1. 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?)

2. Visual Inspection

3. 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

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

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

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

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

11. Problems with eye closure
7th nerve paralysis
General paralysis

12. 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

13. Lymphatic drainage

14. 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

15. 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

16. 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

17. 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

18. 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?