The Face

The Face
 Skin of the Face
 possesses numerous
sweat and sebaceous
glands.
 connected to underlying
bones by loose
connective tissue, in
which are embedded the
muscles of facial
expression.
 No deep fascia is
present in the face.
 Wrinkle lines of the face result
from the repeated folding of
the skin perpendicular to the
long axis of the underlying
contracting muscles, coupled
with the loss of youthful skin
elasticity.

 Surgical scars of the face are

less conspicuous if they follow
the wrinkle lines.
 Sensory Nerves of the Face
 The skin of the face is
supplied by branches of
the three divisions of
the trigeminal nerve
 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).
 There is overlap of the
three divisions of the
trigeminal nerve
 Sensory Nerves of the Face
 The ophthalmic nerve supplies
the region developed from the
frontonasal process

 the maxillary nerve serves the

region developed from the
maxillary process of the first
pharyngeal arch

 the mandibular nerve serves

the region developed from the
mandibular process of the first
pharyngeal arch.
 Sensory Nerves of the Face
 These nerves not only supply the skin of
the face, but also supply proprioceptive
fibers to the underlying muscles of facial
expression.
 They are, in addition, the sensory nerve
supply to the mouth, teeth, nasal cavities,
and paranasal air sinuses.
 Ophthalmic Nerve
 Five branches of the nerve
pass to the skin.

 lacrimal nerve supplies the

skin and conjunctiva of the
lateral part of the upper
eyelid

 supraorbital nerve winds

around the upper margin of
the orbit at the supraorbital
notch.
 Ophthalmic Nerve
 supratrochlear nerve winds
around upper margin of orbit
medial to supraorbital nerve.

 infratrochlear nerve leaves

the orbit below pulley of
superior oblique muscle.

 external nasal nerve leaves

the nose by emerging between
nasal bone and upper nasal
cartilage.
 Maxillary Nerve
 Three branches of the nerve
pass to the skin.
 infraorbital nerve is a direct
continuation of maxillary nerve.
It enters the orbit and appears
on face through infraorbital
foramen.
 zygomaticofacial nerve
passes onto the face through a
small foramen on the lateral
side of the zygomatic bone.
 zygomaticotemporal nerve
emerges in the temporal fossa
through a small foramen on the
posterior surface of the
zygomatic bone.
 Mandibular Nerve
 Three branches of the nerve
pass to the skin.
 mental nerve emerges from
the mental foramen of the
mandible
 buccal nerve emerges from
beneath the anterior border
of the masseter muscle
 auriculotemporal nerve
ascends from upper border of
parotid gland between the
superficial temporal vessels
and auricle.
 Arterial Supply of the Face
 The face receives a
rich blood supply from
two main vessels: the
facial and superficial
temporal arteries,
which are
supplemented by
several small arteries
that accompany the
sensory nerves of the
face.
 The facial artery
 arises from the external carotid artery
 Having arched upward and over submandibular
salivary gland, it curves around the inferior
margin of the body of the mandible at the
anterior border of the masseter muscle.
 The facial artery
 It runs upward in a tortuous course toward angle of
the mouth and is covered by platysma and risorius
muscles.
 It then ascends deep to zygomaticus muscles and
levator labii superioris muscle and runs along side of
nose to medial angle of eye, where it anastomoses
with terminal branches of ophthalmic artery
 Branches of facial artery

 submental artery arises

from the facial artery at the
lower border of the body of
the mandible.

 inferior labial artery arises

near the angle of the mouth.

 superior labial artery

arises near the angle of the
mouth.

 lateral nasal artery arises

from facial artery alongside
nose.
 Other arteries of face
 superficial temporal artery: smaller terminal branch of external
carotid artery, commences in the parotid gland. It ascends in front of
the auricle to supply the scalp
 transverse facial artery: a branch of the superficial temporal
artery, arises within the parotid gland. It runs forward across the
cheek just above the parotid duct
 supraorbital and supratrochlear arteries, branches of the
ophthalmic artery, supply the skin of the forehead
 Venous Drainage of the Face

 facial vein is formed at medial angle of eye by union of

supraorbital and supratrochlear veins
 It is connected to superior ophthalmic vein directly
through supraorbital vein.
 By means of superior ophthalmic vein, facial vein is
connected to cavernous sinus
 facial vein descends behind facial artery to lower margin
of body of the mandible.
 It crosses superficial to submandibular gland and is
joined by anterior division of retromandibular vein.
 facial vein ends by draining into the internal jugular vein.
 Tributaries of facial vein

 The facial vein receives tributaries that correspond to

the branches of the facial artery.
 It is joined to the pterygoid venous plexus by the
deep facial vein and to the cavernous sinus by the
superior ophthalmic vein.
 The transverse facial vein joins the superficial
temporal vein within the parotid gland.
 Lymph Drainage of the Face

 Lymph from the forehead and the anterior part

of the face drains into the submandibular lymph
nodes
 A few buccal lymph nodes may be present
along the course of these lymph vessels.
 The lateral part of the face, including the lateral
parts of the eyelids, is drained by lymph vessels
that end in the parotid lymph nodes.
 The central part of the lower lip and the skin of
the chin are drained into the submental lymph
nodes.
 Bones of the Face

 The superior orbital margins and the

area above them are formed by the
frontal bone, which contains the
frontal air sinuses.
 The lateral orbital margin is formed
by the zygomatic bone
 the inferior orbital margin is formed
by the zygomatic bone and the
maxilla.
 The medial orbital margin is formed
above the maxillary process of the
frontal bone and below by the frontal
process of the maxilla.
 The root of the nose is formed by the
nasal bones, which articulate below
with the maxilla and above with the
frontal bones.

 The important central bone of the

middle third of the face is the
maxilla, containing its teeth and the
maxillary air sinus.

 The bone of the lower third of the

face is the mandible, with its teeth.
Muscles of the Face (Muscles of Facial Expression)

 The muscles of the face are embedded in the superficial

fascia, and most arise from the bones of the skull and are
inserted into the skin
 The orifices of the face, namely, the orbit, nose, and mouth,
are guarded by the eyelids, nostrils, and lips, respectively.
 It is the function of the facial muscles to serve as sphincters
or dilators of these structures.
 A secondary function of the facial muscles is to modify the
expression of the face.
 All the muscles of the face are developed from the second
pharyngeal arch and are supplied by the facial nerve.
 Muscles of the Eyelids

 The sphincter muscle orbicularis oculi

 dilator muscles are the levator palpebrae
superioris and the occipitofrontalis
 Muscles of the Nostrils

 The sphincter muscle is the compressor

naris and the dilator muscle is the dilator
naris
 Sphincter Muscle of the Lips:
Orbicularis Oris
 Origin and insertion: The fibers encircle the oral orifice within the
substance of the lips

 Some of the fibers arise near the midline from the maxilla above
and the mandible below

 Other fibers arise from the deep surface of the skin and pass
obliquely to the mucous membrane lining the inner surface of the
lips.

 Many of the fibers are derived from the buccinator muscle.

 Nerve supply: Buccal and mandibular branches of the facial nerve

 Action: Compresses the lips together

 Dilator Muscles of the Lips
 The dilator muscles radiate out from the lips, and
their action is to separate the lips
 The muscles arise from the bones and fascia around
the oral aperture and converge to be inserted into the
substance of the lips.
 the muscles are named as follows:
1. Levator labii superioris alaeque nasi
2. Levator labii superioris
3. Zygomaticus minor
4. Zygomaticus major
5. Levator anguli oris
6. Risorius
7. Depressor anguli oris
8. Depressor labii inferioris
9. Mentalis
 Nerve Supply Buccal and mandibular branches of the
facial nerve
Muscle of the Cheek (Buccinator)

 Origin: From the outer surface of the alveolar margins of the

maxilla and mandible opposite the molar teeth and from the
pterygomandibular ligament
 Insertion: The muscle fibers pass forward, forming the
muscle layer of the cheek. The muscle is pierced by the
parotid duct. At the angle of the mouth the central fibers
decussate, those from below entering the upper lip and those
from above entering the lower lip; the highest and lowest
fibers continue into the upper and lower lips, respectively,
without intersecting. The buccinator muscle thus blends and
forms part of the orbicularis oris muscle.
 Nerve supply: Buccal branch of the facial nerve
 Action: Compresses the cheeks and lips against the teeth
 Facial Nerve

 As the facial nerve runs forward within the substance of the

parotid salivary gland, it divides into its five terminal branches

 temporal branch emerges from the upper border of the gland

and supplies the anterior and superior auricular muscles, the
frontal belly of the occipitofrontalis, the orbicularis oculi, and
the corrugator supercilii.

 The zygomatic branch emerges from the anterior border of

the gland and supplies the orbicularis oculi.
 buccal branch emerges from the anterior border of the gland
below the parotid duct and supplies the buccinator muscle and
the muscles of the upper lip and nostril.

 mandibular branch emerges from the anterior border of the

gland and supplies the muscles of the lower lip.

 cervical branch emerges from the lower border of the gland

and passes forward in the neck below the mandible to supply
the platysma muscle; it may cross the lower margin of the
body of the mandible to supply the depressor anguli oris
muscle.
 Facial palsy(bells palsy)
 Trigeminal neuralgia
 Face development
Cleft