vein is identified running parallel to the facial artery. This vessel MOST likely drains into:
During a surgical dissection, a small, easily compressible vein is identified running parallel to the facial artery. This vessel MOST likely drains into:
You are explaining to a junior resident why facial lacerations bleed so profusely. What is the BEST possible mechanism to explain this phenomena?
You are explaining to a junior resident why facial lacerations bleed so profusely. What is the BEST possible mechanism to explain this phenomena?
Flashcards
Origin of facial muscles
Origin of facial muscles
Muscles of facial expression originate from the mesoderm of the 2nd branchial arch embryologically.
Panniculus carnosus
Panniculus carnosus
Facial muscles are morphologically remnants of the panniculus carnosus.
Facial muscle function
Facial muscle function
Facial muscles regulate openings with single sphincter and variable dilators.
Facial muscle innervation
Facial muscle innervation
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Deep fascia in face
Deep fascia in face
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Orbicularis oculi action
Orbicularis oculi action
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Corrugator supercilii
Corrugator supercilii
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Occipitofrontalis
Occipitofrontalis
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Levator palpebrae superioris
Levator palpebrae superioris
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Procerus muscle action
Procerus muscle action
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Compressor naris action
Compressor naris action
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Dilator naris action
Dilator naris action
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Depressor septi action
Depressor septi action
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Orbicularis oris action
Orbicularis oris action
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Action of levator labii superioris
Action of levator labii superioris
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Action of levator anguli oris
Action of levator anguli oris
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Zygomaticus major muscle
Zygomaticus major muscle
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Depressor anguli oris muscle
Depressor anguli oris muscle
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Depressor labii inferioris muscle
Depressor labii inferioris muscle
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Mentalis muscle
Mentalis muscle
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Risorius muscle
Risorius muscle
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Buccinator muscle action
Buccinator muscle action
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Platysma muscle
Platysma muscle
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Muscle for surprise/horror
Muscle for surprise/horror
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Muscle for winking
Muscle for winking
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Muscles for frowning
Muscles for frowning
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Muscles for anger
Muscles for anger
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Muscles for sadness
Muscles for sadness
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Muscle for smiling/laughing
Muscle for smiling/laughing
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Muscle for grinning
Muscle for grinning
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Ophthalmic nerve (V1)
Ophthalmic nerve (V1)
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Facial artery
Facial artery
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Dangerous facial zone
Dangerous facial zone
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Facial nerve damage
Facial nerve damage
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Study Notes
- The Face
Muscles of Facial Expression
- Muscles of facial expression originate from the mesoderm of the 2nd branchial arch embryologically.
- Morphologically, these muscles are remnants of the panniculus carnosus.
- Functionally, they regulate three openings.
- Each opening has a single sphincter (circular) muscle and a variable number of dilator (radial) muscles.
- These muscles are supplied by the nerve of the second arch, also known as the seventh cranial (facial) nerve.
- There is no deep fascia on the face where these muscles are located.
Muscles of Eyelids
- Orbicularis oculi functions as a sphincter muscle for the eyelids.
- Corrugator supercilii is a muscle of the eyelids.
- Occipitofrontalis Muscle and Levator palpebrae superioris are dilator muscles of the eyelids.
Muscles of the Nose
- Procerus is a muscle of the nose.
- Compressor naris is a muscle of the nose.
- Dilator naris is a muscle of the nose.
- Depressor septi is a muscle of the nose.
Muscles Around the Mouth
- Orbicularis oris is a muscle around the mouth.
- Levator labii superioris et alaque nasi is a muscle around the mouth.
- Levator labii superioris is a also muscle around the mouth.
- Levator anguli oris is located around the mouth.
- Both Zygomaticus minor and Zygomaticus major muscles are located around the mouth.
- Depressor anguli oris is a mouth muscle.
- Depressor labii inferioris is also a mouth muscle.
- Mentalis is a muscle around the mouth.
- Risorius is a muscle around the mouth.
- Buccinator is a muscle around the mouth.
Muscle of the Neck
- The Platysma is a muscle of the neck.
Common Facial Expressions
- Surprise/horror is expressed via the frontal belly of occipitofrontalis muscle.
- Winking involves the orbicularis oculi muscle.
- Frowning uses the corrugator supercilii and procerus muscles.
- Anger is shown through dilator naris and depressor septi muscles.
- Sadness involves depressor labii inferioris and depressor anguli oris muscles.
- Smiling/laughing happens via zygomaticus major muscle.
- Grief is expressed through depressor anguli oris muscle.
- Doubt is shown using the mentalis and depressor labii inferioris muscles.
- Grinning involves the risorius muscle.
Muscles of the Head (Scalp and Facial Expression)
- Occipitofrontalis has two bellies: occipital and frontal.
- The occipital belly originates from the highest nuchal line of the occipital bone and inserts into the epicranial aponeurosis, and is controlled by the facial nerve, it moves the scalp on the skull and raises eyebrows.
- The frontal belly originates from the skin and superficial fascia of eyebrows and inserts into (again) the epicranial aponeurosis, it is controlled by the facial nerve.
- The orbicularis oculi has palpebral and orbital parts.
- Its palpebral part originates from the medial palpebral ligament and inserts into the lateral palpebral raphe, which is controlled by the facial nerve, it closes the eyelids and dilates the lacrimal sac
- Its orbital part originates from the Medial palpebral ligament and adjoining bone loops and return to origin, which is controlled by the facial nerve, it throws the skin around the orbit into folds to protect the eyeball.
- The Corrugator supercilii originates from the superciliary arch, and it inserts into the skin of the eyebrow, it is controlled by the facial nerve and vertically wrinkles the forehead as in frowning.
- The compressor nasi originates from the frontal process of the maxilla and inserts the aponeurosis of the bridge of nose; and controlled by the facial nerve, it compresses mobile nasal cartilages..
- The dilator naris originates from the maxilla and inserts the ala of nose and controlled by the facial nerve, it widens the nasal aperture.
- The procerus originates from the nasal bone and inserts the skin between eyebrows and it controlled by the facial nerve, which wrinkles skin of nose.
- The orbicularis oris originates from the maxilla, mandible, and skin inserts encircles oral orifice and it controlled by the facial nerve, which compresses lips together.
Dilator Muscles of Lips
- Levator labii superioris alaeque nasi, Levator labii superioris, Zygomaticus minor/major, Levator anguli oris, Risorius, Depressor anguli oris, Depressor labii inferioris, and Mentalis muscles all arise from bones and fascia around the oral aperture to insert into the substance of the lips - used to separate lips, and are controlled by the Facial nerve.
- The Buccinator originates from the outer surface of the alveolar margins of maxilla, mandible, and pterygo-mandibular ligament, which is also controlled by the Facial nerve, and compresses cheeks and lips against teeth.
Muscles of Mastication
- The Masseter originates at the zygomatic arch and It inserts the lateral surface ramus of mandible with innervation from the Mandibular division of the trigeminal nerve, elevates mandible to occlude teeth.
- The Temporalis originates at the floor of the temporal fossa and inserts as Coronoid process of mandible with innervation from the Mandibular of the trigeminal nerve, anterior and superior fibers elevate mandible; posterior fibers retract the mandible.
- The Lateral pterygoid (two heads) originates at the greater wing of sphenoid and lateral pterygoid plate and inserts as Neck of mandible and articular disc with innervation from the Mandibular of the trigeminal nerve.
- The Medial pterygoid (two heads) originates the tuberosity of maxilla and lateral pterygoid plate, with innervation from the *Mandibular of the trigeminal nerve which elevates the mandible.
Platysma
- Originates from the upper part of the pectoral fascia and deltoid fascia.
- It inserts the base of the mandible and the skin of lower face/lip.
- Action of this muscle releases pressure on veins & pull angle of mouth downwards
Sensory Nerves of the Face
- The ophthalmic nerve supplies the region developed from the frontonasal process.
- The maxillary nerve serves the region developed from the maxillary process of the first pharyngeal arch.
- The mandibular nerve serves the region developed from the mandibular process of the first pharyngeal arch.
- Cutaneous innervation of the face is supplied by branches of trigeminal nerve (CN V): Ophthalmic (V1), Maxillary (V2), and Mandibular (V3).
- Cervical plexus branches (C2): Lesser occipital and Great auricular also supply sensory nerves to The Face.
- There are also Greater occipital nerve which originate from dorsal ramus of C2, also supply Cutaneous innervation to The Face.
Ophthalmic Nerve (V1)
- Supplies the skin on the forehead, upper eyelid, conjunctiva, and the side of the nose that goes reaches as far as the tip - having five branches that pass to the skin.
Lacrimal Nerve
- Supplies the skin and conjunctiva of the lateral part of the higher upper Eyelid.
Supraorbital nerve
- Winds around the upper margin of the orbit at the supraorbital notch.
- Divides into supply the skin and conjunctiva on the central part of the upper eyelid, and supplies the skin of the forehead.
Supratrochlear Nerve
- It is medial to the supraorbital nerve.
- Supplies skin and conjunctiva on the medial part of the upper eyelid and skin over the lower part of the forehead, close to the median plane.
Infratrochlear Nerve
- Supplies skin and conjunctiva on the medial part of the upper eyelid and the adjoining part of the side of the nose.
External Nasal Nerve
- Emerges between nasal bone and upper nasal cartilage, leaving the nose, and supplies skin on the side of the nose down as far as the tip.
Maxillary Nerve (V2)
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Supplies the skin on the posterior part of the side of the nose, the lower eyelid, the cheek, the upper lip, and the lateral side of the orbital opening. It has 3 cutaneous branches.
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The infraorbital nerve is a direct continuation of the maxillary nerve that enters the orbit and appears on the face through the infraorbital foramen.
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It quickly divides into small branches that radiate out from the foramen, supplying the skin of the lower eyelid, cheek, the side of the nose, and the upper lip.
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Zygomaticofacial nerve passes onto the face through a small foramen on the lateral side of the zygomatic bone, and it supplies the skin over the prominence of the cheek.
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Zygomaticotemporal nerve emerges in the temporal fossa through a small foramen on the posterior surface of the zygomatic bone, thereby supplying skin over the temple.
Mandibular Nerve (V3)
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Supplies the skin of the lower lip, the lower part of the face, temporal region, and part of the auricle then passes upward to the side of the scalp having three branches that pass to the skin.
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The mental nerve emerges from the mental foramen of the mandible and supplies skin, the lower lip and chin.
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The buccal nerve comes from beneath the anterior border of the masseter muscle and supplies skin over a small area of the cheek.
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The auriculotemporal nerve ascends from the upper border of the parotid gland between the superficial temporal vessels and the auricle, supplying the skin of the auricle, the external auditory meatus, the outer surface of the tympanic membrane, and the skin of the scalp above the auricle.
Arterial Supply of the Face
- Mainly through the facial and superficial temporal arteries.
- The facial artery arises from the external carotid artery which curves around the inferior margin of the body of the mandible at the anterior border of the masseter muscle and this is point to get pulse easily.
- It ascends in a tortuous course to the angle of the mouth, covered by the platysma and the risorius muscles, ascends deep to the zygomaticus and levator labii superioris muscles, runs along the side of the nose to the medial angle of the eye, and anastomoses with the terminal branches of the ophthalmic artery
Branches of the Facial Artery
- The submental artery branch arises from the facial artery at the lower border of the body of the mandible and supplies skin of the chin and lower lip.
- The inferior labial artery comes near the angle of the mouth, runs medially in the lower lip, and anastomoses with its fellow of the opposite side.
- Superior labial artery: arises near the angle of the mouth.
- The lateral nasal artery arises from the facial artery alongside the nose thus supplies the skin of the side and dorsum of the nose.
- The superficial temporal artery, a smaller terminal branch of the external carotid artery which commences within in the parotid gland and ascends in front of the auricle to supply the scalp.
- The transverse facial artery is a branch of the superficial temporal artery, which arises within the parotid gland and runs forward across the cheek just above the parotid duct.
- The supraorbital and supratrochlear arteries (branches of the ophthalmic artery) supply the skin of forehead.
Venous Drainage of the Face
- The facial vein is formed at the medial angle of the eye by the union of the supraorbital and supratrochlear veins.
- This drains directly to the superior ophthalmic through the supraorbital vein.
- This means that the facial vein is linked/connected to the cavernous sinus, through the superior ophthalmic.
- This connection is of great clinical significance because it provides a pathway for the spread infection from the face to the cavernous sinus
- Descends behind the facial artery to the lower margin of the body of the mandible
- It crosses superficial to the submandibular gland and is joined by the anterior division of the retromandibular vein, and ends by draining into the internal jugular vein.
- The facial vein receives tributaries that correspond to branches of the facial artery and joins the pterygoid venous plexus by the deep facial vein and to the cavernous sinus by the superior ophthalmic vein.
- The transverse facial vein joins the superficial temporal vein within the parotid gland.
Lymphatic Drainage of the Face
- Lymph from the forehead and anterior parts of the face drains into the submandibular lymph nodes.
- A few buccal lymph nodes will be present along the course of the lymph vessels.
- The lateral part of the face (including the eyelids) is drained by lymph vessels that end in the parotid lymph nodes.
Applied Anatomy
- Facial muscles are innervated by the facial nerve, therefore damage (a tumor) to to the facial nerve in the internal acoustic meatus, in the middle ear (infection or operation), in the facial nerve canal (perineuritis, Bell's palsy), or in the parotid gland or lacerations will cause distortion of face with drooping the lower eyelid and sagging angles of the mouth on affected side.
- Injury to the nerve supplying the orbicularis oculi muscle leads to paralysis that causes dropping of lower eyelid aka as "Ectropion" and Spilling of tears, called as "Epiphora".
- Radiation wrinkles at angle of eye (strong closures) is called as "Crow's Feet".
- Trigeminal neuralgia is common; patient experiences excruciating pain in distribution of mandibular/maxillary division.
- Superficial temporal and facial arteries are commonly used by anesthetists to take patient's pulse (radial is too far from the brain).
- No deep fascia and loose SC tissue causes lacerations to gape widely.
- Bruising and inflammation lead to a Large swelling.
- Wrinkles run perpendicular to muscle fibres.
Facial Infections and Cavernous Sinus Thrombosis
- Any infection, boil or otherwise, in the area of facial skin bounded by the nose, the eye, and the upper lip is dangerous, and may cause thrombosis of the facial vein.
- Organisms through the inferior ophthalmic veins can spread to the cavernous sinus; results can be fatal unless treated with antibiotics.
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Description
Overview of facial expression muscles, originating from the 2nd branchial arch. These muscles control facial openings via sphincter and dilator actions, innervated by the facial nerve. Includes muscles of eyelids and nose.
