The document discusses the anatomy of the face, including: - The muscles of the face develop from the 2nd pharyngeal arch and are innervated by branches of the facial nerve. They control facial expressions and act as sphincters of the facial orifices. - The face is richly vascularized. It receives blood supply from the facial artery and its branches, as well as arterial branches that accompany cutaneous nerves. Venous drainage is through the facial vein and retromandibular vein. - The trigeminal nerve provides sensory innervation to most of the face, while the facial nerve supplies motor innervation to the muscles of facial expression.

1. ANATOMY OF FACE
DR.MEHER MOIN KHAN

2. LEARNING
OBJECTIVES
• Muscles of facial expressions
• Arterial supply of face ( facial artery)
• Venous drainage of face (facial vein )
• Danger space / area of face
• Sensory and motor innervation of
face
• Clinical scenarios

3. Face
Boundaries
• Extends superiorly to
the hair line,
inferiorly to the chin
and base of
mandible, and on
each side to auricle
• Forehead is common
to both scalp and
face.

4. Face
• Due to rich
vascularity face
blush and blanch.
• Facial skin is rich
in sebaceous
gland and sweat
gland.
• Wounds of face bleed
profusely but heal
rapidly.
• Sebaceous gland keep
the skin oily but also
cause acne in adult.

5. Face
• muscle of facial
expression ,lie in
superficial fascia.
• Embryologically they
develop from
mesoderm of 2nd
branchial arch,
therefore supplied by
facialnerve.
• No deep fascia is
present in the face.

6. Bones of the
Face

7. Bones of the
Face

8. Muscles of the Face
• The muscles of the face develop from the
2nd pharyngeal arch and are innervated by
branches of the facial nerve [VII].
• They are in the superficial fascia, with
origins from either bone or fascia, and
insertions into the skin.
• these muscles control expressions of the
face.
• They act as sphincters and dilators of the
orifices of the face (i.e. the orbits, nose, and
mouth).

10. Muscles of the
Face
• Orbital group
• Nasal group
• Oral group
• Other muscle
groups

12. Muscles of the Face

13. Orbital
group
• Two muscles
are
– Orbicularis oculi
– Corrugator
supercilii

14. Orbicularis oculi

15. Orbicularis oculi

16. Corrugator supercillii
• Action: produces vertical
wrinkles of the forehead
in frowning as an
expression of annoyance

17. Nasal group
• Three muscles
are associated
with the nasal
group:
– Nasalis
– Procerus
– Depressor septi
nasi

18. Procerus
• Action:
– pulls down the medial
end of the eyebrow
– wrinkles the skin of the
nose transversely in
frowning

19. Oral group• The muscles in the oral
group move the lips and
cheek:
– Orbicularis oris
– Buccinator
– Lower group of oral muscles
• depressor anguli oris
• depressor labii inferioris
• Mentalis
– Upper group of oral muscles
• risorius
• zygomaticus major and
zygomaticus minor
• levator labii superioris
• levator labii superioris alaeque
nasi
• levator anguli oris

21. Orbicularis oris
• Origin: from
maxilla above
incisor teeth
• Insertion: into skin
of lip.
• Action: closes
the mouth

22. Buccinator
• Upper fibers
– Origin- from maxilla opposite
molar
teeth
– Insertion-upper lip
• Lower fibers
– Origin-from mandible opposite
molar teeth
– Insertion-lower lip
• Middle fibers
– Origin –from
pterigomandibular raphe
– Insertion-decussate before
passing to lips
• Action- it aids in mastication by
prevent accumulation of food in
vestibule of mouth. It is used every
time air expanding the cheeks is
forcefully expelled

23. Other muscle
groups
• They include:
– Platysma
– Auricular (anterior,
superior, and
posterior auricular
muscles)
– Occipitofrontalis

24. Platysma
• Origin– upper part
of pectoral and
deltoid fascia
• Insertion– base of
mandible, skin of
lower face and lip
• Action– releases
pressure of skin on the
subjacent veins,
depress
mandible, pulls angle
of
mouth downwards.

25. Muscles of Face Revision

27. Blood Supply
The face is richly
vascular, it is supplied
by :
• The facial artery
• Transverse facial
•Arteries that
accompany the
cutaneous
nerves

28. Facial Artery
It is chief artery of
face It is branch of
external carotid
artery
Two parts of facial
artery-
1.Cervical part- runs
downwards in the
neck

29. Course-
•It enters the face by winding around
the base of the mandible, by
piercing th deep cervical fascia at
the antero- inferior angle of the
masseter muscle.
•First it runs upwards & forwards to a
point 1.25cm lateral to the angle of
the mouth.
•Then it ascends by the side of the
nose up to the medial angle of the
eye, where it terminates by
anastomosing with the dorsal nasal
branch of the ophthalmic artery.
e
s
•The facial artery is very tortuous.
Tortuosity of the artery prevents its
wall from being unduly stretched
during movement of mandible,lips &
the cheeks.
Massete
r
muscle
Facia
l
arter

30. Branches of facial part
1. Inferior labial –
- supplies lower lip
2. Superior labial-
- supplies the upper
lip & the anteroinferior
part of the nasal septum.
3. Lateral nasal-
- supplies to the ala
& dorsum of the nose.

31. Anastomoses
The large anterior
branches anastomoses
with similar branches of
the opposite side & with
the submental artery.
At the medial angle of the
eye terminal branches of
the facial artery
anastomoses with
branches of the
ophthalmic artery

32. Transverse facial Ar.
Branch of superficial
temporal artery.
•After emerging from the parotid
gland, it runs forward over the
masseter between the parotid duct
& zygomatic arch.
•Accompanied by the upper
buccal branch of facial nerve.
•It supplies the parotid gland & its
duct
,the masseter & overlying skin.

33. Venous Drainage of Face
The venous blood from the face
is drained by two veins-
1. Facial vein
2. Retromandibular vein
Facial Vein
Formation- it is the largest vein of
the face
• At the medial angle of the
eye by the union of
supratrochlear and
supraorbital veins, angular
vein is formed.

34. e
o
• Course- The angular
vein continues as the
facial vein , running
downwards and
backwards behind the
facial artery ,but with a
straighter course at
anteroinferior angl of
masseter.
• Here it pierces the deep
fasia, crosses superficial
to submandibular
gland and joins the
anterior division of
retromandibular vein
below the angle of the
mandible to form the
common facial vein,
which drains into the
internal jugular vein.

35. The facial vein
communicates with the
cavernous sinus
through the two routes:-
1. A communication between
the supraorbital and
superior ophthalmic vein.
2. Connection with the
pterygoid plexus through
the deep facial vein which
passes backward over the
buccinator
Facial vain – Deep facial vein
–pterygoid venous plexus–
Emissary vein –cavernous
sinus

36. Dangerous area of face
• Infection from face can spread in a retrograde direction and
cause thrombosis of the cavernous sinus.
• This is specially likely to occur in the presence of infection in the
upper lip
and in the lower part of the nose, this is known as dangerous area of
face.
• facial vein is connected to cavernous sinus through superior
ophthalmic vein & it provides a pathway for spread of infection from
face to cavernous sinus.

37. Blood Supply Of Face

38. NERVE
SUPPLY
Each half of face
has
Sensory
Branches of
Trigeminal
Nerve 5th
cranial nerve
Motor
Branches
of Facial
nerve
7th cranial
nerve

39. Sensory Nerves of the Face
• The skin of the face is
supplied by the
trigeminal nerve (V),
except for the small area
over the angle of the
mandible and the
parotid gland which is
supplied by the great
auricular nerve (C2 and
3).
• The trigeminal nerve
(V) divides into three
major divisions-the
ophthalmic (V1),
maxillary (V2), and
mandibular (V3)
nerves

40. Sensory Nerves of the
Face

41. Sensory Nerves of the Face

42. Testing the Integrity of the
Trigeminal Nerve
(temperature & pain)

43. Motor Nerves of the Face
• Motor supply:
– Facial nerve
• Facial nerve divides into
five terminal branches for
muscles of facial
expression:
– Temporal
– Zygomatic
– Buccal
– Marginal mandibular
– Cervical

45. Applied
• Trigeminal neuralgia
– Maxillary and mandibular nerve are involved
– Excruciating pain in the region of distribution of these nerve
• In infranuclear lesions of facial nerve (eg, bell’spalsy)-
whole face is paralyzed
– c/f
• Affected side is motionless
• Loss of wrinkles
• Eye cannot be closed
• In smiling the mouth is drawn to normal side
• During mastication food accumulates in vestibule of mouth

46. bell’spalsy

48. Facialnerve lesion ( Bell’s palsy)

49. Lymphatic Drainage of the
Face
The face has 3 lymphatic territories-
1. Upper territory- Preauricular (parotid)
nodes
Including:
• The greater part of the forehead
• Lateral halves of the eylids
• The conjunctiva
• Lateral part of the cheek
• Parotid area

50. Middle territory-
Submandibular
nodes
• Median part of the
forehead
• External nose
• Upper lip
• Lateral part of lower lip
• Medial halves of eyelids
• Medial part of cheek
• Greater part of the lower
jaw

51. Lower territory –
Submental nodes
• Central part of the
lower lip
• Chin

53. Read about
•Arterial supply of the face
•Venous drainage of the face
•Lymphatic drainage of the
face.