FACE, PALATE AND MANDIBLE

‘LEYE OLABIYI
CMUL
 OUTLINE
• FACE
– Definition/Boundaries
– Skin and Fascia
– Bones and Muscles
– Blood Supply / Lymphatic Drainage
– Innervation
• PALATE
• MANDIBLE
 Definition / Boundaries
• Structures in the anterior part of the head,
Significant part or identification. ‘Window of
the soul'
• Boundaries
– Superiorly; the hair line
– Inferiorly; the chin and base of mandible
– Laterally; the auricle
• Forehead is common to both scalp and face.
 Skin and Fascia
• SKIN
– Is Skin but, has many sebaceous and sweat
glands, Very Vascular
• Acne, Oily Face
– Hair follicles
• Male/Female Patterns
• Secondary sexual characteristics
• SUPERFICIAL FASCIA
– Loose (except at nose) no deep fascia.
– Muscles in superficial fascia
• Wounds gape
• Form the basic shape
Bones
• Function
– Provide attachments for
• Muscles that make the
jaw move
• Facial expressions.
• Discrepancies
• Consists of 14
stationary bones
and…...
Bones of the Face
 Muscles
• Develop from the 2nd pharyngeal arch
– Innervated by branches of the facial nerve [CN VII].
• Lie in the superficial fascia
– Origins; Bone/Fascia
– Insertions; Skin.
• Functions
– Facial expressions
– Sphincters and Dilators of orifices
• orbits, nose, and mouth
 Muscles (Cont’d)
• Orbital group

• Nasal group

• Oral group

• Other muscle groups

 Orbital group

• Two muscles are

– Orbicularis oculi
– Corrugator supercilii
 Orbicularis oculi
• 3 parts-
• Orbital part(outer)
– Originate from medial part of medial palpebral ligament and form concentric
rings, return to point of origin
Action –closes the lids tightly
• Palpebral part(Inner)
– Originate from lateral part of medial palpebral ligament
– Insert into lateral palpebral raphe
Action-closes the lids gently
• Lacrimal part(Small)
– Originate from lacrimal fascia& lacrimal bone
– Insert into upper &lower tarsi
Action-dilate lacrimal sac
Orbicularis oculi
 Corrugator supercillii
• Origin : superciliary
arch
• Insertion: skin of the
eyebrow
• Action: produces
vertical wrinkles of the
forehead in frowning
as an expression of
annoyance
 Nasal group
• Three muscles are
associated with the
nasal group:
– Nasalis
– Procerus
– Depressor septi nasi
 Compressor naris
• Origin: Frontal
process of the maxilla
• Insertion:
Aponeurosis which
crosses the bridge of
the nose
• Action: Compresses
the mobile nasal
cartilages
 Dilator naris
• Origin : Maxilla bone
• Insertion: Ala of the
nose
• Action: Widens the
nasal aperture (by
pulling the alar
laterally) in deep
inspiration; is also a
sign of anger
 Procerus
• Origin: nasal bone
and lateral nasal
cartilage
• Insertion: skin
between the eyebrows
• Action:
– pulls down the medial
end of the eyebrow
– wrinkles the skin of the
nose transversely in
frowning
 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
 Orbicularis oris
• Origin: from maxilla
above incisor teeth
• Insertion: into skin of
lip.
• Action: closes the
mouth
 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
– Aids in mastication by prevent accumulation of food in vestibule of
mouth.
– It is used every time air expanding the cheeks is forcefully expelled
 Other muscle groups
• They include:
– Platysma
– Auricular (anterior,
superior, and posterior
auricular muscles)
– Occipitofrontalis
 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.
 Blood Supply (Arterial)
• Highly vascular Supplied by both Carotids
– Extensive anastomoses of branches of both

• Internal Carotid
– Supraorbital, Supratrochlear, Infraorbital

• External Carotid
– Facial, Superficial temporal
Supraorbital Superficial
A. temporal
A.

Supratroch
lear A.

Buccal
A.

Infraorbital Facial
A.
A.
Mental
A.
• Facial External Carotid
– Extremely winding and
tortuous (skin moves).
Courses first medial to
mandible then lateral. • Superficial Temporal
– Site of Facial Pulse – One of terminal
branches, - arises
• Branches: anterior to External
– 1) Superior and Inferior auditory meatus.
Labial Arteries to – Many branches to scalp
upper and lower lips • Branches to face:
– 2) Angular Artery to • 1)Transverse Facial
nose and angle
(corner) of eye
Internal Carotid
 Venous Drainage
• Follow the Arteries
• No valves; drain to neck and into skull;
Extensive anastomoses between branches of
Facial & Ophthalmic Veins
• Infections can spread via veins (pressure low, no
valves)
• - Pass through orbit to Cavernous Sinus.
• Infections lateral to nose particularly dangerous
 Superficial
Maxillary V.
Temporal V.

Retro-
Mandibular V.

Anterior Posterior
devision devision
+ +
Post.auricular
Facial vein
V.
= =
I.J.V. Common facial External
vein Jugular vein
 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
Motor Innervation
 Ophthalmic
Sensory Innervation
n

Maxillary
n. Great
auricular
n.

Mandibular
n.
Sensory Nerves of the Face
Parotid L.N.
 Lymphatic Drainage
• Lateral part
– Parotid lymph nodes .
• Medial part
– Submandibular lymph nodes .
• Central part of lower lip +
chin
– Submental lymph nodes .
Mandible
 Introduction
• Bone of the lower jaw
• Part of the skeleton of the face (Largest,
strongest and only mobile bone of the face)
• Consists of
– curved horizontal portion – body
– 2 perpendicular parts – the rami
• Function
– Receives lower teeth
– Mastication
 Body
• 2 lateral parts united anteriorly in the median
plane
– Point of union is marked by a vertical ridge –
symphysis menti (SM)
• SM divides below to enclose a triangular eminence –
mental protuberence (MP) – a human characteristic
• It has
– 2 surfaces; external (lateral) and internal (medial)
– 2 borders/margins; Superior (alveolar) and inferior
40
 External Surface
• Marked anteriorly in the mid line by SM
– Splits inferiorly to mark the MP
• MP consists of 2 mental tubercles (MT) on either side of a
depression.
• Below the incisor is the incisive fossa
– Origin to mentalis and part of orbicularis oris
• Below the 2nd premolar midway btw the borders is the
mental foramen
– Mental vessels and nerve
• The oblique line runs MT to be continuous with the anterior
border of the ramus
– Quadratus labii inferioris, and Triangularis; the Platysma is attached
below it, the buccinator is attached to the posterior aspec
 Internal surface
• Concave from side to side.
• Near the lower part of the SM is is a pair of laterally placed spines -
mental spines,
– Origin to the Genioglossus.
• Immediately below these is a median ridge or impression
– Origin of the Geniohyoid
• Below the mental spines, are oval depressions – digastric fossae
– Attachment of the anterior belly of the Digastric.
• Extending upward and backward on either side from the lower part of
the symphysis is the mylohyoid line
– Origin to Mylohyoid
– The posterior part of this line, near the alveolar margin, gives attachment to
a small part of the Superior Constrictor and the pterygomandibular raphé.
• Above the anterior part of this line is a smooth triangular area against
which the sublingual gland rests, and below the posterior part, an oval
fossa for the submandibular gland.
43
 Borders
• The superior or alveolar border, wider behind
than in front, is hollowed into cavities, for the
reception of the teeth.
– To the outer lip of the superior border, on either
side, the Buccinator is attached as far forward as
the first molar tooth.
• The inferior border is rounded, longer than
the superior, and thicker in front than behind;
at the point where it joins the lower border of
the ramus (Angle) a shallow groove; for the
external maxillary artery, may be present.
 Ramus
• Quadrilateral
• Has;
• 2 surfaces
– Lateral and Medial
• 4 borders
– Upper, Lower, Anterior and Posterior
• 2 processes
– Coronoid anteriorly, Condyloid Posteriorly
 Borders
• Lower border; is thick, straight, and continuous with the inferior
border of the body
• At its junction with the posterior border is the angle of the
mandible, which may be either inverted or everted and is marked
by rough, oblique ridges on each side, for the attachment of the
Masseter laterally, and the medial Pterygoid medially;
• The stylomandibular ligament is attached to the angle between
these muscles.
• Anterior border is thin above, thicker below, and continuous with
the oblique line.
• Posterior border is thick, smooth, rounded, and covered by the
parotid gland.
• Upper border is thin, and has two processes, the coronoid in
front and the condyloid behind, separated by a deep concavity,
the mandibular notch.
 Surfaces
• Lateral surface is flat and marked by oblique ridges at its lower
part;
– Attachment throughout nearly the whole of its extent to the
Masseter.
• Medial surface has its center the oblique mandibular foramen
(MF)
– Inferior alveolar vessels and nerve.
• The margin of the MF has a prominent ridge - the lingula
– Attachment to the sphenomandibular ligament
• At its lower and back part is a notch from which the mylohyoid
groove runs obliquely downward and forward, and lodges the
mylohyoid vessels and nerve.
• Behind this groove is a rough surface, for the insertion of the
 Coronoid Processes
• Thin, triangular eminence, which is flattened from side to side
• Its anterior border is convex and is continuous below with the
anterior border of the ramus;
• its posterior border is concave and forms the anterior
boundary of the mandibular notch.
• Its lateral surface is smooth, and affords insertion to the
Temporalis and Masseter.
• Its medial surface gives insertion to the Temporalis, and
presents a ridge which begins near the apex of the process
and runs downward and forward to the inner side of the last
molar tooth. Between this ridge and the anterior border is a
grooved triangular area, the upper part of which gives
attachment to the Temporalis, the lower part to some fibers
 Condyloid Process
• consists of two portions: the condyle, and the constricted portion which
supports it, the neck.
• The condyle has an articular surface for articulation with the articular
disk of the temporomandibular joint; it is convex from before backward
and from side to side, and extends farther on the posterior than on the
anterior surface. Its long axis is directed medially and slightly backward,
and if prolonged to the middle line will meet that of the opposite condyle
near the anterior margin of the foramen magnum.
• At the lateral extremity of the condyle is a small tubercle for the
attachment of the temporomandibular ligament.
• The neck is flattened from before backward, and strengthened by ridges
which descend from the forepart and sides of the condyle. Its posterior
surface is convex; its anterior presents a depression for the attachment of
the Lateral Pterygoid.
 Mandible
• alveolar processes house the mandibular teeth
• mental foramina- inf to 2nd PM – n & vessels
• mandibular symphysis- unite the 2 halves of fetal
mandible
• mental protuberance- triangular elevation inf to
mand symphysis

50
Palate
 PALATE
• Forms the concave roof of the oral cavity proper
but, also forms the floor of the nasal cavity
• Consists Of 2 Regions
– Hard Palate
• Located Anterioly, Hard, Made Of Bone
– Soft Palate
• Located Posterioly, Made Of Muscle
• Play Important Role In Swallowing
– Hard Palate
• Food Is Pushed Against It
– Soft Palate
• Closes The Nasopharynx During Swallowing
 HARD PALATE
• Formed By
– Palatine Process Of The Maxilla
– Horizontal Plates Of The Palatine Bones
• Bounded
– Anterioly And Laterally by Alveolar Arches and
Gums
– Posterioly; Continuous With The Soft Palate
• Covered In Fibrous Tissue Formed By
– Periosteum and Mucous Membrane
• It Has A Median Raphe that ends In A Papilla
Overlying The Incisive Foramen
• On Either Sides Of The Median Raphe
– Anterioly
• Corrugated
– Posterioly
• Smooth
• Posterior ½ Has Palatine Mucous Glands
– Between Periosteum And Mucous Membrane

• Covered With
– Keratinized Stratified Squamous Epithelium
 SOFT PALATE
• The Posterior Part Of The
– Roof Of The Oral Cavity Proper
– Floor Of The Nasal Cavity
• Suspended From
– Posterior Border Of The Hard Palate
• Extends
– Downwards And Backwards
– Between The Nasal And Oral Parts Of The Pharynx
• Consists Of
– An Aponeurosis
– Covered By A Fold Of Mucous Membrane
– Muscle Fibers
 POSTERIOLY,
• A Small Conical Process Hangs At Its Midline
– Uvula
• 2 Pairs Of Curved Fold Of Mucuous Membrane
– Extends Downwards And Laterally From Each Side
– The Anterior
• Contains Palatoglossus
• Called Palatoglossal Arch
– The Posterior
• Palatopharyngeal Arch
• Epithelium
– Stratified Squamous
– Upper Part Of The Posterior Surface
• Ciliated Columnar
 MUSCULATURE
ACTION
Levator veli palatini Elevates soft palate
Tnsor veli palatini Together; tightens it
Singly; move it
Musculus uvulae Pulls up and contract
the uvula
Palatoglossus Pulls up the root of the
tongue
Close of the oral cavity
from the oropharynx
palatopharyngeus Shorten the pharynx
during swallowing

Nerve supply. All except tensor veli palatini (mandibular nerve) are
supplied by fibers which leave the MO with cranial accessory and
reach the pharyngel plexus via X
 BLOOD SUPPLY, LYMPHATICS AND NERVES

• Arteries
– Greater Palatine Branch Of Maxillary
– Ascending Palatine Branch Of Facial
– Palatine Branch Of Ascending Pharyngeal
• Veins
– End Mainly In The Pterygoid And Tonsilar Plexuses
• Lymphatics
– Deep Cervical Nodes
• Sensory
– Greater Palatine
– Lesser Palatine
– Nasopalatine