Head & Neck (The Face) Lecture Notes PDF

Dr. Eman El Sawaf Anatomy & Embryology Department Faculty Of Medicine, Helwan University Locomotor Module Anatomy Head & Neck The Face  Objectives By the end of this lecture, student should be able to: Describe the anatomy of the face. ...

Dr. Eman El Sawaf Anatomy & Embryology Department Faculty Of Medicine, Helwan University Locomotor Module Anatomy Head & Neck The Face  Objectives By the end of this lecture, student should be able to: Describe the anatomy of the face.  Contents - Definition. - Muscles:(origin – insertion – nerve supply – action) Orbicularis oculi – Orbicularis oris - Buccinator - Nerve supply of the face: Motor: Facial nerve Sensory: Trigeminal nerve + Cervical plexus - Arterial supply of the face: Ophthalmic artery (Supraorbital & Supratrochlear) Superficial temporal artery Maxillary artery Facial artery - Venous drainage of the face: Anterior facial vein Posterior facial (Retromandibular) vein - Dangerous area of the face. Definition  Definition Of The Face - The face is the region of the head and neck between the eye brows (1) superiorly, 1 1 the chin (2) 3 3 inferiorly, and the two ears (3) from side to side. 2  Definition Of The Face - The face is the region of the head and neck between the superciliary arches (1) 1 1 superiorly, lower edge of the 3 3 mandible (2) inferiorly, and the two ears (3) from side to side. 2 Muscles Of The Face  Muscles Of The Face -The muscles of the face are located in the superficial fascia. -They originate from either bone or fascia and inserted into the skin.  Muscles Of The Face -The muscles of the face are located in the superficial fascia. - They originate from either bone or fascia, and inserted into the skin.  Muscles Of The Face -They control the expressions of the face (muscles of facial expressions). -They also act as sphincters and dilators of the orifices of the face (eye , nose and mouth).  Muscles Of The Face The facial muscles include: -Small muscles: e.g. Zygomaticus major & minor , mentalis , levator labii superioris …… 1 -Three large muscles: 1-Orbicularis oculi. 2-Orbicularis oris. 3-Buccinator. 2 3  Orbicularis oculi muscle The orbicularis oculi muscle surrounds the orbital opening and extends into the eyelids. 2  Parts Orbicularis oculi muscle (Origin & Insertion) Parts of orbicularis oculi: 1-Outer orbital part: It encircles (surrounds) the orbital opening. 1 2 Orbit 2 3 2-Inner palpebral part: 1 It lies in the eyelids. 3-Small lacrimal part: 2 It is deep and medial. It attaches to bone posterior to the lacrimal sac.  Parts (Origin & Insertion) Orbicularis oculi muscle Lacrimal sac  Parts (Origin & Insertion) Orbicularis oculi muscle Lateral palpebral raphe Orbital part Medial palpebral Palpebral part ligament Palpebral part Orbital part Action Orbicularis oculi muscle -The palpebral part closes -The orbital part closes the the eye gently. eye more forcefully and produces some wrinkling on the forehead. 2 Action Orbicularis oculi muscle -The palpebral part closes -The orbital part closes the the eye gently. eye more forcefully and produces some wrinkling on the forehead. 2  Orbicularis oris muscle The orbicularis oris muscle encircles (surrounds) the mouth. 2 Origin & Insertion Orbicularis oris muscle - The orbicularis oris muscle originates from the maxilla superiorly and the mandible inferiorly. -It inserts into the skin and mucous membrane of the lips. - Some of the fibers of 2 orbicularis oris are derived Mandible from the buccinator and from other muscles acting on the lips. Origin & Insertion Orbicularis oris muscle - The orbicularis oris muscle originates from the maxilla (1) superiorly and the mandible (2) inferiorly. -It inserts into the skin and mucous membrane of the lips. - Some of the fibers of orbicularis oris are derived from the buccinator and from 1 2 other muscles acting on the lips (arrows). 2 Action Orbicularis oris muscle The orbicularis oris narrows the mouth and closes the lips. 2  Buccinator muscle -The buccinator muscle forms the muscular component of the cheek. -It is located in the space between the mandible and the maxilla. 2  Buccinator muscle -The buccinator muscle forms the muscular component of the cheek. -It is located in the space between the mandible and the maxilla. 2 Origin & Insertion Buccinator muscle The buccinator muscle originates from: -The alveolar margin (arrows) of the maxilla and mandible opposite the molar teeth. Maxilla -The pterygomandibular raphe (ligament). 2 Mandible Pterygomandibular ligament Origin & Insertion Buccinator muscle The fibers of buccinator muscle insert into the lips, blending with fibers from the orbicularis oris: 1-The upper fibers enter the upper lip. 2-The lower fibers enter the lower lip. U M 2 3-The middle fibers cross (the L lower part enters the upper lip and the upper part enters the lower lip). Relations Buccinator muscle -The buccinator muscle is covered by buccal pad of fat (F). -The buccinator muscle is pierced by the parotid duct (D). Parotid gland D F 2 Relations Buccinator muscle -The buccinator muscle is pierced by the parotid duct (arrow). 2 Action Buccinator muscle -The buccinator muscle -The muscle assists in the forceful presses the cheek against expulsion of air from the cheeks the teeth and this aids in (Blowing and Whistling). mastication and preventing food from accumulating between the teeth and the cheek. 2 Nerve Supply Of The Face  Motor Innervation -All muscles of the face are innervated by branches of the facial nerve (7th cranial nerve).  Motor Innervation The facial nerve has: 1-Intracranial part. 2-Extracranial part. 1 2  Motor Innervation -The facial nerve pierces the parotid gland (P) and ends by giving 5 terminal branches in the face. 1 2 3 P 4 5  Motor Innervation Branches 1-Temporal 2-Zygomatic 3-Buccal 4-Marginal 2 1 mandibular 3 4 5-Cervical 5  Motor Innervation Branches Muscles Temporal supplies the frontal belly of occipito-frontalis muscle and the orbicularis oculi muscle. Zygomatic supplies the orbicularis oculi muscle and the muscles between the eye and the mouth including the muscles of the nose. Buccal supplies the buccinator 1 and orbicularis oris 2 muscles. Marginal supplies the muscles of the lower lip and chin. 3 mandibular Cervical supplies the platysma 4 muscle (in the neck). 5 Facial Palsy (Paralysis) Facial Palsy (Paralysis)  Sensory Innervation Most of the skin covering the face is innervated by branches of the trigeminal nerve (5th cranial nerve). Trigeminal Nerve  Sensory Innervation -The trigeminal nerve divides into three major divisions: 1- Ophthalmic nerve. 2- Maxillary nerve. 3- Mandibular nerve. 1 -Branches from the three 2 divisions supplies most of 3 the skin of the face. -Small area is supplied by Trigeminal Nerve branch from the cervical plexus. Sensory Innervation Blood Supply Of The Face  Arterial Supply The arterial supply of the face is through branches from the external (1) and internal (2) carotid arteries. 21 Common carotid artery  Arterial Supply Branches from the external carotid artery to the face: 1-Facial artery. 2-Maxillary artery. 3-Superficial temporal artery. 3 2 1  Arterial Supply Ophthalmic Artery Branches from the internal carotid artery to the face: 1 1-Supratrochlear artery. 2 2-Supra orbital artery. (From the ophthalmic branch of internal carotid artery). I.C.A. Arterial Supply  Venus Drainage Venous drainage of the face is through of veins which drain into the internal jugular vein (arrow). 1-Anterior facial vein 2-Posterior facial (retromandibular) vein. 2 1  Dangerous Area Of The Face - The dangerous area of the face includes the nose, near by cheek and the upper lip. -The veins in this area are connected with the venous sinuses inside the cranial cavity through emissary veins and infection in this area can be transmitted into the venous sinuses and produces venous sinus thrombosis. Dangerous Area Of The Face Cavernous sinus thrombosis  References Gray's Anatomy for Students, 3rd Ed.With STUDENT CONSULT Online Access Drake, Vogl & Mitchell 2014. 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