Download MBBS Face Lecture PPT

Download MBBS (Bachelor of Medicine and Bachelor of Surgery) Latest Face Lecture PPT


FACE
FACE

? Extent
? Superiorly up to the hair line,
? Inferiorly up to the chin and base of the mandible
? on each side up to the auricle.
? The forehead is common to both the face and the

scalp.

? Skin of the Face
? The skin of the face is thick, elastic, and very vascular.
? It contains large number of sweat (regulate the body

temperature ) and sebaceous glands (oily face).
? Superficial Fascia
? It contains muscles of facial expression, vessels and

nerves, and variable amount of fat.

? Fat absent in the eyelids
well-developed in cheeks (buccal pad of fat)
buccal pads very prominent in infants
(suctorial pad of fat).
? Deep Fascia
? The deep fascia is absent in the region of face (except

over the parotid gland and masseter muscle, which are

covered by parotidomasseteric fascia)

? Absence of deep fascia in the face is essential for the

facial expression.
MUSCLES OF FACIAL EXPRESSION

? The muscles of facial expression are embedded in

the superficial fascia.

? Most of them arise from bones of the skull and

are inserted into the skin.

? Characteristic Features
1.Lie in superficial fascia and inserted into the skin.
2.Develop from mesoderm of 2nd pharyngeal arch,

supplied by facial nerve.

3.Perform all important functions of non-verbal

communication.
? Location and Function
? The facial muscles are arranged in groups around

the orifices of mouth, eye, and nose as sphincters

and dilators of these orifices.

? To perform fine movements of facial expressions

the facial muscles have small motor units.


Muscles Around the Orifice of the Eye

1. Orbicularis oculi
-- orbital part
-- palpebral part
--lacrimal part
2. Corrugator supercilii.
3. Frontalis.
4. Levator palpebrae

superioris.


Muscles Around the Nasal Cavity

1. Procerus
2. Nasalis
3. Depressor septi


Muscles Around the Mouth

? Orbicularis oris
? Levator labii superioris

alaeque nasi.

? Levator labii superioris.
? Levator anguli oris.
? Zygomaticus minor.
? Zygomaticus major.
? Depressor labii

inferioris.

? Depressor anguli oris.
? Risorius.
? Buccinator.
? Mentalis


Facial muscles and emotional expressions


NERVE SUPPLY

? Motor Nerve Supply
? Derived from the facial nerve.
? It leave the cranial cavity through

stylomastoid foramen

? It divides into 5 terminal branches
Temporal
Zygomatic
Buccal
marginal mandibular
cervical
? These terminal branches form the

goose-foot pattern (pes anserinus)

on the face.




? Sensory Nerve Supply
? By trigeminal nerve
? It supplies the whole of the

face.

? Except skin over the angle

of mandible [supplied by

great auricular nerve

derived from ventral rami

of the 2nd and 3rd cervical

nerves C2, C3 ].

? V1= Ophthalmic division
? V2= Maxillary division
? V3= Mandibular division




? Trigeminal neuralgia (tic douloureux)
? It is a clinical condition characterized by

sudden paroxysmal attacks of lancinating 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
? Herpes zoster ophthalmicus
? It is a viral infection involving the ophthalmic nerve
? It presents as severe pain and edema in the

ophthalmic territory.

? Characterized by the appearance of vesicles along

the course of cutaneous branches of the

ophthalmic nerve


Bell's palsy

? Lower motor neuron type

paralysis

? Due to compression of facial

nerve near stylomastoid foramen.

? Etiology unknown (viral infection)
? Characteristic Features on the

Side of Paralysis

1. Facial asymmetry-- unopposed

action of muscles of normal side.

2. Loss of horizontal wrinkles on

forehead -- occipitofrontalis

muscle
3. Widening of palpebral fissure and inability to close the eye--

orbicularis oculi.

4. Tears flow down from the eye (epiphora) -- lower part of the

orbicularis oculi.

5. Sagging of the angle of the mouth towards the affected side

--zygomaticus major.

6. Loss of nasolabial furrow-- levator labii superioris alaeque

nasi.

7. Accumulation of food into the vestibule of the mouth--

buccinator muscle.

8. Dribbling of saliva from the angle of the mouth--

orbicularis oris.

9. Loss of resistance when one presses cheek with inflated

vestibule and air leaks out from between the lips--

buccinator muscle.
ARTERIAL SUPPLY

? The face is the highly vascular region.
? Supplied by the following arteries
1. Facial artery.
2. Transverse facial artery.
3. Arteries that accompany the cutaneous nerves.
? Chief artery of the face is facial artery.
? Facial Artery
? It arises from external carotid artery in the neck
? In the face, the it passes tortuously.
? The tortuosity of art. prevents its walls from being

unduly stretched during the movements of

mandible, lips, and cheeks.

? The terminal part of art. is called angular artery.
? It ends by anastomosing with the dorsal nasal

branch of ophthalmic artery
? Branches of the Facial Artery in the Face

? In the face it gives three sets of named branches
1. Inferior labial artery supply the lower lip.
2. Superior labial artery supply the upper lip.
3. Lateral nasal artery supply the ala and dorsum

of the nose. All these branches arise anteriorly.

4. Muscular branchesare small, unnamed and

arise from the posterior aspect of the artery


1 = zygomaticotemporal

2= zygomaticofacial

3= infraorbital

4= palpebral branch of

lacrimal artery
? Transverse Facial Artery br. of superficial

temporal artery ter. br. of external carotid

artery

? Branches of the maxillary artery (ter. br. of ext.

carotid artery)

? Infra orbital artery
? Buccal artery
? Mental artery

? Branches of the ophthalmic artery (br.of int.

Carotid art.)

? zygomaticofacial art.
? zygomaticotemporal art.
? dorsal nasal artery
? Supraorbital art.
? supratrochlear art.


* Branches of the ophthalmic artery
VENOUS DRAINAGE

? Venous blood from the face is drained by two veins

1. Facial vein.

2. Retromandibular vein
? Facial Vein
? It is the largest vein of the face.
? It is formed by the union of supratrochlear and

supraorbital veins.

? It joins the ant. div. of retromandibular vein and form

the common facial vein, which drains into the internal

jugular vein.

? Tributaries of facial vein correspond to the branches of

facial artery.

? Deep Connections
? The facial vein communicates with the cavernous

sinus through the following two routes

1.Facial vein communicates superior ophthalmic

vein drains into cavernous sinus

2. Facial vein is joined to the pterygoid venous

plexus by the deep facial vein.

? Deep facial vein communicates with pterygoid

venous plexus which in turn communicates with

the cavernous sinus through an emissary vein

? Retromandibular Vein
? Formed by the union of the superficial temporal

and the maxillary vein.

? it divides into two divisions: anterior and

posterior.

? The anterior division joins the facial vein to form

the common facial vein.

? posterior division joins the posterior auricular

vein to form the external jugular vein.


Dangerous area of the face

? The facial vein and its

communications are devoid of

valves

? the spread of septic emboli from

infected area of the

lower part of the nose,
upper lip, and
adjoining part of the cheek
in retrograde direction through
deep facial vein pterygoid

venous plexus emissary vein

cavernous sinus leading to

meningitis and cavernous sinus

thrombosis


LYMPHATIC DRAINAGE

? Preauricular (superficial

parotid) L.N Forehead, later

halves of the eyelids including

conjunctiva, parotid area, and

adjoining part of the cheek.

? Submandibular L.N Central

part of the forehead, medial

halves of the eyelids, external

nose, upper lip, lateral part of

lower lip, medial part of cheek,

and greater part of the lower

jaw.

? Submental L.N Central part

of the lower lip and chin


LACRIMAL APPARATUS


Components of lacrimal apparatus

1. Lacrimal gland.
2. Ducts of lacrimal gland.
3. Conjunctival sac.
4. Lacrimal puncta.
5. Lacrimal canaliculi.
6. Lacrimal sac.
7. Nasolacrimal duct.
1.Lacrimal gland:
? J-shaped serous gland.
? It consists of
Orbital part upper large
Palpebral part lower small.
? The two parts are continuous with each other

around the lateral margin of the levator palpebrae

superioris.
2.Ducts of the lacrimal gland:
? Approximately 12 in number,
? From orbital part 4 or 5 ducts
? From palpebrae part 6?8 ducts.
? They open into the lateral parts of the superior

fornix of the conjunctival sac.

? Lacrimal gland secretes the lacrimal (tear) fluid
? About 1 ml of lacrimal fluid is secreted per day.
? Half of it evaporates and remaining half is drained

into lacrimal sac.
Functions of lacrimal fluid
i. Flushes the conjunctiva and keeps the cornea moist
ii. Provides nourishment to cornea.
iii. Serves to express emotions
iv. Prevents infection (bactericidal lysozyme).
? Accessory lacrimal glands (glands of Krause):
? Very small serous glands located beneath the

palpebral conjunctiva near the fornices.

? They are about 35?40 in the upper eyelid and 6?8 in

the lower eyelid.

3.Conjunctival sac: It is a potential space between

palpebral and bulbar conjunctiva.

4.Lacrimal puncta: These are small openings on the

lid margins.

5.Lacrimal canaliculi: There are two lacrimal canaliculi

, superior and inferior in upper and lower eyelids,

respectively.

6.Lacrimal sac: It is the upper dilated end of the

nasolacrimal duct.

? 7.Nasolacrimal duct: It is a membranous canal. Its

lower opening presents lacrimal fold or valve of

Hasner
Epiphora

? It is an overflow of tears from conjunctival sac over

the cheeks.

? It may occur due to:
(a) excessive secretion of tears (hyperlacrimation)

following intake of spicy food or emotional outbreak,

or

(b) obstruction in lacrimal passages, viz. lacrimal

punctum, lacrimal canaliculi, lacrimal sac and

nasolacrimal duct,

(c) eversion of lower eyelid (ectropion), hence that of

lacrimal papilla and lacrimal punctum due to laxity of

orbiculi oculi in old age or loss of its tone due to

paralysis

This post was last modified on 30 November 2021