The Face and Facial Expression 235 Human Anatomy Dr Stuart Bunt Use video Face and faces, shows a variety of facial types, Rembrandt, Fergie, Aborigines etc. Slides: RC2 Buccinator and orbicularis oris RC3 facial muscles, cartoon from front RM3 Embryo showing pharyngeal arches from the side RC11 facial muscles from side like Grants NOTE: for next year get slides from Clinical Anatomy, case studies..nice pictures for slides (scan?)

Visual Inspection

The muscles of the lips Orbicularis oris Elevators of the upper lip sphincter muscle of the mouth Elevators of the upper lip Zygomaticus minor Levator labii superioris Nasalis Zygomaticus major

Depressors of the lips Depressor labii inferioris Platysma Depressor anguli oris Mentalis

Retractors of the angle of the mouth Zygomaticus major Depressor anguli oris Risorius Platysma

Muscles attached to the nose Nasalis Levator labii, superioris alaeque nasi Levator labii superioris Zygomaticus minor Procerus

Muscles around the orbit and ear Orbicularis oculi orbital palpebral Depressor supercilli Corrugator supercilli Temporoparietalis Procerus Occipito frontalis frontalis

Problems with eye closure 7th nerve paralysis General paralysis

Lymphatic Drainage Maxillary and anterior mandibular region Ant. Middle and Post. submandibular nodes very tip to submental nodes Anterior Temporal, zygomatic and posterior manidibular regions Parotid nodes Ear retroauricular and subauricular nodes All drain into the cervical lymph nodes around the jugular

Lymphatic drainage

Nerve Supply Entirely by 7th Nerve Entirely motor except taste from ant 2/3 of tongue Also supplies tensor tympani of same side NOT upper eyelid 3rd Nerve

The Facial Nerve Auditory and facial nerve enter internal auditory canal Fibres leave for Pterygo-palatine ganglion/otic ganglion External petrosal nerve Chorda tympani to tongue Through facial canal in mastoid

Clinical Evaluation “Upper Motor Neuron” “Lower Motor Neuron” cortex controls lower opposite face forehead and eye closure dual consensual reflexes “Lower Motor Neuron” all muscles on one side affected taste affected

7th nerve damage Bell’s palsy pain around ear no sensory impairment complete palsy rapid recovery(2-8wks) Entrapment in facial canal after infection? steroids in severe cases where taste affected

Other 7th nerve lesions Ramsay-Hunt syndrome Hemifacial spasm Herpes Zoster of 7th nerve very severe pain in ear vescicles poor recovery Hemifacial spasm irritation of nerve by blood vessel?