Facial muscles

Dr Mohd Imran ANATOMY JNMC AMU 1

 Skin of the Face
• Thick, elastic and very vascular
• Large number of sweat and sebaceous glands

• Sweat glands- regulate the body temperature

• Sebaceous glands- keep the face oily

• Skin on the face is lax

• Except- nose where it is firmly attached to the
underlying cartilages and provides insertion to
the muscles of facial expression
Dr Mohd Imran ANATOMY JNMC AMU 2
 Face
• Since the blood supply to the skin of the
face is profuse- it is rare in plastic
surgery for skin flaps to necrose

• Laxity of greater part of skin facilitates

rapid spread of edema

• Face is also the common site for acne due

to the presence of large number of
sebaceous glands in this region

Dr Mohd Imran ANATOMY JNMC AMU 3

 Cleavage Lines of Skin
• Tension lines/
Langer’s lines

• Incisions made
parallel to these
lines heal more
rapidly and
produce minimal
scarring
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• Incisions made
across these lines Cleavage Lines
heal poorly and
produce wide ugly
scars

Cut-
• Pus drainage
• Lesions of skin
E.g. scars,
pigmented patches,
skin cancers
Dr Mohd Imran ANATOMY JNMC AMU 5
 Superficial Fascia
Contains-
1. Muscles of facial expression
2. Vessels
3. Nerves
4. Variable amount of fat

Fat is absent in the eyelids

but is well-developed in cheeks (buccal pad
of fat), gives rounded contour to cheeks
Dr Mohd Imran ANATOMY JNMC AMU 6
 Deep Fascia
Absent

• except over the parotid gland and

masseter muscle
• Covered by parotidomasseteric fascia

• Absence of deep fascia in the face is

essential for the facial expression
Dr Mohd Imran ANATOMY JNMC AMU 7
Characteristics of the muscles of
facial expression
1. Lie in superficial fascia

2. Inserted into the skin

3. Morphologically, they represent the

specialized members of the
subcutaneous muscle (panniculus
carnosus), of lower animals
Dr Mohd Imran ANATOMY JNMC AMU 8
Characteristics of the muscles of
facial expression
4. Embryologically, they develop from mesoderm
of 2nd pharyngeal arch, hence supplied by
facial nerve, the nerve of 2nd arch

5. Functionally, they perform all important

functions of non-verbal communication in
addition to closing and opening the orifices in
the region of the face
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 Muscles around the
Orifice of the Eye
1. Orbicularis oculi

2. Corrugator supercilii

3. Frontalis

4. Levator palpebrae superioris

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Muscles around Nasal Cavity

1. Procerus

2. Nasalis

3. Depressor septi

Dr Mohd Imran ANATOMY JNMC AMU 14

 Muscles around the mouth
1. Orbicularis oris: Acts as sphincter

2. Nine muscles converging around the

mouth act as dilators

Dr Mohd Imran ANATOMY JNMC AMU 15

 Nine muscles converging around
the mouth
1. Levator labii superioris alaeque nasi
2. Levator labii superioris
3. Levator anguli oris
4. Zygomaticus major
5. Zygomaticus minor

6. Depressor labii inferioris

7. Depressor anguli oris
8. Risorius
9. Buccinator
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 Orbicularis oculi
1. Orbital part
2. Palpebral part
3. Lacrimal part

Dr Mohd Imran ANATOMY JNMC AMU 18

Ectropion

• Paralysis of orbicularis oculi results in

outward turning of the eyelid
• Drooping of lower eyelid (more common)
• Causes spilling of tear on the cheek
(epiphora)
Dr Mohd Imran ANATOMY JNMC AMU 19
 Corrugator
supercilii
Origin- medial end
of superciliary arch
passes laterally and
upwards

Inserted- into the skin of the eyebrow

Action- Drags the eyebrow medially and
downwards producing vertical wrinkles on
the forehead
Frowning- an expression of annoyance
Dr Mohd Imran ANATOMY JNMC AMU 20
 Frontalis

• Elevates the eyebrows

• Produces transverse wrinkles on the
forehead
• an expression of surprise, horror

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 Levator
Palpebrae
Superioris

Origin- lesser wing of sphenoid

Insertion- skin of upper eyelid
Action: Elevation of the upper eyelid to
open the eye
Nerve supply- Occulomotor nerve
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Origin- nasal bone Procerus
Passes upwards
Insertion- skin of
the lower part of
the forehead

Action- produces
transverse
wrinkles across
the bridge (root)
of the nose as in
frowning
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 Origin- maxilla Nasalis
bone

1. Transverse part
(compressor
naris)
2. Alar part (dilator
naris)

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 Depressor Septi Nasi
• Assists in widening
the nares

• Pulls the nose

inferiorly
• So assists the alar
part of the nasalis
in opening the
nares
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Orbicularis oris

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Orbicularis oris

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 Orbicularis oris
• variety of movements of lips such as-

• Closing
• Pouting
• Pursing
• Twisting

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 Paralysis of orbicularis oris
• The paralysis of half of orbicularis oris
prevents the proper closure of lips on
that side

• Consequently the speech is slurred and

the saliva escapes between the lips at
the angle of the mouth (dribbling of
saliva from the angle of the mouth)

Dr Mohd Imran ANATOMY JNMC AMU 30

Levator labii superioris alaeque nasi

• O- frontal process of the maxilla

• I- ala of nose and the upper lip
• A- elevates the upper lip and helps to
dilate the nostril
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 Levator labii superioris

• Origin- maxilla
• Insertion- upper lip
• Action- elevates the upper lip
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 Levator anguli oris

• Origin- maxilla
• Insertion- angle of mouth
• Action- raises the angle of the mouth
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 Zygomaticus minor

• Origin- zygomatic bone

• Insertion- upper lip
• Action- elevates the upper lip
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 Zygomaticus major

• Origin- zygomatic bone

• Insertion- angle of mouth
• Action- draws the angle of the mouth
upward and laterally
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 Depressor labii inferioris

• Origin- mandible
• Insertion- lower lip
• Action- draws the lower lip downwards and
somewhat laterally
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 Depressor anguli oris

• Origin- mandible
• Insertion- angle of mouth
• Action- draws the angle of the mouth
downward and laterally
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 Risorius

• Origin- parotid fascia

• Insertion- angle of mouth
• Action- retracts the angle of the mouth
gently
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 Mentalis

• Origin- mandible
• Insertion- lower lip
• Action- puckers the chin and protrudes
the lower lip
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 Buccinator

• (Bugler’s muscle / trumpeter’s muscle)

• Muscle of the cheek

Dr Mohd Imran ANATOMY JNMC AMU 40

Buccinator

Origin-
1. Alveolar process of maxilla
2. Pterygomaxillary raphe
3. Pterygomandibular raphe
4. Alveolar process of mandible
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Buccinator

• Fills the gap between the upper and lower jaws

Insertion- 1. Upper fibres pass into upper lip
2. Lower fibres pass into lower lip
3. Intermediate fibres decussate
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Buccinator

Actions:
• Flattens the cheek against the gum and teeth,
and thus prevents the accumulation of food in
the vestibule of mouth during mastication
• Responsible for blowing the cheek and
expelling the air between the lips from
inflated vestibule as in blowing the trumpet
(hence named trumpeter’s muscle)
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 Paralysis of buccinator muscle
• If the buccinator muscle is paralyzed,
as it occurs in facial palsy—

• Food accumulates in the vestibule of

mouth during mastication
• the person cannot blow his cheek

Dr Mohd Imran ANATOMY JNMC AMU 44

Modiolus

• Dense, compact, mobile, fibromuscular

mass situated about 1.25 cm lateral to the
angle of the mouth
Formed due to interlacing of fibres of:
1. Levator anguli oris
2. Zygomaticus major
3. Buccinator
4. Depressor anguli oris
5. Risorius Dr Mohd Imran ANATOMY JNMC AMU 45
Modiolus

• can be easily palpated by using opposed

thumb and index finger to compress the
skin and mucosa simultaneously
• Pulsations of facial artery can be felt
just lateral to the modiolus
• The inadvertent damage of modiolus during
plastic surgery leads to unacceptable
facial asymmetry
Dr Mohd Imran ANATOMY JNMC AMU 46
Emotional Presenting Facial
expression features muscle
Surprise/ • Transverse wrinkles • Frontalis
horror/ of the forehead
fright • Vertical wrinkles of • Corrugator
the forehead supercilii
Frowning • Transverse wrinkle • Procerus
across the root of
nose
Anger • Dilation of anterior • Dilator
nasal aperture naris
• Depression of lower • Depressor
mobile part of the septi
nasal septum
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Emotional Presenting Facial
expression features muscle
• Angle of mouth • Zygomaticus
Laughing
drawn upwards and major
laterally
• Accentuation of • Levator labii
Sadness/ nasolabial fold superioris
sorrow/ • Elevation and • Levator anguli
grief eversion of the oris and
upper lip zygomaticus
• Angle of mouth minor
drawn downwards • Depressor
and laterally anguli oris
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Emotional Presenting Facial
expression features muscle
Grinning • Retraction of angle • Risorius
of mouth laterally
Disdain/ • Puckering of chin,
• Mentalis
doubt protrusion of lower
lip
Worry • Skin folds radiating
laterally from lateral • Orbicularis
angle of the eye oculi
Irony • Angle of the mouth • Depressor
drawn downwards labii
and somewhat inferioris
laterally
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