Anatomy of

The Face and the Mouth

Naser Albarbari
FRACDS, AFACHSE,MOMS RCPS
Glasgow, MFDS RCS Ireland,
MSc Oral & Max Fax Surg, BDS

Zygomatic Arch

-Starts at the lateral wall of the Orbit to the
External Auditory Meatus

Superficial during it s Course

Beneath the posterior part of the Zygoma ,
in front of the Tragus is the Head of the
mandible

Superior and inferior Orbital foramen

Mastoid

Superior Nuchal Line

External Occipital Protuberance

C1 C6

Spinous Process of the 7th Cervical
Vertebrae and TI

Transverse of Atlas is a fingertip between
the angle of the Mandible and the Mastoid

Adams Apple Thyroid

Cartilage , C5

Fingerprint above is
the Hyoid Bone C4

Finger print is C3
Submandibular Gland

C2 Submental

Finger print down is
Cricoid Cartilage C6

Sternocleidomastoid
– Accessory nerve Spinal
Root
– Flexes the Neck
– Lymph Node
– Deep Cervical LN ,
Deep to SCM and
internal Jugular Vein
– Superficial Cervical LN
Sup to SCM and Ext
Jugular
 Arteries of the Head and neck
Common Carotid Artery
-Arises from Brachiocephalic 1 cm above the Sternoclavicular joint
-1 cm below the greater cornu of the hyoid bifurcation
carotid Body and pulsation for CPR

- Internal carotid deep to SCM and into the Carotid Sheath gives the
ophthalmic supratrochlear and supraorbital

- External Carotid passes superficial to SCM behind the Mandible angle and
neck, furcates around the neck to form the maxillary and superficial temporal
 Blood Supply of the Face

Supraorbital and Supratrochlear

Facial Artery
– Starts above the Hyoid, deep to the posterior belly of
Digastric
– Crosses on top of the submandibular salivary gland
– Crosses below the lower border of the mandible at
the anterior boundary of Masseter
– Post to the angle of the mouth 1 cm
– Branches to the upper lip , lower lip and cheek
Superficial Temporal supplies the temporal and
zygomatic skin

Blood Supply of the Face

Maxillary Artery

Begins in the Parotid posterior to the
condyle neck

Infratemporal fossa

Crosses the lateral head of Lat Pterygoid

Pterygomaxillary fissure

Pterygopalatine fossa
 Parotid Gland

Wedge Shaped between the Ramus of the

Mandible, Sternocleidomastoid and Mastoid

Sometimes accessory part covers the Masseter
Muscle

Duct from the Superior Part of the Gland at the
Masseter anterior Edge , pierces the Buccinator

Partoid Space Infection & Diseases elevates the
Ear lobe

Parasympathetic
CN IX Glossopharyngeal
Otic Ganglion
Auriculotemporal Nerve

Sympathetic
Superior Cervical Ganglion
 Structure Within the Parotid Gland

External Carotid Artery

Retromandibular Vein ( forms by Maxillary
and Superficial Temporal and then divides
into anterior and posterior division)

Facial Nerve

Auriculotemporal nerve
 Facial Nerve

Leaves the cranium through the stylomastoid
foramen

Posterior Auricular to occipital belly

Branches to posterior Digastric and stylohyoid
muscles

Partoid Plexus
– Temporal branch to frontalis
– Zygomatic branch to orbicularis oculi
– Buccal Branch to Buccinator and Dilators
– Mandibular to the mentalis Muscle
– Cervical Branch to Platysma
 TMJ

Between the Mandible condyle head and articular

part of the squamous temporal

Covered by fibrocartilage

Capsule attached to Squamotympanic Fissure,
Squamous Temporal Bone& Neck of the
mandibular condyle

ligaments
– Lateral :TMJ ligament
– Lateral :Stylomandibular Ligament
– Medial :Sphenomandibular

Disk is biconcave, not uniform

Posterior part of the disk is inserted in
squamous temporal and posterior surface of
the mandible
 Infratemporal Region

Posterior Boundary is the Styloid Process and the Carotid

Sheath including the last 4 Cranial Nerves

1- Lateral Pterygoid
– Origin:

Sphenoid External Surface

Lateral Wall of the Lateral Pterygoid Plate
– Insertion

Neck of the Mandibular Condyle,
Condyle, TMJ , and Disk
– Nerve to lat Pterygoid V3
– Pulls disk and head of condyle forward to open the mouth

2-Medial Pterygoid
– Origin

Medial surface of the lateral Pterygoid Plate

Maxillary Tuberosity

Hamulus
– Insertion

Mandibular angle

opens the mandible moves the mandible up
, medially and forward
 Pterygomandibular Space
Ramus Medial Surface is not a flat

Posterior Boundary of Pterygomandibular
space is Parotid

Insertion of the needle lateral to the
pterygomandibular raphe

Mandibular foramen is midway between
anterior and posterior of the ramus

3-Sphenomandibular Ligament
– Origin

Sphenoid Ligament
– Insertion

lingula
– Medical to the maxillary artery and Inferior
Dental Neurovascular bundle

4- Maxillary Artery

5- Pterygoid Plexus of Veins
– Around the lateral pterygoid muscle
– Communicate with the facial vein
– Cavernous sine
– Interior ophthalmic
– Posterior Alveolar Nerve Blocks carries the risk
of hematoma in the inferior orbital fissure
causing a Black eye

6- Mandibular Nerve
 Mandibular Nerve

Leaves cranium through foramen ovale

Passes between the lateral Pterygoid and the
Tensor Veli Palatini

Separated by Otic Ganglion

Branches of the Mandibular nerve Main Stem
– Meningeal Branch ( through foramen spinosum)
– Nerve to medial pterygoid

Passes the Otic Ganglion without synapses and
supply the Tensor Veli Palatini and Tensor
Tympani, Malleus and Incus

Anterior Division
Nerve to lateral Pterygoid
Master
Nerve to Temporalis
Buccal sensory

Posterior Trunk
Nerve to Mylohyoida & Anterior
belly of digastric
Auriculotemporal
Lingual Nerve
Inferior Dental Nerve
 Lingual Nerve

Arises between the lat Pterygoid and the
Tensor Veli Palatini

Joined by Chorda Tympani from CN VII in
the space between the medial pterygoid and
Ramus

Lingual passes next to lower third molar

Then passes medially to the superficial
surface of hyoglossus muscle

- Submandibular ganglion
 Inferior Dental Nerve

Emerges below lateral pterygoid in the

Pterygomandibular space, where it gives an
branch to the mylohyoida

7- Otic ganglion

Below formen ovale

Preganglionic Parasympathatic from the
Glossopharyngeal,

Sympathetic from the Superior Cervical Ganglion

Through
– Auriculotemporal to the Parotid
– Inferior Dental and Buccal to the lower lip and Cheek

Motor (No Synapse) to the Tensor Villi palatini and

Tensor Tympani