The Face

Skin of the face

• Connected to the underlying bones by loose

connective tissue, in which are embedded the
muscles of facial expression. No deep fascia is
present in the face.
Sensory Nerves of the Face
 Three divisions of the trigeminal nerve

• The ophthalmic nerve supplies

the region developed from the
frontonasal process;
• The maxillary nerve serves the
region developed from the
maxillary process of the first
pharyngeal arch;
• The mandibular nerve serves the
region developed from the
mandibular process of the first
pharyngeal arch.
 Ophthalmic Nerve

• supplies the skin of the forehead, the upper eyelid,

the conjunctiva, and the side of the nose down to
and including the tip.
• Lacrimal nerve
• Supraorbital nerve
• Supratrochlear nerve
• Infratrochlear nerve
• External nasal nerve
 Lacrimal nerve

• supplies the skin and conjunctiva of the lateral part

of the upper eyelid
 Supraorbital nerve

• winds around the upper

margin of the orbit at the
supraorbital notch.

• It divides into branches

that supply the skin and
conjunctiva on the
central part of the upper
eyelid; it also supplies the
skin of the forehead
 Supratrochlear nerve

• winds around the upper margin of

the orbit medial to the
supraorbital nerve.
 Infratrochlear nerve

• leaves the orbit below the

pulley of the superior
oblique muscle.

• It supplies the skin and

conjunctiva on the medial
part of the upper eyelid and
the adjoining part of the
side of the nose
 External nasal nerve

• leaves the nose by

emerging between the
nasal bone and the upper
nasal cartilage.

• It supplies the skin on the

side of the nose down as
far as the tip
 Maxillary Nerve

• supplies the skin on the posterior part of the side of

the nose, the lower eyelid, the cheek, the upper lip,
and the lateral side of the orbital opening.
 Three branches of the nerve pass to the skin

• Infraorbital nerve
• Zygomaticofacial nerve
• Zygomaticotemporal nerve
 Infraorbital nerve

• direct continuation of the maxillary nerve.

• Enters the orbit and appears on the face

through the infraorbital foramen.
 Zygomaticofacial nerve

• passes onto the face through a small foramen on the

lateral side of the zygomatic bone.
 Zygomaticotemporal nerve

• emerges in the temporal fossa through a small

foramen on the posterior surface of the zygomatic
bone.
 Mandibular Nerve

• supplies the skin of the lower lip, the lower part of

the face, the temporal region, and part of the auricle.

• passes upward to the side of the scalp

• Mental nerve
• Buccal nerve
• Auriculotemporal nerve
 Mental Nerve

• emerges from the mental foramen of the mandible

and supplies the skin of the lower lip and chin
 Buccal nerve

• emerges from beneath the anterior border of the

masseter muscle and supplies the skin over a small
area of the cheek.
 Auriculotemporal nerve

• ascends from the upper border of the parotid gland

between the superficial temporal vessels and the
auricle.
 Arterial Supply of the Face

• Two main vessels

– Facial artery
– Superficial temporal arteries
 Facial Artery

• arises from the external carotid artery

Branches
• Submental artery
• Inferior labial artery
• Superior labial artery
• Lateral nasal artery
• Superficial temporal artery
• Transverse facial artery
• Supraorbital and Supratrochlear arteries,
 Venous Drainage of the Face

• Facial vein
– formed at the medial angle of the eye by the
union of the supraorbital and supratrochlear veins
Lymph Drainage of the Face
Bones of the Face
Muscles of the Face (Muscles of Facial Expression)
 Facial Nerve

• Temporal branch
• Zygomatic branch
• Buccal branch
• Mandibular branch
• Cervical branch
The Neck
• region of the body that lies between the lower
margin of the mandible above and the suprasternal
notch and the upper border of the clavicle below.
 Skin of the Neck

• Natural lines of cleavage of the skin are constant and

run almost horizontally around the neck.
Cutaneous Nerves
 Superficial Fascia

• forms a thin layer that encloses the platysma muscle.

• embedded in it are the cutaneous nerves referred to

in the previous section, the superficial veins, and the
superficial lymph nodes.
Superficial Veins
 Tributaries

The external jugular vein has the following tributaries:

• Posterior auricular vein

• Posterior division of the retromandibular vein
• Posterior external jugular vein
• Transverse cervical vein
• Suprascapular vein
• Anterior jugular vein
Superficial Lymph Nodes
 Bones of the Neck

• Cervical Vertebrae
• Hyoid Bone
Muscles of the Neck
 Key Muscles of the Neck

• Sternocleidomastoid
• Scalenus Anterior
Muscle
Muscles of the Neck
Muscles of the Neck
 Deep Cervical Fascia

• Investing Layer
• Pretracheal Layer
• Prevertebral Layer
• Carotid Sheath
 Cervical Ligaments

• Stylohyoid ligament:
• Stylomandibular ligament:
• Sphenomandibular ligament:
• Pterygomandibular ligament:
Arteries of the Head and Neck
Branches of Common Carotid Artery
 Branches of the External Carotid Artery

• Superior thyroid artery

• Ascending pharyngeal artery
• Lingual artery
• Facial artery
• Occipital artery
• Posterior auricular artery
• Superficial temporal artery
• Maxillary artery
Middle Meningeal Artery
Internal Carotid Artery
 Branches of the Internal Carotid Artery

• Ophthalmic Artery
• Posterior Communicating Artery
• Anterior Cerebral Artery
• Middle Cerebral Artery
• Circle of Willis
• Subclavian Arteries
– Right Subclavian Artery
– Left Subclavian Artery
– First Part of the Subclavian Artery
– Second Part of the Subclavian Artery
– Third Part of the Subclavian Artery
 Veins of the Head and Neck
The veins of the head and neck may be divided into:

• The veins of the brain, venous sinuses, diploic veins,

and emissary veins
• The veins of the scalp, face, and neck
 Veins of the Brain

• Venous Sinuses
• Diploic Veins
• Emissary Veins
 Veins of the Face and the Neck

• Facial Vein
• Superficial Temporal Vein
• Maxillary Vein
• Retromandibular Vein
• External Jugular Vein
• Anterior Jugular Vein
• Internal Jugular Vein
• Subclavian Vein
 Lymph Drainage of the Head and Neck

• The lymph nodes are arranged as a regional collar

that extends from below the chin to the back of the
head and as a deep vertical terminal group that is
embedded in the carotid sheath in the neck
 Regional Nodes

• Occipital nodes: • Retropharyngeal

• Retroauricular (mastoid) nodes:
nodes: • Laryngeal nodes:
• Parotid nodes: • Tracheal
• Buccal (facial) nodes: (paratracheal) nodes
• Submandibular nodes:
• Submental nodes:
• Anterior cervical nodes:
• Superficial cervical
nodes:
 Deep Cervical Nodes

• Jugulodigastric node
• Juguloomohyoid node,
Deep Cervical Nodes
 Cranial Nerves

The cranial nerves are • VI. Abducent

named as follows: • VII. Facial
• I. Olfactory • VIII. Vestibulocochlear
• II. Optic • IX. Glossopharyngeal
• III. Oculomotor • X. Vagus
• IV. Trochlear • XI. Accessory
• V. Trigeminal • XII. Hypoglossal