Dr. Devi

1. Sensory Innervation of the Face
& Muscles of Facial Expression
08-04-2019

2. 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.

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

4. • Laxity of skin facilitates
rapid spread of
oedema
• Renal oedema appears
first in the eye lids and
face before spreading
to other parts of the
body
• Boils in the nose and ear
acutely painful due to the
fixity of the skin to the
underlying cartilages
• Facial skin is very elastic
and thick because the
facial muscles are inserted
into it. The wounds of the
face therefore tend to
gape

5. Superficial fascia
• It contains
1. Facial muscles
2. Vessels and nerves
3. Fat
• Deep fascia is absent in face (except parotid
gland and buccinators muscle)

6. Face
• Muscle of facial
expression lie in
superficial fascia
(subcutaneous).
• Embryologically they
develop from
mesoderm of 2nd
branchial arch,
therefore supplied by
facial nerve.
• No deep fascia is
present in the face.

7. Bones of the Face
• The facial skeleton
consists of 14 stationary
bones and the mandible.
• These 14 bones form the
basic shape of the
face, and are responsible
for providing attachments
for muscles that make the
jaw move and control
facial expressions.

8. Bones of the Face

9. Muscles of the Face
(Muscles of Facial Expression)
• They are in the superficial fascia, with origins
from either bone or fascia, and insertions into the
skin. (subcutaneous muscles)
• 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).

11. Muscles of the Face

12. Muscles of the Face
1. Muscle of scalp
2. Muscles of the
eyelids (Orbital
group)
3. Muscle of auricle
4. Muscles of nose
(Nasal group)
5. Muscles around
mouth (Oral group)
6. Muscles of neck

13. Muscles of scalp
occipitofrontalis
• Two bellies
• Occipitalis / frontalis
• Both inserted into epicranial aponeurosis
• Occipital belly arises from lateral two thirds
of superior nuchal lines
• Frontalis belly arises from skin of forehead

15. Action of frontalis : surprise, frightening

16. Orbital group
• Three muscles are
– Orbicularis oculi
– Corrugator supercili
– Levator palpebrae
superioris

17. Orbicularis oculi
• 3 parts-
• Orbital part(outer)
– Originate from medial part of medial palpebral ligament and
adjoining bone.
– Insertion- form concentric rings, return to point of origin
Action –closes the lids tightly, wrinkling
• Palpebral part(Inner)
– Originate from lateral part of medial palpebral ligament
– Insert into lateral palpebral raphe
Action-closes the lids gently, blinking
• Lacrimal part(Small)
– Originate from lacrimal fascia& lacrimal bone
– Insert into upper &lower eyelids
Action-dilate lacrimal sac, support lower eye lid

18. Orbicularis oculi

21. Orbicularis oculi
Palpebral part Orbital part

22. Orbicularis oculi

23. Actions : • Acts as sphincter of the eyelid
• Palpebral part closes the eyelid gently in
sleep or blinking
• Movement-reflexly oriented or voluntarily
mediated
• Contraction of entire muscle-crow feet
appearance
• Lacrimal part –transport lacrimal fluid

24. Corrugator supercillii
• Origin : superciliary arch
• Insertion: skin of the
eyebrow
• Action: produces vertical
wrinkles of the forehead
in frowning as an
expression of annoyance

26. 26

27. levator palpabrae superioris
• Origin: lesser wing
of sphenoid bone
• Insertion : upper
eyelid
• Function : lid
elevation

28. Nasal group
• Three muscles are
associated with the
nasal group:
– Compressor naris
– Dilator naris
– Procerus
– Depressor septi nasi

29. Compressor naris
• Origin: Frontal process
of the maxilla
• Insertion: Aponeurosis
which crosses the bridge
of the nose
• Action: Compresses the
mobile nasal cartilages

30. 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

31. 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

36. Depressor septi
• Origin : maxilla above central incisor
• Insertion : mobile part of nasal septum
• Action : depress the nasal septum,
expression of anger acts along with dilator
naris

37. 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

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

39. 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
• Action : whistling along with orbicularis oris

40. Levator labii superioris alaque nasi
o Arises- frontal process of
maxilla near nasal
o Inserted-ala of the nose
by one slip
o To skin of upper lip by
another slip
o Action-elevates and
everts the upper lip and
dilates the nostril

41. Depressor anguli oris
Arises-posterior part of the
oblique line of the mandible
inserted-angle of mouth
Extends further into the skin of
upper lip upto the midline
Action-draws the angle of
mouth downward and laterally
,expression-sadness , grief

44. Levator labii superioris
• Arises-lower margin of orbit
Just above the infraorbital foramen
• Inserted-upper lip
• Action-elevates and everts the upper lip increase the
nasolabial furrow, sadness

45. Zygomaticus major
• Arises-zygomatic bone
• Inserts- angle of
mouth
• Action-draws angle of
mouth upward and
laterally as in laughing
- smiling and laughing
• Spasm- risus
sardonicus

47. Zygomaticus minor
• Small muscle
• Extending from zygomatic bone to the upper
lip
• Action-elevates and everts the upper lip
increase the nasolabial furrow

49. Depressor
labii
inferioris
• Muscle attached to lower lip
• Arises-oblique line of mandible
• Quadrilateral sheet
• Inserted into skin of lower lip
Action-it draws the lower lip
downward and laterally
Expression-irony

50. Levator anguli oris
• Arises-maxilla, below the infra orbital
foramen
• Inserted-angle of mouth
• Intermingle with other muscles
• Extends further into skin of lower lip up to
midline

51. • Action-raises the angle of mouth
• Accentuates the nasolabial furrow
• Expression of sadness

52. Risorius
• Arises-parotid fascia, as a continuation of
posterior fibers of platysma
• Insert-angle of mouth
• Action-retract the angle of mouth as in
grinning

53. Mentalis
• Muscle of chin
• Conical in shape
• Arises-incisive fossa
• Insert-skin of chin
• Action-puckers the chin
• Protrudes the lower lip in
drinking
• Expression of disdain

55. Muscles of auricle
• Auricularis anterior
• Auricularis posterior
• Auricularis superior
 Functionally unimportant
 Insert into epicranial aponeurosis

56. Muscles of neck
• They include:
– Platysma

57. 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.

58. Action : terror,
fright, horror

59. Muscles of the Face

61. 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

62. Sensory Nerves of the Face

63. Sensory Nerves of the Face

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

65. 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

66. Frontalis, auricular
muscles, orbicularis
oris
Orbicularis
oculi
Muscles of cheek
and upper lip
Muscles of lower lip
platysma

67. Applied Anatomy
• 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’s palsy)- 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

68. bell’s palsy

70. Facial nerve lesion ( Bell’s palsy )

71. Arteries of face
1. Facial artery
2. Transverse facial artery
3. Arteries that accompany cutaneous nerves

72. Facial artery
• Enters the
face by
winding
around the
base of the
mandible
• By piercing
the deep
cervical fascia
at the
anteroinferior
angle of the
masseter
muscle

74. • Runs upwards and forwards to a point 1.25
cm lateral to the angle of the mouth
• Then it ascends by the side of the nose up to
the medial angle of the eye , terminates by
supplying lacrimal sac, anastomosing with
the dorsal nasal branch of the ophthalmic
artery

76. • It lies between superficial and deep muscles
of the face
• Branches :
1. Inferior labial
2. Superior labial
3. Lateral nasal
• Posterior muscular branches- small and
unnamed
Anterior branches

77. Transverse facial artery
• Branch of superficial artery
• After emerging from parotid gland, it runs forwards over th
masseter between the parotid duct and zygomatic arch
• Supplies parotid and its duct , masseter and overlying skin
an ends by anastomosing with neighbouring arteries

78. Veins of face
• Veins on each side
forms a W-shaped
arrangement
• Facial vein is the largest
• Begins as angular vein
at the medial angle
• Continues as facial vein
• Joins with
retromandibular vein
(ant divi) forms
common facial vein

79. • Facial vein communicates with cavernous sinus ;
infections from face can spread in a retrograde direction
and can cause thrombosis of the cavernous sinus .
• This is specifically likely to occur in the presence of
infection in the upper lip and in the lower part of the
nose
• This area is called the dangerous area of the face

80. Lymphatic drainage of face
• Pre-auricular parotid
• Submandibular: strip over the median part of
forehead, external nose, upper lip, lateral
part of lower lip, medial halves of eyelids,
medial part of cheek and greater part of
lower jaw
• Submental: central part of lower lip, chin

82. Glands
• Labial glands
• Buccal glands
• Molar mucous glands