1. THE FACE AND THE SCALP

2. The Face
The face is that part of the head visible in a
frontal view, that is, anterior to the external
ears.
Boundaries:
1. Superior -Hairline
2. Inferior - Lower border of the
mandible

3. Regions of the Face
1. Forehead
2. Temporal
3. Orbital
4. External nose
5. Zygomatic
6. Oral
7. Cheeks
8. Mental
9. External ear

4. FEATURES OF THE FACE

5. Lips
- Surround the mouth, or
entrance to the oral
cavity.
- Separated from the
cheek by nasolabial
groove.
- Philtrum extends
superiorly from at the
columnella, the fleshy
partition between the
nostrils to the vermillion
border inferiorly

6. - Lower lip is separated
from the chin by the
labiomental groove.
- Upper and lower lip
meets at the angle of the
mouth.

7. Layers of the Lips:
1. Skin - thin and
hairless, allowing
the redness of the
underlying capillary
bed to show
through.
2. Superficial Fascia -
loosely arranged and
contains some fats.
3. Muscle - orbicularis
oris

8. 3. Submucous Tissue -
contains blood vessels
and labial mucous glands
which opens to the
vestibule of the mouth.
4. Mucous membrane - coats
the intraoral vestibule of
the lips and then reflects
from the upper and lower
lips to the attached
gingiva. This is called the
vestibular or mucolabial
fold.

9. External Ear
- Contains a single elastic
cartilage which provides
support to the external
ear.
- Skin is tightly bound to the
cartilage with no
intervening subcutaneous
layer.
- Skin and cartilage is
thrown into several folds.

10. Cheeks (Buccae):
- Form the lateral movable walls of the oral cavity.
- Mucosa of the cheeks ends in the mucobuccal fold
superiorly and inferiorly.
- Buccal fat pad is lies superficial to the buccinator
muscle.
- Parotid duct opens intraorally thru the mucosa of
the cheeks at the occlusal level of the second
maxillary molar.

11. Layers of the Cheeks:
1. Skin,
2. Superficial fascia containing
the fat of Bichot, zygomatic
major, risorius, platysma, the
parotid duct, and the branches
of the facial and trigeminal
nerves.
3. Muscular layer – Buccinator
muscle
4. Submucous layer containing
mucous buccal glands,
5. Mucous membrane

12. External Nose
- The framework is
composed of the nasal
bones, septal cartilage,
lateral cartilages, and alar
cartilages.
- Skin of the nose is
continues beyond the
external nares into the
vestibule of the nose,
with nasal hairs to filter
larger particles of dusts in
the air.

13. Eyelids (Palpebrae)
Form a curtain for the ocular globe or the eyeball.
External features:
1. Palpebral fissure -
transverse eliptical opening
between the upper and
lower eyelid.
2. Palpebral commissure - the
lateral and medial junctions
of the upper and lower
eyelids.
3. Superior palpebral margins
- covers the superior 1/5s
of the iris when the lids are
open.

14. 4. Inferior palpebral margins -
cuts across the lower border
of the iris when the lids are
open.
5. Cilia or eyelashes - project
from the palpebral margins
intwo or three irregular
rows.
6. Plica semilunaris - a
cresent fold at the medial
angle of the eye that
separates the white of the
eye from the medial,
reddish-colored lacrimal
lake.

15. External features:
7. Lacrimal lake - small, raised,
triangular are bordered by the
plica semilunaris; a raised,
reddish area within the lake is
the caruncle.
8. Superior and inferior papillae -
are small, raised bumps at the
junction of the ciliated hairless
margins of the lids; at the apex
of which is the lacrimal
punctum.
9. Conjuctivum - mucous
membrane inner lining of the
lid.

16. The Scalp

17. The Scalp
The scalp extends from the supraorbital
margins back to the superior nuchal line
posteriorly. Laterally, the scalp extends up to
the temporal fossae.

18. The Five Layers of the Scalp

19. The Five Layers of the Scalp
Skin
a layer of thin skin containing numerous hair
follicles, sweat glands, and sebaceous glands
Connective tissue
A thick, dense, subcutaneous connective tissue
is anchored firmly to the skin above and the
membranous layer below.

20. Aponeurosis
Is formed by the galea aponeurotica.
Loose Connective Tissue
Allows freedom of movement of the superficial three
layers over the top of the skull
Periosteum
Firmly anchored to the underlying bone.

21. The Musculature of the Head

22. THE TWO GROUPS OF THE
MUSCLES OF THE HEAD

23. 1. Craniofacial muscles
- related mainly to the
orbital margins and
eyelids, the external
nose and nostrils, the
lips, the cheeks and
mouth, the pinna, scalp,
and cervical skin. These
are collectively referred
to as the muscles of
facial expression.

24. Common Characteristics of the
Muscles of Facial Expression
• All are inserted into the skin of the face;
• All are supplied by the muscular branches of
the facial nerve

25. 2. Masticatory muscles-
- concerned primarily with the
movements of the temporomandibular joint.

26. The Craniofacial Muscles
• They are grouped as:
1. epicranial
2. circumorbital and
palpebral
3. nasal
4. buccolabial

27. 1. The Epicranial Muscles
The epicranius is made
up of two main
parts:
1. Occipitofrontalis
2. Temporo-parietalis

28. The Muscles of the Scalp
Muscle Origin Insertion Action Cranial
Nerve
Frontalis Aponuerosis Skin of the Pulls the VII –
of the scalp forehead scalp up and temporal
back branches
Occipitalis Lateral 2/3s Skin of the Pulls the VII –
of the occipital scalp posterior
superior area backward auricular
nuchal line, and forward branches
mastoid
process

29. 2. Circumorbital and Palpebral Muscles
This group of muscle if composed of the
following:
1. orbicularis oculi,
2. corrugator supercilii,
3. and levator palpebrae superioris.

30. Muscle Origin Insertion Action Cranial
Nerve
Orbital part Bone of the Medial Closes eyes VII –
upper medial palpebral forcefully temporal
orbital ligament and
margin zyomatic
branches
Palpebral Medial Fibers arch Closes the VII –
part palpebral laterally thru eye gently temporal
ligament lids and and
interdigitate zyomatic
laterally in a branches
raphe
Lacrimal Lacrimal Medial Squeezes VII –
part bone behind aspects of lubricating temporal
the lacrimal the lid tears against and
sac the eyeball zyomatic
branches

31. Muscle Origin Insertion Action Cranial
Nerve
Corrugator Medial Skin Vertical VII -
supercilii aspect of the underlying wrinkling of temporal
supraorbital the eyebrow the bridge of branches
margin the nose as
in frowning

32. 3. Nasal Muscles
The nasal muscle
group is composed
of the following
muscles:
1. Procerus
2. Nasalis
- compressor
nares
- dilator nares
3. Depressor septi

33. Muscle Origin Insertion Action Cranial
Nerve
Depressor Medial fibers Mobile part Draw the VII –
septi of dilator of the nasal septum Superior
naris muscle septum downwards buccal
to narrow the branches
nostrils

34. Muscle Origin Insertion Action Cranial
Nerve
Procerus Nasal bone Skin of Transverse VII –
and lateral glabella wrinkling of Temporal
nasal the bridge of and
cartilages the nose zygomatic
branches
Nasalis
Compressor Canine Midline Compresses VII –
Nares eminence of aponeurosis the nostrils Zygomatic
the maxilla overlying and buccal
nasal branches
cartilages
Dilator Nares Nasal notch Skin of Dilates or VII –
of the margin of flares the Zygomatic
maxilla nostril nostrils and buccal
branches

35. 4. Buccolabial Muscles
I. Elevators, retractors, and evertors of the
upper lip
II. Depressors, retractors, and evertors of
the lower lip
III. A compound sphincter

36. I. elevators, retractors, and
evertors of the upper lip :
levator labii superioris
alaque nasi,
levator labii superioris,
zygomaticus major and
minor,
levator anguli oris,
and risorius

37. II.
Depressors, retr
actors, and
evertors of the
lower lip
depressor labii
inferioris,
depressor anguli
oris, and
mentalis

38. III. A compound
sphincter
orbicularis oris,
accessory muscles to
the orbicularis
oris
incisivus superior,
and
incisivus inferior

39. Muscle Origin Insertion Action Cranial
Nerve
Levator labii Frontal One slip goes Elevate the VII –
superioris process of the to the ala of ala of the zygomatic and
alaque nasi maxilla the nose the nose and the buccal
other to the upper lip branches
orbicularis oris
Zygomaticus Zygomatic Angle of the Draws the VII –
major bone mouth angle of the zygomatic and
mouth up and buccal
back as in branches
smiling or
laughing
Zygomaticus Zygomatic Skin on the Deepen the VII –
minor bone medial nasolabial nasolbial zygomatic and
to the groove groove as in buccal
zygomaticus sorrow branches
major muscle

40. Muscle Origin Insertion Action Cranial
Nerve
Levator labii 3 heads:
superioris Angular Alar Elevates the VII -
head: frontal cartilacge upper lip zygomatic
process of and skin of and flares and buccal
the maxilla the nose the nostrils branches
Infraorbital
head: Upper lip Gives the
inferior expression
margin of of sadness
the orbit
Zygomatic Contraction
head: Nasolabial
groove and of the whole
zygomatic muscle gives
bone upper lip
the
expression
of disdain or
doubt

41. Muscle Origin Insertion Action Cranial
Nerve
Levator Canine fossa Angle of the Elevates the VII –
anguli oris of the mouth angle of the zygomatic
or caninus maxilla mouth and buccal
below the (muscle of branches
infraorbital happiness)
foramen
Mentalis Incissive Skin of the Elevate the VII –
fossa of the chin chin. It also mandibular
mandible causes branches
trembling of
the chin. It
wrinkles the
skin of the
chin as in
disdain or
doubt.

42. Muscle Origin Insertion Action Cranial
Nerve
Risorius Superficial Skin and Draw the VII –
fascia over mucosa of anglef the zygomatic
the parotid the angle of mouth and buccal
fascia the mouth laterally, branches
giving an
expression
of strain or
tenseness
Depressor Oblique line Lower lip Depresses VII –
labii of the the lower lip mandibular
inferioris mandible as in “irony” branches
Depressor Oblique line Angle of the Depresses VII – buccal
anguli oris of the mouth the angle of and
or mandible the mouth mandibular
Triangularis branches

43. Muscle Origin Insertion Action Cranial
Nerve
Buccinator Pterygmandi The fibers Draw the VII - buccal
Or Bugler’s bular raphe, are directed angle of the branches
or buccal towards the mouth
Trumpeter’s alveolar angle of the laterally and
muscle processes of mouth to press the
maxilla and blending cheeks
mandible with he against the
upper or teeth while
lower chewing.
portions of Useful in
the mastication,
orbicularis swallowing,
oris muscle whistling,
sucking, and
blowing

44. Muscle Origin Insertion Action Cranial
Nerve
Orbicularis Extrinsic Pass around Compresses VII -
oris fibers: the mouth the lips zygomatic,
From within the against the buccal and
insertions of lips as a anterior mandibular
circumoral sphincter teeth, closes branches
muscles the mouth,
and
protrudes
Intrinsic Pass the lips
fibers: obliquely
From the forward and
incisive insert into
fossae of the the skin of
mandible the lip
and maxilla

45. Muscle Origin Insertion Action Cranial
Nerve
Platysma Skin and The fibers Retract and VII -
-thin, sub- superficial are directed depress the cervical
cutaneous fascia of the upward and angle of the branch
quadrilateral pectoral and forward to mouth
muscular deltoid be inserted
sheet regions into the
covering the lower border
upper part of the
of the chest, mandible
side of the
neck and
lower part of
the face

46. Muscles of the External Ear
Muscle Origin Insertion Action Cranial
Nerve
Anterior Aponeurosis Anterior Pulls the ear VII -
auricular of the scalp, medial forward temporal
temporal aspect of the branches
fascia helix of the
auricle
Posterior Superior Inferior Pulls the ear VII -
auricular lateral medial backward Posterior
aspect of aspect of auricular
mastoid auricle branches
process
Superior Aponeurosis Superior Pulls ear VII -
auricular of the scalp, medial superiorly temporal
temporal aspect of branches
fascia auricle

47. The Facial Nerve

48. The facial nerve arises as two distinct trunks
from the lower border of the pons:
1. the smaller of the
two trunks is the
nervus intermedius ( a
sensory
and parasympathetic
root)
2. the larger root is the
motor root

49. The Course of the
Facial Nerve
From the lower border of the pons varolli, the two
roots of the facial nerve approach and enter the
internal acoustic meatus. The meatus leads to the
petrous temporal bone and joins the facial canal.
The facial nerve runs laterally within the facial canal,
turns sharply at the genu (knee) to run posteriorly,
and then drops inferiorly to exit thru the
stylomastoid foramen at the base of the skull. The
nerve enters the substance of the parotid gland and
then breaks up into 5 sets of muscular branches. The
genu of the nerve contains the sensory geniculate
ganglion.

50. Schematic Diagram
Pons varolii
internal auditory meatus
petrous temporal
facial canal
genu to run posteriorly
stylomastoid foramen
parotid gland
five muscular branches.

52. Branches of the Facial Nerve
1. The greater petrosal
nerve
2. The nerve to the
stapedius muscle
3. The chorda tympani
nerve
4. The posterior auricular
nerve
5. The facial branches
(motor)

53. Branches of the Facial Nerve
1. The greater petrosal nerve
- arises from the genu of the facial nerve within the facial
canal.
- contains mainly taste fibers to the palatal mucosa and
- parasympathetic fibers to the lacrimal gland, the mucosa of
the palate, nasopharynx and the nasal cavity.

54. Branches of the Facial Nerve
2. The nerve to
the
stapedius
muscle
- arises within the
facial canal
and is motor
to the
stapedius
muscle of the
middle ear.

55. Branches of the Facial Nerve
3. The chorda
tympani nerve
- arises from the
descending portion
of the facial nerve
within the facial
canal.
- leaves the skull
thru the
petrotympanic
fissure
- Taste fibers are
distributed to the
anterior two thirds
of the tongue via the
lingual nerve.

56. The Chorda Tympani

57. Branches of the Facial Nerve
4. The posterior auricular nerve arises from the
stylomastoid foramen and communicates with
the great auricular and lesser occipital nerves.
It has 2 branches:
1. auricular branch which supplies the
auricularis posterior and intrinsic muscles on
the cranial aspect of the auricle, and
2. occipital branch which supplies the
occipital belly of the occipitofrontalis.

58. Branches of the Facial Nerve
5. Facial branches (motor) arise within the parotid
gland as five main groups. These are:
a. Temporal
b. Zygomatic
c. Buccal
d. Mandibular, and
e. Cervical
These branches innervate the muscles of
facial expression and platysma.

59. Motor Branches of the Facial Nerve
1. Temporal
2. Zygomatic
3. Buccal
4. Mandibular
5. Cervical

60. Motor Branches of the Facial Nerve
1. Temporal
2. Zygomatic
3. Buccal
4. Mandibular
5. Cervical

61. Motor Branches of the Facial Nerve
1. Temporal branches
- travel superiorly and anteriorly to supply the
facial muscles situated above the zygomatic arch,
including the orbit and the forehead.
They innervate:
1. the anterior and superior auricular muscles,
2. the frontalis muscle, and
3. the superior portion of the orbicularis oculis
muscle.

62. Motor Branches of the Facial Nerve
2. Zygomatic branches
- runs transversely across the face to supply
the facial muscles in the
zygomatic, orbital, and infraorbital areas.
They supply:
1. the inferior portion of the orbicularis oculis
muscle,
2. the superior portions of the zygomaticus major,
levator labii superioris,
levator anguli oris, nasalis, and
orbicularis oris muscles.

63. Motor Branches of the Facial Nerve
3. Buccal branches
- supplies the muscles of the cheek and circumoral
muscles. They innervate:
1. the buccinator, and
2. the inferior portions of
the zygomaticus major,
levator labii superioris,
levator anguli oris,
nasalis, and
orbicularis oris muscles.

64. Motor Branches of the Facial Nerve
4. Mandibular branches
- supplies the muscles of the chin and the
lower lip. Specifically they pass to:
1. the depressor anguli oris,
2. depressor labii inferioris, and to
3. the mentalis muscles.

65. Motor Branches of the Facial Nerve
5. Cervical branches
- descend to the neck to supply:
1. the platysma,
2. posterior belly of the digastric,
3. stylohyoid muscles

66. Cranial Nerve Test
Lesions of the facial nerve may cause:
(1) paralysis of facial muscles,
(2) loss of taste sensation from the
anterior two thirds of the tongue,
(3) decreased salivation.