Nerves and vessels of Face

Dr Mohd Imran ANATOMY JNMC AMU 1

Dr Mohd Imran ANATOMY JNMC AMU 2
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Terminal branches

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 Facial palsy
• Facial muscles
paralysis

• Which side??
• Right or left??

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Facial asymmetry:
• affected side is drawn to healthy side
• due to unopposed action of muscles of
normal side Dr Mohd Imran ANATOMY JNMC AMU 6
Loss of horizontal wrinkles on forehead:
• due to paralysis of occipitofrontalis
muscle
Dr Mohd Imran ANATOMY JNMC AMU 7
 Widening of palpebral fissure and
inability to close the eye :
• due to paralysis of orbicularis oculi
Dr Mohd Imran ANATOMY JNMC AMU 8
Tears flow down from the eye (epiphora):
• due to paralysis of the lower part of the
orbicularis oculi
Dr Mohd Imran ANATOMY JNMC AMU 9
 Sagging of the angle of the mouth towards
the affected side and inability of the
angle of the mouth to move upwards and
laterally during laughing-
• due to paralysis of zygomaticus major
Dr Mohd Imran ANATOMY JNMC AMU 10
Loss of nasolabial furrow-
• due to paralysis of levator labii
superioris alaeque nasi
Dr Mohd Imran ANATOMY JNMC AMU 11
 Accumulation of food into the vestibule
of the mouth-
• due to paralysis of buccinator muscle
Dr Mohd Imran ANATOMY JNMC AMU 12
Dribbling of saliva from the angle of the
mouth-
• due to paralysis of orbicularis oris
Dr Mohd Imran ANATOMY JNMC AMU 13
 Sensory nerve supply
• Trigeminal nerve
(5th) is the
sensory nerve of
the face because
it supplies the
whole of the face

Dr Mohd Imran ANATOMY JNMC AMU 14

 Sensory nerve supply
Except-
• Skin over the angle
of mandible, which
is supplied by Great
auricular nerve
derived from
ventral rami of the
2nd and 3rd
cervical nerves
(C2, C3)

Dr Mohd Imran ANATOMY JNMC AMU 15

 Trigemial nerve
V1- Ophthalmic
division

V2- Maxillary
division

V3- Mandibular
division
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 Branches of ophthalmic division

1. Supraorbital

2. Supratrochlear

3. Infratrochlear

4.External nasal

5. Lacrimal

Dr Mohd Imran ANATOMY JNMC AMU 17

 Branches of maxillary division

1. Infraorbital

2.Zygomatico-
facial

3.Zygomatico-
temporal

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 Branches of mandibular division

1.Mental

2.Buccal

3.Auriculo-
temporal

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 Trigeminal neuralgia
• It is a clinical condition characterized
by sudden paroxysmal attacks of pain
lasting from few hours to several days
• Confined to distribution of one or more
divisions of trigeminal nerve
• It commonly starts in the maxillary
territory and more frequently on the
right side

Dr Mohd Imran ANATOMY JNMC AMU 20

 Herpes zoster ophthalmicus
• Viral infection involving the ophthalmic
nerve
• Presents as severe pain and edema in
the ophthalmic territory and is
characterized by the appearance of
vesicles along the course of cutaneous
branches of the ophthalmic nerve

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Arterial supply of face

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Venous drainage of face

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 Dangerous area of the face
• Cavernous sinus
thrombosis

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