Face
&
scalp
Vanessa Restrepo Esquivel
Perla Zuriel Santiago Galindo
Grupo 101
Límits
Muscles of the face
Orbital group
Orbicularis oculi
-Consists of:
•orbital part: Closes the eye more forcefully
•palpebral part: Closes eye gently
•Lacrimal part: deep, attaches to bone posterior to the lacrimal sac of the lacrimal apparatus in the
orbit.
Corrugator supercilii
-Active when frowning. It draws the eyebrows toward the midline, causing vertical wrinkles
above the nose.
Nasal group
Nasalis
-Constists of:
•transverse part:compresses nasal aperture
•alar part: dilator naris
Procerus
-Superficial to the nasal bone
-Draws the medial border of the eyebrows downward
to produce transverse wrinkles over the bridge of the
nose. Frown
Depressor septi nasi
-Pulls the nose inferiorly, so assisting the alar part of
the nasalis in opening the nares.
Oral group
Orbicularis Oris
-Narrows the mouth and closes and protrudes the lips.
Buccinator
- Muscular component of the cheeks
- Its contraction presses the cheek against teeth so in mastication it
prevents food from acumulating between the teeth and the cheek.
-Forceful expulsion of air from the cheeks
Lower group of oral muscles
Depressor anguli oris
-Draws corner of mouth down and laterally
Depressor labii inferioris
- Draws lower lip downward and laterally
Mentalis
- Raises and protrudes lower lip as it wrinkles skin on chin.
Used when drinking
Upper group of oral muscles
Risorius
- Retracts corner of mouth laterally and in upward direction
Zygomaticus major
- Draws the corner of the mouth upward and laterally
Zygomaticus minor
- Draws the upper lip upward
Levator labii superioris
- Raises upper lip; helps form nasolabial furrow
Levator labii superioris alaeque nasi
- Raises upper lip and opens nostril
Levator anguli oris
- Raises corner of mouth; helps form nasolabial furrow
Other muscles
*Not in the area defined as the face, but derived from the second pharyngeal arch and innervated
by the facial nerve [VII], are considered muscles of facial expression.
Platysma
- Tenses the skin of the neck and
can move the lower lip and corners
of the mouth down
Auricular
- They are three
posterior
anterior
superior
- Move ears
Occipitofrontalis
- Frontal belly: Wrinkles forehead;
raises eyebrows
- Occipital belly: Draws scalp backward
The frontal belly is innervated by temporal
branches of the facial nerve [VII] and the
posterior belly by the posterior auricular
branch.
mastication (chewing) muscles
Innervation
•the trigeminal nerve [V] innervates facial structures
derived from the first arch
•the facial nerve [VII] innervates facial structures
derived from the second arch
Sensory innervation
Braches of Trigeminal nerve (V)
•Ophtalmic nerve (V1)
•Maxillary nerve (V2)
•Mandibular nerve (V3)
Motor innervation
Second pharyngeal arch
Facial nerve (VII)
POSTERIOR BRANCHES
-Exits the posterior cranial fossa through
the internal acoustic meatus
-Passes through the temporal bone gives
braches.
-Emerges from the base of the skull
through the stylomastoid foramen -->
posterior auricular nerve
•Gives one branch to digastris muscle:
Digastric branch
ANTERIOR BRANCHES
Parotid gland gives two braches temporofacial and cervicofacial braches (parotid Plexus)
•Temporal: superior border of the parotid
gland- supply muscles in the area of the
temple, forehead, and supra-orbital area
Temporal
•Zygomatic: anterosuperior border of the
parotid gland- infra-orbital area, the lateral
nasal area, and the upper lip
•Buccal: anterior border of the parotid gland-
Zy
go ma cheek, the upper lip, and the corner of the
t ic mouth
Bu •Marginal mandibular branches:
cca
Cervical
l anteroinferior border of the parotid gland-
lower lip and chin
M nd
m
a r ibu
a
gi la
na r
•Cervical branches: inferior border of the
l
parotid gland- platysma
Blood supply
Arteries
-Primarily from branches of the
external carotid artery
-Branch of the internal carotid
artery.
Veins
-Most of the venous return is back
to the internal jugular vein
-Intracranial pathway involving the
cavernous sinus.
Arteries
Facial Artery
•Branch of the external carotid
artery,
•Curving around the inferior
border of the mandible just
anterior to the masseter, here
enter to the face.
•Terminates as the angular
artery at the medial corner of
the eye.
•Braches of the facial artery
• inferior labial branch
• superior labial branch
• lateral nasal branch
Braches of the maxillary artery
•Branch of the external carotid
artery,
•Infra-orbital artery
•Buccal artery
•Mental artery
Transversal facial Artery
•Branch of the superficial
temporal artery,
•Passes through the gland, and
crosses the face in transverse
direction
•Ly on the superficial surface of
the master muscle.
Braches of the ophthalmic artery
•Branch of the internal carotid
artery, afer the ophthalmic artery
enters the orbita gives:
•Zygomaticofacial and
Zygomaticotemporal
come from the lacrimal branch.
•Dorsal nasal artery
•Exits the orbit in the medial
corner.
Veins
Facial Vein
•Origin is near the medial corner
of the orbit as the supratrochlear
and supra- orbital veins come
together to form the angular vein.
• Enters the internal jugular vein.
Transverse facial Vein
•Accompanies the artery
•It emoeties into the superficial
temoral vein within the substance
of the paratid gland
Intercranial Venous connections
Has numerous connections with venous
channels passing into deeper regions of
the head.
• Ophthalmic veins
Communicates with veins passing into the
infra-orbital foramen and deeper regions
of the face
Interconnections with the intracranial
cavernous sinus through emissary veins
that connect intracranial with extracranial
veins.
*There are no valves.
SCALP
Hair
-First three layers form a single unit:
referred to as the scalp proper and is the
tissue torn away during serious
"scalping" injuries.
Skin
-the outer layer of the scalp.
Connective tissue (dense)
- Anchors the skin to the third layer
- Arteries, veins, and nerves supplying the
scalp.
Aponeurotic layer
-Consists of the occipitofrontalis muscle and
epicranial aponeurosis (galea aponeurotica)
Loose connective tissue
-Facilitates movement of the scalp
over the calvaria.
*Because of its consistency,
infections tend to localize and spread
through it
Pericranium
-Periosteum on the outer surface of
the calvaria.
-Attached to the bones of the
calvaria, but is removable, except in
the area of the sutures.
Innervation
Sensory innervation: cranial nerves or cervical nerves, depending on whether it is anterior or
posterior to the ears and the vertex of the head.
Anterior to the ears and the vertex
Branches of Trigeminal nerve [V]:
• Supratrochlear:
• Supra-orbital:
• Zygomaticotemporal
• Auriculotemporal
Posterior to the ears and the vertex
Is by cervical nerves from C2 and C3.
Branches:
Anterior
• Great auricular nerve
• Lesser occipital nerve
Posterior
• Greater occipital nerve
• Third occipital nerve
Vessels
Arteries
Branches of either the external carotid artery or the ophthalmic artery, which is a branch
of the internal carotid artery.
Branches from the ophthalmic artery
The supratrochlear and supra-orbital arteries
*anterior and superior aspects of the scalp
*posteriorly as the vertex of the head.
Branches from the external carotid artery
• Posterior auricular artery
• Occipital artery
• Superficial temporal artery
Veins
Veins draining the scalp follow a pattern
similar to the arteries:
• The supratrochlear and supra-orbital
Ophthalmic
Angular vein
Facial vein
•Superficial temporal vein
Retromandibular vein
• Posterior auricular vein
Retromandibular vein
• Occipital vein
Plexus of veins in the suboccipital
triangle
Lymphatics
Pattern of arterial distribution
Lymphatic drainage of the scalp
generally follows the pattern of arterial
distribution.
Occipital nodes:
Trapezius muscle at the base of the skull
To upper deep cervical nodes.
Mastoid nodes :
Retro-auricular/posterior auricular nodes
Cervical nodes
Pre-auricular and parotid nodes:
To the ear on the surface of the parotid
nodes
Submandibular nodes:
Forehead medial part of the lower lip and chin bilaterally
medial corner of the orbit
most of the external nose
medial part of the cheek
upper lip most of the eyelids, a part of the external nose,
lateral part of the lower lip and the lateral part of the cheek
Clinic
Bell’s palsy
-Facial nerve
-Passes through internal acoustic meatus, temporal bone and emerges from stylomastoid foramen.
-Can affect
Orbicularis oculi
Buccinator
Orbicularis oris
Sphincters and dilators
-May me caused my damaging of:
Greater petrosal major
Slylomastoid foramen
Temporal bone
Or may be idiopathic
Trigeminal neuralgia (tic douloureux)
-Sensory root of the trigeminal nerve
-Pain: regin of mandibular [V3] and maxillary [V2] nerves
-Excruciating
-May be triggered by touching a sensitive region of skin.
Clinic
Scalp laceration
-Bleed profusely, predominantly arterial, because:
in the erect position the venous pressure is extremely low
vessels do not retract when lacerated because the connective tissue in which they are found prevents
retraction.
Pulse points
Facial pulse
- facial artery
- inferior border of the mandible immediately
adjacent to the anterior margin of masseter
muscle
Temporal pulse
- superficial temporal artery
- anterior to the ear and immediately
posterosuperior to the position of the
temporomandibular joint
Temporal pulse
- anterior branch of the superficial temporal
artery
-posterior to the zygomatic process of the
frontal bone
Carotid pulse
-the common or external carotid artery.
*common carotid artery posterolateral to the
larynx *the external carotid artery lateral to the
pharynx midway
