Superficial Face and Muscles of Facial Expression

Question 1

Where is the face?

Answer 1

The anterior aspect of the head from forehead to chin and from one ear to the other

Question 2

What is the main role of the face?

Answer 2

Communicating by making expressions through the facial muscles

Question 3

What nerves provide cutaneous innervation of the scalp and face?

Answer 3

CNV
Cervical nerves from C2 and C3

Question 4

What branches of CNVa innervate the scalp and face?

Answer 4

Supraorbital
Supratrochlear
Infratrochlear
External nasal
Lacrimal

Question 5

What branches of CNVb innervate the scalp and face?

Answer 5

Zygomaticotemporal
Zygomaticofacial
Infraorbital

Question 6

What branches of CNVc innervate the scalp and face?

Answer 6

Auriculotemporal
Buccal
Mental

Question 7

Which spinal nerves innervate the scalp and face?

Answer 7

C2 - greater occipital
C3 - third occipital
C2 and 3 - great auricular and lesser occipital

Question 8

What supplies the angle of the mandible?

Answer 8

C2 and 3 - great auricular nerve

Question 9

What are the muscles of facial expression?

Answer 9

Buccinator
Orbicularis oris
Orbicularis oculi
Occipitofrontalis
Platysma

Question 10

Where does the frontal belly of the occipitofrontalis originate and insert?

Answer 10

Originates from the epicranial aponeurosis and inserts into the skin/subcutaneous tissue of the eyebrows and forehead

Question 11

Where does the occipital belly of the occipitofrontalis originate and insert?

Answer 11

Originates from the lateral 2/3 of the superior nuchal line and inserts into the epicranial aponeurosis

Question 12

What are the actions of the occipitofrontalis?

Answer 12

Retract the scalp - occipital belly
Wrinkle the forehead and elevate the eyebrows - frontal belly

Question 13

Where does the palpebral part of the orbicularis oculi originate and insert?

Answer 13

Originates from the medial palpebral ligament and inserts into the lateral palpebral raphe at the ligament

Question 14

Where does the orbital part of the orbicularis oculi originate and insert?

Answer 14

Originates from the nasal part of the frontal bone, frontal process of maxilla and medial palpebral ligament
Inserts into skin around margin of orbit

Question 15

What are the actions of the orbicularis oculi?

Answer 15

Close the eyelids gently (palpebral) - involuntary or blinking reflex
Close the eyelids tightly (orbital) - voluntary

Question 16

What innervates the occipitofrontalis?

Answer 16

Frontal belly - temporal branch of CNVII
Occipital belly - posterior auricular branch of CNVII

Question 17

What innervates the orbicularis oculi?

Answer 17

Temporal and zygomatic branches of CNVII

Question 18

Where does the orbicularis oris originate and insert?

Answer 18

Originates partially from buccinator/surrounding muscles and also from medial mandible/maxilla
Inserts into mucous membrane of lips

Question 19

What are the actions of the orbicularis oris?

Answer 19

Close and/or protrude the lips
Together with the buccinator and tongue, keeps food between occlusal surfaces of teeth
Assists in whistling

Question 20

What innervates the buccinator?

Answer 20

Buccal and marginal mandibular branches of CNVII

Question 21

Where does the buccinator originate and insert?

Answer 21

Originates from posterior part of alveolar processes of maxilla/mandible and from pterygomandibular raphe
Inserts as fibres merge with orbicularis oris

Question 22

What are the functions of the buccinator?

Answer 22

Presses the cheeks against the molars and works with the tongue to keep food between occlusal surfaces of teeth
Assists with smiling and resists distension

Question 23

What innervates the buccinator?

Answer 23

Buccal branch off CNVII

Question 24

Where is the buccal fat pad and why is it important?

Answer 24

Lies superficially to the buccinator and is pierced by the parotid duct

Question 25

Where does the platysma originate and insert?

Answer 25

Originates from subcutaneous tissue of the infra and supraclavicular regions Inserts at base of mandible to merge with orbicularis oris, skin of check, lower lip and angle of mouth

Question 26

What are the actions of the platysma?

Answer 26

To tense the skin of inferior face/neck and depress the mandible

Question 27

What are the functions of the dilators?

Answer 27

To widen the mouth or to lift or depress corners of the mouth

Question 28

What are the different dilator muscles?

Answer 28

Levator anguli oris Levator labii superioris Zygomatic major Zygomatic minor Risorius Depressor anguli oris Depressor labii inferioris

Question 29

What are the facial muscles of the nose and what are their actions?

Answer 29

Levator labii superioris alaeque nasi - flaring of nostrils Nasalis - wrinkles skin over dorsum of nose

Question 30

Which branches of the internal carotid artery supply the face?

Answer 30

Branches of the ophthalmic artery: Zygomaticofacial Zygomaticotemporal Supraorbital Supratrochlear

Question 31

Which branches of the external carotid artery supply the face?

Answer 31

Facial Maxillary - buccal, mental, infraorbital Superficial temporal - transverse facial

Question 32

Where can a pulse be taken in the face?

Answer 32

Facial artery at inferior border of mandible Transverse facial artery just anterior to the auricle

Question 33

What drains into the cavernous sinus?

Answer 33

Ophthalmic vein Facial vein

Question 34

What drains into the retromandibular vein?

Answer 34

Superior temporal vein Maxillary vein

Question 35

Where does the facial vein drain?

Answer 35

Cavernous sinus Internal jugular vein

Question 36

Why is there a danger triangle of the face?

Answer 36

No valves in the external facial veins so blood flows both ways Skin infections in this area may spread as intracranial infections No deep fascia so in lacerations blood and fluid can accumulate and inflammation causes large swellings

Question 37

What innervates the muscles of facial expression of the ear?

Answer 37

CNVII

Question 38

What supplies and drains the muscles of facial expression of the ear?

Answer 38

Arterial supply via the posterior auricular and superficial temporal arteries of the ECA Venous drainage to EJV Lymphatic drainage via parotid and mastoid nodes to deep cervical nodes

Question 39

What are the layers of the eyelids?

Answer 39

Skin Connective tissue Conjunctiva - palpebral and bulbar Muscle (orbicularis oculi) Tarsus Orbital septum

Question 40

What role does the tarsus play in the eyelids?

Answer 40

Eyelid support

Question 41

What is the orbital septum?

Answer 41

A fibrous membrane going from tarsi to margins of orbit Anterior border of orbit is continuous with the periosteum

Question 42

What connects the superior and inferior tarsi?

Answer 42

Lateral palpebral ligament

Question 43

Describe arterial supply of the eyelids

Answer 43

Arterial supply via the facial, transverse facial and superficial temporal arteries (ECA) and the supratrochlear, supraorbital and lacrimal arteries (ICA)

Question 44

Describe venous and lymphatic drainage of the eyelids

Answer 44

Venous drainage is via veins following the arteries Lymphatic drainage is via parotid nodes