THE FACE AND THE SCALP

The Face
The face is that part of the
head visible in a frontal
view, that is, anterior to the
external ears.
Boundaries:
1. Superior -
Hairline
2. Inferior - Lower
border of the
mandible
 Regions of the Face
1. Forehead
2. Temporal
3. Orbital
4. External nose

5. Zygomatic
6. Oral
7. Cheeks
8. Mental
9. External ear
FEATURES OF THE FACE
 Lips

- Surround the mouth, or

entrance to the oral
cavity.
- Separated from the
cheek by nasolabial
groove.
- Philtrum extends from
the nose to the vermilion
border.
- Superiorly, the philtrum
terminates at the
columella, the fleshy
partition between the
nostrils.
- Lower lip is separated
from the chin by the
labiomental groove.
- Upper and lower lip
meets at the angle of the
mouth.
 Layers of the Lips:

1. Skin - thin and

hairless, allowing
the redness of the
underlying capillary
bed to show through.
2. Superficial Fascia -
loosely arranged
and contains some
fats.
3. Muscle -
orbicularis oris
4. Submucous Tissue -
contains blood vessels
and labial mucous glands
which opens to the
vestibule of the mouth.
5. Mucous membrane -
coats the intraoral
vestibule of the lips and
then reflects from the
upper and lower lips to
the attached gingiva. This
is called the vestibular or
mucolabial fold.
 External Ear
- Contains a single elastic
cartilage which provides
support to the external ear.

- Skin is tightly bound to the

cartilage with no
intervening subcutaneous
layer.

- Skin and cartilage is

thrown into several folds.
 Cheeks (Buccae):
- Form the lateral movable walls of the oral cavity.
- Mucosa of the cheeks ends in the mucobuccal fold
superiorly and inferiorly.
- Buccal fat pad is lies superficial to the buccinator
muscle.
- Parotid duct opens intraorally thru the mucosa of
the cheeks at the occlusal level of the second
maxillary molar.
 Layers of the Cheeks:

1. Skin,
2. Superficial fascia
containing the fat of Bichot,
zygomatic major, risorius,
platysma, the parotid duct,
and the branches of the
facial and trigeminal nerves.
3. Muscular layer –
Buccinator muscle
4. Submucous layer
containing mucous buccal
glands,
5. Mucous membrane
 External Nose

- The framework is composed of the nasal

bones, septal cartilage, lateral cartilages, and
alar cartilages.
- Skin of the nose is continues beyond the
external nares into the vestibule of the nose,
with nasal hairs to filter larger particles of
dusts in the air.
4. Inferior palpebral margins
- cuts across the lower
border of the iris when the
lids are open.
5. Cilia or eyelashes -
project from the palpebral
margins intwo or three
irregular rows.
6. Plica semilunaris - a
cresent fold at the medial
angle of the eye that
separates the white of the
eye from the medial,
reddish-colored lacrimal
lake.
External features:
7. Lacrimal lake - small,
raised, triangular are
bordered by the plica
semilunaris; a raised,
reddish area within the
lake is the caruncle.
8. Superior and inferior
papillae - are small,
raised bumps at the
junction of the ciliated
hairless margins of the
lids; at the apex of which
is the lacrimal punctum.
9. Conjuctivum - mucous
membrane inner lining of
the lid.
The Scalp
 The Scalp

The scalp extends from the supraorbital

margins back to the superior nuchal line
posteriorly. Laterally, the scalp extends up to
the temporal fossae.
The Five Layers of the Scalp
 The Five Layers of the Scalp
Skin
a layer of thin skin containing numerous hair
follicles, sweat glands, and sebaceous glands

Connective tissue
A thick, dense, subcutaneous connective tissue is
anchored firmly to the skin above and the
membranous layer below.
Aponeurosis
Is formed by the galea aponeurotica.

Loose Areolar Tissue

Allows freedom of movement of the superficial three
layers over the top of the skull

Pericranium
Firmly anchored to the underlying bone.
The Facial Nerve
 The Course of the
Facial Nerve
From the lower border of the pons varolli, the two roots
of the facial nerve approach and enter the internal
acoustic meatus. The meatus leads to the petrous
temporal bone and joins the facial canal. The facial
nerve runs laterally within the facial canal, turns
sharply at the genu (knee) to run posteriorly, and then
drops inferiorly to exit thru the stylomastoid foramen
at the base of the skull. The nerve enters the
substance of the parotid gland and then breaks up into
5 sets of muscular branches. The genu of the nerve
contains the sensory geniculate ganglion.
 The facial nerve arises as two distinct
trunks from the lower border of the
pons:
1. the smaller of the
two trunks is the
nervus intermedius ( a
sensory
and parasympathetic
root)

2. the larger root is the

motor root
Schematic Diagram
Pons varolii
internal auditory meatus
petrous temporal
facial canal
genu to run posteriorly
stylomastoid foramen
parotid gland
five muscular branches.
 Branches of the Facial Nerve
1. The greater petrosal
nerve
2. The nerve to the
stapedius muscle
3. The chorda tympani
nerve
4. The posterior
auricular nerve
5. The facial branches
(motor)
 Branches of the Facial Nerve
1. The greater
petrosal nerve
- arises from the
genu of the facial
nerve within the
facial canal.
- contains mainly
taste fibers to the
palatal mucosa
and
- parasympathetic
fibers to the
lacrimal gland,
the mucosa of the
palate,
nasopharynx and
the nasal cavity.
 Branches of the Facial Nerve
2. The nerve
to the
stapedius
muscle
- arises within the
facial canal
and is motor to
the stapedius
muscle of the
middle ear.
 Branches of the Facial Nerve
3. The chorda
tympani nerve
- arises from the
descending portion
of the facial nerve
within the facial
canal.
- leaves the skull
thru the
petrotympanic
fissure
- Taste fibers are
distributed to the
anterior two thirds of
the tongue via the
lingual nerve.
The Chorda Tympani
Nerve Distribution for the Tongue
 Branches of the Facial Nerve
4. The posterior auricular nerve arises from
the stylomastoid foramen and communicates
with the great auricular and lesser occipital
nerves. It has 2 branches:
1. auricular branch which supplies the
auricularis posterior and intrinsic muscles on
the cranial aspect of the auricle, and
2. occipital branch which supplies the
occipital belly of the occipitofrontalis.
The Posterior Auricular Nerve
 Branches of the Facial Nerve
5. Facial branches (motor) arise within the parotid
gland as five main groups. These are:
a. Temporal
b. Zygomatic
c. Buccal
d. Mandibular, and
e. Cervical
These branches innervate the muscles
of facial expression and platysma.
 Motor Branches of the Facial Nerve

1. Temporal
2. Zygomatic
3. Buccal
4. Mandibular
5. Cervical
 Motor Branches of the Facial Nerve

1. Temporal
2. Zygomatic
3. Buccal
4. Mandibular
5. Cervical
 Motor Branches of the Facial Nerve
1. Temporal branches
- travel superiorly and anteriorly to supply the
facial muscles situated above the zygomatic arch,
including the orbit and the forehead.
They innervate:
1. the anterior and superior auricular
muscles,
2. the frontalis muscle, and
3. the superior portion of the orbicularis
oculis muscle.
 Motor Branches of the Facial Nerve
2. Zygomatic branches
- runs transversely across the face to supply
the facial muscles in the zygomatic, orbital,
and infraorbital areas. They supply:
1. the inferior portion of the orbicularis oculis
muscle,
2. the superior portions of the zygomaticus major,
levator labii superioris,
levator anguli oris, nasalis, and
orbicularis oris muscles.
 Motor Branches of the Facial Nerve
3. Buccal branches
- supplies the muscles of the cheek and circumoral
muscles. They innervate:
1. the buccinator, and
2. the inferior portions of
the zygomaticus major,
levator labii superioris,
levator anguli oris,
nasalis, and
orbicularis oris muscles.
 Motor Branches of the Facial Nerve
4. Mandibular branches
- supplies the muscles of the chin and the
lower lip. Specifically they pass to:
1. the depressor anguli oris,
2. depressor labii inferioris, and to
3. the mentalis muscles.
 Motor Branches of the Facial Nerve
5. Cervical branches
- descend to the neck to supply:
1. the platysma,
2. posterior belly of the digastric,
3. stylohyoid muscles
 Cranial Nerve Test
Lesions of the facial nerve may cause:
(1) paralysis of facial muscles,
(2) loss of taste sensation from the
anterior two thirds of the tongue,
(3) decreased salivation.