Face
By belilo
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
Skin
Very vascular
Due to rich vascularity face blush and blanch
Wounds of face bleed profusely but heal rapidly
Results of plastic surgery are excellent on face
Facial skin is rich in sebaceous gland and sweat gland
Sebaceous gland keep the skin oily but also cause
acne in adult
Sweat gland regulate body temperature
Facial muscle
Called muscle of facial expression and lie in
superficial fascia
Embryologically they develop from mesoderm of
2nd branchial arch, therefore supplied by facial
nerve
Orbicularis oculi
3 parts-
Orbital part
Originate from medial part of medial palpebral ligament and form
concentric rings, return to point of origin
Action –closes the lids tightly
Palpebral part
Originate from lateral part of medial palpebral ligament
Insert into lateral palpebral raphe
Action-closes the lids gently
Lacrimal part
Originate from lacrimal fascia& lacrimal bone
Insert into upper &lower tarsi
Action-dilate lacrimal sac
Orbicularis auris
Originate from maxilla above incisor teeth and
insert 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- prevent accumulation of
food in vestibule of mouth
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
Nerve supply of face
Motor supply
Facial nerve
Sensory supply
Ophthalmic division
Supratrochlear
Supraorbital
Lacrimal
Infratrochlear
External nasal
Maxillary nerve
Infraorbital
Zygomaticofacial and
zygomaticotemporal
Mandibular nerve
Auriculotemporal
Buccal nerve
Mental
Skin over the mandibular angle is supplied
by ant. Div. Of greater auricular n.
Blood supply of face
Arterial supply-
Facial artery
Superficial temporal
artery
Ophthalmic artery
Supraorbital and
Supratrochlear
Venous drainage
Vein follow the arteries and
drain into common facial vein
and retromandibular vein
Deep connections of facial vein-
Communication between
supraorbital &superior
ophthalmic vein
With pterigoid plexus of vein
through deep facial vein.
Superior ophthalmic vein &
ptergoid plexus of vein
communicate with cavernous
sinus
Lymphatic drainage
3 territories-
Upper territories- greater part of
forehead, lateral ½ of eye lid,
conjunctiva, lateral part of cheek
and parotid area– preauricular
lymph node (parotid)
Middle territories- median part of
forehead, external nose, upper lip,
lateral part of lower lip, medial ½ of
eye lid, medial part of cheek,
greater part of lower jaw–
submandibular lymph node
Lower territories- central part of
lower lip, chin– sub mental lymph
node
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’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
In supranuclear lesions of facial nerve only the lower part of
face is paralyzed. The upper part (frontalis &part of orbicularis
oculi) escapes due to its bilateral innervation
Dangerous area of
face- infections from
face mainly from
upper lip & nose
can go to cavernous
sinus through
ophthalmic vein and
deep facial vein
