Superficial face and scalp Bony framework – the skull Glands and muscles of facial expression Innervation somatic sensory somatic motor parasympathetic sympathetic Arteries and veins

TEMPORAL (squamous part) FRONTAL coronal suture PARIETAL temporal line pterion TEMPORAL (squamous part) FRONTAL lambdoid suture LACRIMAL NASAL OCCIPITAL infraorbital foramen (major V2 exit) SPHENOID ZYGOMATIC MAXILLA external auditory meatus mastoid process mental foramen (major V3 exit) MANDIBLE

Anterior view of the skull supraorbital foramen/ notch (major V1 exit) SPHENOID ZYGOMATIC MAXILLA infraorbital foramen (major V2 exit) mental foramen (major V3 exit)

Ventral view of the skull MAXILLA ZYGOMATIC PALATINE SPHENOID VOMER foramen ovale (V3 exit) foramen lacerum foramen spinosum styloid process carotid canal jugular foramen stylomastoid foramen (CN VII exit) foramen magnum OCCIPITAL

Upper and lower dentition incisors canine premolars molars

frontonasal process maxillary process mandibular process

Somatic sensory innervation of the face: Trigeminal nerve (CN V) supratrochlear nerve supraorbital nerve dorsal rami of cervical spinal nerves Ophthalmic division (V1) infraorbital nerve auriculotemporal nerve Maxillary division (V2) buccal nerve Mandibular division (V3) branches from cervical plexus mental nerve

Muscles of facial expression (somatic motor, CN VII) frontalis orbicularis oculi levator labii superioris zygomaticus minor zygomaticus major orbicularis oris depressor anguli oris depressor labii inferioris mentalis platysma

Facial nerve: pathway for somatic motor branches to muscles of facial expression stylomastoid foramen (CN VII exit)

To Zanzibar By Motor Car Temporal branches Zygomatic branch posterior auricular branch Buccal branch parotid gland facial nerve emerging from stylomastoid foramen Mandibular branch Cervical branch The facial nerve runs through, but does not control, the parotid gland. Parasympathetic innervation originates in the glossopharyngeal nerve (CN IX) and follows a complex path to reach the gland.

epicranial aponeurosis frontalis occipitalis

epicranial aponeurosis (galea aponeurotica) Skin Connective tissue Aponeurosis Loose connective tissue Pericranium frontal belly occipital belly

Innervation of face and scalp Somatic motor to muscles of facial expression Somatic sensory to skin and conjunctiva Visceral motor (autonomics) parasympathetics to parotid gland sympathetics to blood vessels, arrector pili mm., sweat glands postganglionic axons from superior cervical ganglion, follow arteries to targets

Parotid gland and duct parotid duct orbicularis oris Parotid gland buccinator masseter

Parotid gland and duct parotid papilla buccinator parotid duct

supratrochlear arteries Superficial arteries of face and scalp supraorbital and supratrochlear arteries superficial temporal artery angular artery occipital artery transverse facial artery facial artery external carotid artery

Superficial arteries of face and scalp from external carotid: from internal carotid: supratrochlear artery superficial temporal artery supraorbital artery facial artery

Superficial veins of face and scalp supraorbital and supratrochlear veins superficial temporal vein angular vein transverse facial vein facial vein external jugular vein (cut) retromandibular vein

SUPERFICIAL FACE AND SCALP -- REVIEW - skull - muscles of facial expression - innervation somatic motor CN VII to muscles of facial expression somatic sensory CN V to face and most of the sides and top of the head, cervical spinal nn. to sides and back of the head parasympathetic CN IX to the parotid gland sympathetic postganglionics from superior cervical ganglion to skin and arteries - blood supply & return external and internal carotid aa. external and internal jugular vv.

7/14/2015 Superficial Face, Scalp: Dissector pp 219 - 229, Prepare for craniotomies at end of day: reflect scalp Skull: All bones and structures on pp 219 – 221, 226 Bodies: Platysma, parotid duct, parotid gland, temporal, zygomatic, buccal, mandibular and cervical branches of facial nerve, parotid plexus, masseter, buccinator, buccal branch (CN VII), buccal nerve (part of CN V3), facial artery and vein, superior and inferior labial arteries, orbicularis oculi with orbital and palpebral parts, levator labii superioris, zygomaticus major, orbicularis oris, buccinator, depressor anguli oris, supraorbital, infraorbital and mental neurovascular bundles (no need to distinguish artery, vein and nerve) (222 – 225) External jugular vein, maxillary artery and vein, superficial temporal artery, external carotid artery, posterior belly of digastric, stylohyoid, sternocleidomastoid (227) Frontal belly of occipitofrontalis (= frontalis), temporalis (229)