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The Face and Scalp
oramosmd
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Muscles of Facial expression
I. Muscles that acts on the eyebrows/eyelids:
1.Occipitofrontalis
elevates eyebrows; wrinkles forehead
(surprise).
2.Corrugator supercilli
draws eyebrows downward and medially
Anger and frowning
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3. Orbicularis oculi
-closes eyelids(squinting).
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II. Muscles that acts on the nose:
1. Nasalis- draws ala of the nose towards the
septum.
2. Depressor septi- constricts the nares.
3. Procerus
wrinkles the skin over the nasal bones.
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III. Muscles that acts on the lips and mouth
1. Orbicularis oriscloses the lips
2. Levator anguli oriselevates angle of themouth medially(disgust).
3. Zygomaticus majordraws angle of the
mouth backward and upward(smile) 4. Zygomaticus minorelevates upper lip.
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5. Depressor labii inferioris- depresses thelower lip.
6. RisoriusRetracts angle of the mouth(false
smile) 7. Depressor anguli orisdepresses angle of
the mouth(frowning).
8. Buccinatorpresses cheek to keep it taut
9. Mentaliselevates and protrudes the lowerlip.
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V. Muscle that acts on the ear:
1. Auricularis muscle-retracts and elevates the
ear
anterior
superior
posterior
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IV Muscles that acts on the nose and upper
lips
1. Levator labii superioris- elevates upper lip
and dilates the nares(disgust)
2. Levator labii superioris alaquae nasae-
elevates ala of the nose and upper lip
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Nerve supply to the face and scalp
A. Facial Nerve:
Exits through the stylomastoid foramen.
Enters the parotid gland and branches in to:
1. Zygomaticotemporal branch that rise to:
a. Temporal branch.
B. Zygomatic branch
2. Cervicofacial branch that branches into:
a. Buccal branch
b. Mandibular branch
c. Cervical branch.
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The Facial Nerve: Innervates the muscles of facial expression.
Also innervates the muscles of the auricle,occipitalis muscle posteriorly and the
posterior digastric and stylohyoid muscle
anteriorly.
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Corneal Blink:
closure of the eyelid in response to blowing on
the cornea or touching it with a cotton wisp.
Efferent limb of the reflex arc is via the facial
nerve, while its afferent limb comes from the
ophthalmic branch of the trigeminal nerve.
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Bells palsy
It is the paralysis of the facial muscles due to a
lesion on the Facial nerve.
Central lesion of the facial nerve: spares the
forehead.
Peripheral lesion of the facial nerve: involves
all the facial muscles.
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Trigeminal nerve
A. Ophthalmic division
Upper eyelid and dorsum of the nose
Branches into:
supraorbital,
supratrochlear,
infratrochlear,
external nasal and
lacrimal nerves.
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B. Maxillary Division
Trigeminal neuralgia(tic douloreux): marked
paroxysmal pain along the course of thetrigeminal nerve especially radiating to themaxillary and mandibular area.
Common ,: aberrant blood vessels, aneurysm,chronic meningeal inflammation,brain tumor andothers like MS.
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C. Mandibular Division;
Innervates the face below the lower lip.
Supplies the face as the auriculotemporal, buccal
and mental nerves.
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Blood Supply
A. Facial artery
Arises from the ECA just above the upper border
of the hyoid bone.
Passes deep to the mandible, winds around the
lower border of the mandible and runs upward
and forward on the face.
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Nxt topic
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Branches of the facial artery:
ascending palatine a.
Tonsillar a.
Glandular a.Submental a.
Inferior labial a.
Superior labial a.Lateral nasal a.
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B. Superficial temporal artery
Terminal br. Of the ECA course anteriorly to the EAM going upto the Scalp.
Accompanies the auriculotemporal nerve
Gives rise to the:
Transverse facial a.Zygomaticotemporal a.
Middle temporal a.
Anterior auricular a.Frontal a.
Parietal a.
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Facial Vein
Begins as Angular vein by the confluence of the supraorbital
and supratrochlear vein.
The angular vein will eventually become the facial vein at the
lower orbital margin.
It receives tributaries from the corresponding branches of the
facial artery, infraorbital and deep facial veins.
It drains directly into the IJV or joins the anterior branch of
the Retromandibular vein to form the COMMON FACIAL
VEIN and eventually draining into the IJV.
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Facial vein
It communicates with the superior
ophthalmic veinand thus with the
CAVERNOUS SINUS, allowing a route of
infection from the face to the CRANIAL FOSSA.
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DANGEROUS AREA OF THE FACE:
area of the face near the nose( from the root of
the nose up to the upper lip) drained by the
facial veins. Septicemia can lead to meningitis andcavernous sinus thrombosis causing neurologic
damage and even death.
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D. Retromandibular vein
Formed by the Union of the superficial
temporal vein and maxillary veins behind the
mandible.
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Branches into:
A. Anterior branch that joins the Facial vein to
form the COMMON FACIAL VEIN.
B.Posterior branch that joins the posterior
auricular vein to form theEXTERNAL
JUGULAR VEIN.
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SCALP
LAYERS:
1. Skinwith hair and sebaceous glands.
2. Connective tissue(close subcutaneous
tissue)- dense connective tissue. Containsblood vessels,and nerves and arteries thatnourish the hair follicles. These arteries are
held by DCT around them and thus theyremain open when cut causing profusebleeding.
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4. Loose Connective Tissuesub aponeurotic
space containing the Emissary veins. It is a
DANGEROUS AREA, because infections from
these area can migrate into the intracranialsinuses via the EMISSARY VEINS.
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5. Pericraniumover the surface of the scalp.
Scalp hemorrhage: results from laceration ofarteriesat the dense subcutaneous tissue that
are unable to contract or retract causing
severe hemorrhage.
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Deep scalp infection : localized in the loose CT
layer and spreads across the calvaria to the
intracranial dural venous sinuses through the
emissary veins causing meningitis orsepticemia
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B. Innervation
Via the SUPRATROCHLEAR, SUPRAORBITAL,
ZYGOMATICOTEMPORAL,
AURICULOTEMPORAL,LESSER OCCIPITAL,
GREATER OCCIPITAL AND OCCIPITAL NERVES.
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C. Blood Supply
I. From the Internal carotid artery:
A. Supratrochlear A.
B. Supraorbital A.
II. From the External carotid artery:
A. Superficial temporal A.
B. Posterior Auricular A.C. Occipital A.