Head and Neck Anatomy of Face PDF

Head and Neck SCALP Dr. Mohamed El Fiky aside SCALP Definition: Is the soft tissue covering the vault of the skull. Extent: (1) Anteriorly : supraorbital margins. (2) Posteriorly: highest nuchal line. nÉ f iii (3) On each side: superior temporal lines: so Superior temporal lines Eye brows ie Temple...

Head and Neck SCALP Dr. Mohamed El Fiky aside SCALP Definition: Is the soft tissue covering the vault of the skull. Extent: (1) Anteriorly : supraorbital margins. (2) Posteriorly: highest nuchal line. nÉ f iii (3) On each side: superior temporal lines: so Superior temporal lines Eye brows ie Temple Scalp Temple Inini rows hereare 3 nuchalline inferiornuchalline superiornuchalline highestnuchalline Superior nuchal lines and external occipital protuberance a MOHAMED EL FIKY Scalp Face MOHAMED EL FIKY 1- s : skin 2- C : connective tissue 3- A : Apponeurosis (Epicranial ) and Occipitofrontalis Muscle 4- L : loose areolar connective tissue (Subapponeurotic Space) 5- P : Pericranium (Periosteum) fatheadecorreetcedescosferatethresses (Subapponeurotic Space) MOHAMED EL FIKY Third layer of scalp E_e df Epicranial Apponeurosis Superior temporal line sinthemiddl nn.mn mm MOHAMED EL FIKY Frontal Bellies of Occipit ofrontal is Occipital Belly Occipital Belly Occiptal belly ( Occiptalis ): Origin : Lateral part of highest nuchal line Insertion : Epicranial aponeurosis. Nerve supply : Posterior auricular branch of facial nerve. Posterior Auricular of Facial nerve Temporal branch of Facial nerve tee Action : Moves the scalp backwards. Frontal bellies (frontalis): Origin: Skin of the forehead (no bony attachment) Insertion: Epicranial ' aponeurois. a Nerve Supply of Occipitofrontalis Muscle : Frontal belly by : temporal branch of facial nerve Occiptal belly by : Posterior Auricular of Facial nerve Facial Nerve 0 MOHAMED EL FIKY Action of Occipitofrontalis Muscle A- Frontal belly : (1) Moves the scalp forwards. (2) Raises the eyebrows (surprise). if (3) Causes horizontal wrinkles in the skin of the forehead (Horror). B- occiptal belly : Moves the scalp backwards. Frontal Bellies of Occipitofrontalis Corrugator Supercelli MOHAMED EL FIKY and Procerus in nwer I Black Eye ii afgigg.it.ie.tt iiiiiiiiiiii Efoaitintt iii i es scalpand4thlayer MOHAMED EL FIKY Arteries of the SCALP Supraorbital artery fffternal fromexternal carotid Supratrochlear artery Superficial temporal artery rgearterypresentintheneck is commoncarotidartery eternalcarotid artery.si i set tneearororain iii i i i fiEi 5 arteries supply the scalp : 1- supratrochlear From internal carotid 2- supraorbital 3- Superficial temporal 4- posterior auricular From external carotid 5- occipital that Fsi Occipital artery fromexternal Posterior auricular artery MOHAMED EL FIKY an Superficial Temporal Artery Maxillary Artery External Carotid Artery MOHAMED EL FIKY Auriculo-temporal Nerve Superficial Temporal Vein The Zygomatic Arch Tragus Parotid Gland MOHAMED EL FIKY 5- Anterior terminal branch 6- Posterior terminal branch 2- Zygomatico-orbital artery 3- Anterior auricular artery 4- Middle Temporal artery 1- Transverse facial artery Superficial temporal Artery MOHAMED EL FIKY 5 Veins of the SCALP and face arain Superficial temporal vein Maxillary vein I Posterior facial vein aIsocaiiedretromandibula m.id External jugular vein Subclavian vein Cavernous sinus Supra-trochlear Supra-orbital 60 Sup. Ophtalmic vein Anterior facial Emissary veins Deep facial effort Pterygoid plexus 0 Internal jugular vein Common facial MOHAMED EL FIKY veins drainage Thesupratrochlearveinandsupraorbitalveinjointoform Anteriorfacialvein Thesuperficialtemporalveinandmaxillary veinjointoformposteriorfacialvienretromandibularvein posteriorfacialvein retromandibularvein willgive 2 divisionanterior posterior ininternaljugular anteriordivisionjoinwithAnteriorfacialvein toform yend commonfacialjoinwithinternaljugularvein posteriordivionjoinwith Posteriorauriculartoform nbeseenundertheskin external subclavian descent ifeng.gg jugularvein to vein The occipitalgoto occipital Iff networkofvein thenwillgotovertebraland cavernoussinusvein.ITrelated tothebrainandits largevein withanteriorfacialvein sonnectthecavernoussinusvein Ii ff.ge couldbe 2 or 3 deepfacialconnectwithPterygoidplexus veinfrompterygoidplexustocavernoussinusvein called emissary vein anteriorfacial connectwith cavernoussinus Alsodeepfacialandemissary ofthe if therisinfectionin avg fa.ci ea it willspreadtothebrain it'sconnectwithcavernoussinus dangerousareabecause dangero Sarea Lymph Drainage of the SCALP Pre-auriculalr Occipital Go Submandibular MOHAMED EL FIKY Cranial nerves 1- Olfactory 2-Optic 3- Oculomtor 4- Trochlear 5- Trigeminal arisefrombrainstem 6- Abducent 7- Facial 8-Vestibulochlear 9-Gloosopgrayngeal 10- Vagus 11- Accessory 12- Hypoglossal. MOHAMED EL FIKY Nerve supply of the SCALP A- Motor Nerve supply of the SCALP * Temporal branch of Facial nerve ( in front of the ear ) * Posterior Auricular of Facial nerve (in the back the ear ) tree B- Sensory Nerve supply of the SCALP His Thetrigeminalnervegives3branch opthalmicmaxillarymandibular Behind the ear In front of ear 1- Supraorbital Nerve dnerves fromopthalmic oftrigeminal 2- Supratrochlear Nerve 1- Greater OccipitalNerve 2- Third Occipital Nerve 3- Zygomatico-temporal Nerve frommaxillaryoftrigeminal3- Lesser Occipital Nerve 4- Auriculo-=temporal Nerve frommandibularoftrigeminal 4- Great Auricular Nerve SRS MOHAMED EL FIKY A- Motor nerve supply Temporal branch of Facial nerve Posterior Auricular of Facial nerve Parotid Gland Facial Nerve MOHAMED EL FIKY B- Sensory Nerve supply of the SCALP sees A- In front of the ear B- Behind ear 1- Supraorbital Nerve Greater Occipital Nerve 2- Supratrochlear Nerve Lesser Occipital Nerve F E 3- Zygomatico-temporal Nerve Third Occipital Nerve 4- Auriculo-=temporal Nerve Great Auricular Nerve MOHAMED EL FIKY NERVE SUPPLY Blood SUPPLY Facial nerve (motor) Facial nerve (motor) MOHAMED EL FIKY Trigeminalneurologia it'sseverpain orthalmicneurologia maxillaryneurologia mandibularneurologia in t SITE lowereyelid lowerofthenose upperlip MOHAMED EL FIKY Head and Neck Anatomy of Face Dr. Mohamed El Fiky MOHAMED EL FIKY Scalp Hair line Face MOHAMED EL FIKY chin Muscles of the Face t__ of the Muscles of the Face General Characters e 1- They are the muscles of Expression MOHAMED EL FIKY 2- They are all developed from the 2nd pharyngeal arch 3- They are all supplied by the Facial nerve III Facial Nerve MOHAMED EL FIKY Cranial nerves 1- Olfactory 2-Optic 3- Oculomtor 4- Trochlear 5- Trigeminal 6- Abducent 7- Facial 8-Vestibulochlear 9-Gloosopgrayngeal 10- Vagus 11- Accessory 12- Hypoglossal. MOHAMED EL FIKY Major muscles 1- Orbicularis Occuli : it is formed of three parts : Adhd A- orbital part B palpebral part C- lacrimal part Festfacian A- Orobital part : * Origin : It arises from the nasal part of the frontal bone, from the frontal process of the maxilla and upper border of medial palpebral lig. * insertion : lower border of medial palpebral ligament * Action : tight closure of the eye B- Palpebral part : * Origin : arises from the the medial palpebral ligament, forms a series of concentric curves. * insertion : inserted into the lateral palpebral raphe at the outer canthus (corner) of eye. * Action : The palpebral portion acts involuntarily, closing the lids gently, as in sleep or in blinking; MOHAMED EL FIKY Medial palpebral ligament Lateral palpebral ligament MOHAMED EL FIKY 1- Orbicularis Occuli : (continue ) C. Lacrimal part : Origin : It arises from the posterior crest and adjacent part of the orbital surface of the I of the lacrimal bone, and passing behind the lacrimal sac. insertion : into the superior and inferior tarsi and wall of lacrimal sac * Action : dilate lacrimal sac * seafffetage * Nerve supply : temporal branch of facial nerve MOHAMED EL FIKY 2- Buccinator * Origin : - upper fibers: from maxilla above three molar - lower fibers : from the mandible below three molar - Middle fibers : from ptergomandibular raphe which separates it from the constrictor ease pharyngis superior ligament. * Insertion : - upper fibers : to the upper lip - lower fibers : lower lip - Middle fibers decussate upper descend to lower lib & lower ascend to the upper limb * Action : Aids in holding the cheek to the teeth and prevent accumulation of food in the vestibule of the mouth during chewing bccinator * Nerve supply : facial nerve ( upper & lower buccal branches ) men iii ii ii palsy and appearslikeedema affect stylomastoidforemen face and the a ffected the the hits will cold air when temporary the swallowing nervecuts the paralysispermanent when MOHAMED EL FIKY tested Nerve Supply of the Face 1- Sensory Nerve Supply : casesscenariolike come thequestionmaybay as I upperlifewhatisthenew Trigeminal nerve : eiiiiiiiiii.se r Maxillary 1 Mar Ophthalmic * Mandibular ftp.T.IT theangleofthe mandible EiEnose by supply greatauricularofcervicalplexus MOHAMED EL FIKY a- Branches of ophthalmic division of Trigeminal Nerve 1- Supraorbital nerve 2-Supratrochlear nerve 3-Lacrimal nerve 4-Infratrochlear nerve 5-External nasal nerve MOHAMED EL FIKY b- Branches of maxillary division of Trigeminal Nerve 1- Zygomaticotemporal nerve 2-Zygomaticofacial nerve Palpebral Nasal 3-Infraorbital nerve Labial MOHAMED EL FIKY c- Branches of mandibular division of Trigeminal Nerve 1-Auriculotemporal nerve 2-Buccal nerve 3-Mental nerve MOHAMED EL FIKY 00 d- Great auricular nerve (C2, 3) of Cervical Plexus Great Auricular Nerve MOHAMED EL FIKY Motor Nerves of the Face ( facial nerve ) Origin : from the pons Type : mixed nerve motor , sensory and containing parasympathetic. a send parotid gland superficial to external carotid artery and posterior facial vein and with in the parotid Course in the face : after the facial nerve comes out from the stylomastoid foramen it inter the tear gland the nerve gives five terminal branches. Branches : beef A- befor it inter the parotid gland ( distal to the stylomastoid foramen : 1- posterior auricular to the occiptal belly of occiptofrontalis muscle and muscles around ear 2- Branch to posterior belly of digasteric and stylohyoid muscle Temporal Branch B- After it inter the parotid gland : 1- Temporal branch parotidgland Zygomatic Branch Upper Buccal Branch 2- Zygomatic branch 3- Buccal (upper U&lower ) branches 4- Mandibular branch 5- Cervical branch MOHAMED EL FIKY to gland borderofthe Lower Buccal Branch related anterior S Mandibular Branch Cervical Branch Facial Palsy : can't closetheeye MOHAMED EL FIKY Blood Supply of the Face ISSTI A- Arteries of the Face ethe 1- Facial Artery : Origin : branch from external carotid Course : arise from external carotid and inter the digasteric triangle in the neck and run between submandibular gland and mandible then inter the face in front of masseter muscle and terminate by giving angular artery. Branches : A- In the neck (cervical ) : 1- Ascending paltine artery. 2- Tonsilar artery 3- Submental artery cnn.ua 4- Glandular branches B- In the face (facial) : 1- inferior labial 2- superior labial 3- lateral nasal 4- Angular ( the terminal branch ) MOHAMED EL FIKY Supraorbital Artery Supratrochlear Artery Lateral Nasal Branch Septal Branch Facial Artery Angular Artery Superior Labial Branch Antro-inferior angle of Masseter Inferior Labial Branch Lower Border of The Mandible 1- Facial Artery MOHAMED EL FIKY 2- Superficial Temporal Artery 5&6 Anterior and posterior terminal branches 3- middle temporal Artery manlysupplythe alsoit supp scalpbut face 4- Anterior auricular Artery 2- Zygomatico-orbital Artery 1- Transverse Facial Artery Superficial Temporal Artery MOHAMED EL FIKY Veins of the SCALP and face Superficial temporal vein Maxillary vein Cavernous sinus Supra-trochlear Supra-orbital Sup. Ophtalmic vein Posterior facial vein External jugular vein Anterior facial Emissary veins Deep facial Subclavian vein Pterygoid plexus Common facial MOHAMED EL FIKY Internal jugular vein Connections with cavernous sinus MOHAMED EL FIKY Facial vein: Beginning: at the medial angle of the eye by the union of I supra-orbital and supratrochear veins. e_ * Runs downwards and backwards behind the facial artery. * Leaves the face to enter the neck by piercing the deep fascia at the antero-Inferior angle of the masseter. *Ends in the neck by joining the anterior division of FILE 0 ISTI T retromandibular (Posterior facial) vein to form the common facial vein which ends in the Internal jugular vein. Tributaries: corresponding to the branches of facial artery. Communications: (1) With the superior ophthalmic veins: at the medial angle of the eye. (2) effete With the pterygoid plexus of veins: through the deep facial vein Which passes backwards deep to the ramus of the mandible. tffter * The facial vein communicates through these two connections with the cavernous sinus. MOHAMED EL FIKY Dangerous Area of the Face fted Tettother This includes the upper lip and the lower part of the nose. It is drained by the facial vein, which communicates with the cavernous veinrelatedtothebrain sinus. Infections of this area can therefore, spread in retrograde direction and cause thrombosis of def 6 Fee the cavernous sinus. iniiI thisareawnieadt MOHAMED EL FIKY MOHAMED EL FIKY Lymph Drainage of the Face Superficial parotid or Preauricular lymph nodes Submandibular lymph nodes Submental lymph nodes MOHAMED EL FIKY