The Facial Muscles | Gross HSB A Muscles of facial expression

1st Year – 1st Semester – 1st Prelims – 3rd Week (M.A. Cruz, M.D.)
▪ Characteristic – attached to bone or fascia & inserts to the skin
Learning objectives (a checklist) ▪ Motor innervation – from CN VII (facial nerve)
✓ Discuss the composition of the face o Also, CN VII (facial nerve) is sensory to the sense of taste, etc.
✓ Illustrate the muscles of the face ▪ Sensory innervation – from CN V (trigeminal nerve)
✓ Differentiate the functions of the muscles of the face o Also, CN V (trigeminal nerve) is motor to the muscles of mastication
✓ Enumerate and describe the neurovascular (nerves, blood vessels, and ▪ Note: Wrinkles or creases are perpendicular to the muscle
lymphatics) structures on the face ▪ Location – usually around the holes of the skull such as the orbit, nose,
Face eyes, and the mouth
▪ Composition – tripartite ▪ Muscles of the forehead (2)
o Skin o Frontalis
o Soft tissue (fat, muscle, and connective tissue) ▪ Characteristic – actually part of the occipitofrontalis with the galea
o Hard tissue foundation (bone) aponeurotica located at the middle
o Note: The hard tissue foundation dictates the appearance of a person ▪ Origin – galea (epicranial) aponeurotica
▪ Facial muscles ▪ Insertion – skin of the eyebrow
o Characteristic – originate from the bone and inserts to the skin ▪ Action – elevates the eyebrows & produces horizontal wrinkles in
o Etymology of the facial muscle names the forehead
▪ First name – action (levator, depression, etc.) ▪ Note: Frequently paralyzed by botox to avoid wrinkles
▪ Second name – insertion (labii, anguli, etc.) o Corrugator supercilii
▪ Third name – adjective (superioris, inferioris, etc.) ▪ Etymology
▪ Example: Levator labii superioris • Corrugator – means to bring together or wrinkle
▪ Review of cranial nerves • Supercilii – means ‘eyebrows’ or hairs above
Cranial Nerves Name Mnemonic Type Mnemonic ▪ Characteristic – horizontally-oriented muscles at the root of the
I Olfactory Oh Sensory Some nose; hence, it produces vertically-oriented frown lines at forehead
II Optic Oh Sensory Say ▪ Location – internal to the frontalis & orbicularis oculi muscles
III Oculomotor Oh Motor Marry ▪ Muscles of the mouth, lips, and cheeks (11)
IV Trochlear To Motor Money o Note: Arranged in a clockwise-manner starting at the median sagittal
V Trigeminal Touch Both But o Orbicularis oris
VI Abducens And Motor My ▪ Action – for speech and social expression
VII Facial Feel Both Brother ▪ Location – sphincter of the mouth (for oral competence)
VIII Auditory A Sensory Says o Depressor septi nasi
IX Glossopharyngeal Girls Both Big ▪ Action – for gummy smile
X Vagus Vagina Both Boobs ▪ Note: Now included in the muscles of the head
XI Spinal accessory Such Motor Matter o Levator labii superioris alaeque nasi
XII Hypoglossal Heaven Motor Most ▪ Action – for elevation of the upper lip & wings of the nose
o Note: Only cranial nerve V & VII innervate the facial muscles o Levator labii superioris
▪ Both – mixed nerves ▪ Action – for elevation of the upper lip
▪ Boundaries of the face ▪ Association – helps zygomaticus minor to deepen the nasolabial
o Vertical boundary – forehead to the chin sulcus (for sadness)
o Horizontal boundary – one ear to the other ear o Levator anguli oris
o Depth boundary – muscles to subcutaneous ▪ Action – for raising the angle of the mouth
o Zygomaticus minor
▪ Action – for raising the lips
▪ Emotion – contempt for sadness
o Zygomaticus major
▪ Action – for pulling of the angle of the mouth supero-laterally
▪ Emotion – smiling or laughing
o Risorius
▪ Action – for drawing the corner of the mouth laterally when grinning
(seen in sardonic smile)
o Depressor anguli oris
▪ Action – for depressing the angle of the mouth
▪ AKA – triangularis
▪ Emotion – frowning
o Depressor labii inferioris
▪ Action – for pulling the lips inferiorly
▪ AKA – quadrangularis
▪ Emotion – impatience
o Mentalis
▪ Action – for raising the skin of the chin
▪ Emotion – expression of douth
▪ Note: Gives the dimpling in the chin
o Buccinator
▪ Action – for whistling, sucking, or blowing
▪ AKA – trumpeter muscle
▪ Etymology – from the word ‘buccina’ or horn
▪ Note: aids in mastication by pressing the cheeks against the molar
teeth
Classification of the muscles of the face ▪ Muscles around the orbital opening
▪ Classification according to actions: o Orbicularis oculi
o Muscles of facial expression – for emotion ▪ Action – closes the eyes
o Muscles of mastication – for chewing ▪ Three components:
▪ Classification according to location around structures: • Orbital – outer orbit
o Forehead • Palpebral – inner orbit
o Mouth o Action – for drainage of tears when crying
o Eyes • Lacrimal
o Nose
▪ Muscles around the nose Nerve supply of the face
o Nasalis ▪ Facial nerve (VII) – motor nerve for muscle of the facial expression
▪ Action – for compressing or dilating of the nostrils o Motor root – for facial expression, platysma, auricular, & scalp muscles
▪ Two components: o Sensory root – has no sensory fibers in the face
• Compressor nares o Nerve tract of the facial nerve
• Dilator nares (alar part) ▪ Pons → Internal auditory meatus → Stylomastoid foramen →
o Procerus Parotid gland (pierces the parotid)
▪ Action – for the horizontal creases at the root of the nose ▪ Note: Exits the internal auditory meatus with the vestibulocochlear
▪ Orientation – vertical nerve
o Depressor septi ▪ Note: Located in between the parotid, hence why the
▪ Action – for gummy smile parotidectomies are hard to perform due to risk of facial nerve injury
▪ Movement – pulls down the nasal septum o Branches of the face nerve (10) – only five are important for the face
Group of muscles per action of the face (composed of many muscles) ▪ Chorda tympani
▪ Squint muscles ▪ Nerve for stapedius
▪ Nerve for stylohyoid muscle
▪ Nerve for posterior belly of digastric muscle
▪ Posterior auricular nerve
▪ Temporal
▪ Zygomatic
▪ Buccal
▪ Mandibular
▪ Cervical
▪ Note: Ten Zillion Bucks Mean Cash
▪ Musculature of the mouth & lips ▪ Trigeminal nerve (V) – sensory nerve for the face

▪ Upper lip & nasal musculature

o Three divisions or nuclei (Mnemonic for skull exit: Standing Room Only)
▪ Ophthalmic nerve (CN V1)
• Skull exit – superior orbital fissure
▪ Orbicularis & nasal musculature • Facial entrance – supraorbital notch
• Branches, sub-branches, & innervations
o Nasociliary nerve
▪ Anterior ethmoidal nerve
• Innervation – skin tip of the nose
▪ Posterior ethmoidal nerve (none on the surface)
▪ Infratrochlear nerve
• Innervation – root of the nose
o Frontal nerve
▪ Supratrochlear nerve
• Innervation – skin middle of the forehead to the
hairline
▪ Smile muscles ▪ Supraorbital nerve
• Innervation – mucous membrane of the frontal
sinus, upper eyelid, palpebral conjunctiva, and
skin of the forehead to the vertex
▪ Maxillary nerve (CN V2)
• Skull exit – foramen rotundum
• Facial entrance – intraorbital notch
• Branches, sub-branches, & innervations
o Infraorbital nerve
▪ Innervation – skin of the upper cheek, mucosa of the
maxillary sinus, upper alveolar, upper gingiva,
▪ Lower lip protrusion
conjunctiva of inferior eyelid, and skin & mucosa of
upper lip
o Zygomatic nerve
▪ Zygomaticotemporal nerve
• Innervation – anterior part of the temple
▪ Zygomaticofacial nerve
• Innervation – skin over zygomatic prominence
o Palatine branches (none on the facial surface)
o Nasal branches (none on the facial surface)
 ▪ Mandibular nerve (CN V3)
• Skull exit – foramen ovale
• Facial entrance – mental foramen
• Characteristic – inferior and largest division of CN V formed by
the union of sensory & motor root of CN V in foramen ovale
o Also, it is the only division of CN V with motor innervation
• Note: Mandibular nerve is the only mixed nerve division of the
trigeminal nerve (and the reason it is considered a mixed CN)
• Branches, sub-branches, & innervations
o Motor innervation – muscles of mastication
o Sensory innervation
▪ Auricolotemporal nerve
• Innervation – auricle, external acoustic meatus,
external surface of tympanic membrane, and skin
above the auricle
▪ Buccal nerve
• Innervation – small skin near the angle of the
mouth
▪ Mental nerve
• Innervation – skin of chin, mucous membrane,
skin of lower lip, and inferior labial gingiva
Muscles of mastication
Lymphatic drainage of the face
▪ Function – cleans up infection or malignancy
▪ Action – parts of the face’s lymph vessels drain into catch areas or ‘lymph
nodes’
▪ Importance – allows approximation of infections & malignancies
▪ Different lymph nodes:
o Parotid lymph nodes
▪ Catch – lymph from lateral part of the face & eyelids
o Deep cervical lymph nodes
▪ Catch – lymph from deep parotid nodes
o Submandibular lymph nodes
▪ Catch – lymph from upper lip & lateral part of the lower lip
o Submental lymph nodes
▪ Catch – lymph from the chin & central part of the lower lip

▪ Masseter muscle
o Characteristic – strongest chewing muscle
o Note: Can cause squaring of the jaw & can be injected with botox for
cosmetic purposes
▪ Pterygoid muscles
o Action – protruding, retruding, left-to-right movement of the mandible
▪ Temporalis
o Characteristics – allows for closing of the mouth when the masseter is
paralyzed
o Insertion – coronoid of the mandible
Vessels & lymphatics of the face
▪ Basics
o Carotids – arteries of the neck (internal & external)
▪ Internal carotid
• Path – directly to the brain & actually branches to the face after
entering the brain (superior orbital & superior trochlear artery)
▪ External carotid
• Path – branches at the neck & face
o Jugulars – veins of the neck (internal & external)
▪ Arteries of the face
o External carotid artery
▪ Facial artery
▪ Superficial temporal artery
▪ Transverse facial artery
o Internal carotid artery
▪ Superior orbital artery
▪ Superior trochlear artery
▪ Veins of the face (named similar to their artery)
o Note: All are drain to the jugular veins
o Supratrochlear vein
o Supraorbital vein
o Angular vein
o Facial vein
o Superficial temporal vein
o Retromandibular vein
Points to remember
▪ Facial skin characteristics:
o Thin, vascular, movable, & muscles insert directly to the skin
▪ ‘Dangerous area’
o Triangular area from the root of the nose & angles of the mouth
▪ Angular vein → superior ophthalmic vein → cavernous sinus (vein)
o Significance – infections may travel to cavernous sinus (brain)
▪ Main artery of the face
o Facial artery (external maxillary) – a branch of the external carotid artery
▪ Nerves of the face
o Facial nerve – supplies muscles of expression
▪ Motor innervation – muscles of expression, stapedius, stylohyoid,
posterior belly of digastric muscle, scalp muscles, auricle, and face
(buccinator & platysma)
o Trigeminal nerve – supplies the integument & muscles of mastication
▪ Note: Innervates the entire skin of the face except that over the
lower half of the ramus of the mandible (great auricular nerve)
▪ Landmarks
o Orbicularis oculi (eyes) and oris (mouth)
o Muscle associates with the nose
▪ Components – procerus & compressor nares
o Muscles associated with smiling (zygomatic area)
▪ Components – zygomaticus major & minor
o Muscles associated with lip elevators
▪ Components – levator labii superioris & levator labii superioris
alaeque nasii
o Muscles associated with angle of the mouth
▪ Components – levator anguli oris & depressor anguli oris
o Muscles associated with lower lip
▪ Components – risorius (grinning muscle) and depressor labii
inferioris
o Muscle associated with chin & cheeks
▪ Components – mentalis & buccinator
o Muscles associated with mastication
▪ Components – temporalis, masseter, internal pterygoid, external
pterygoid, mylohyoid, and anterior belly of digastric

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