The Face
Muscles of the Face: ALL innervated by FACIAL Nerve [VII], located in the superficial fascia
Muscle
Orbicularis oculi
Corrugator
supercilii
Nasalis
Procerus
Depressor septi
Depressor
anguli oris
Depressor labii
inferioris
Mentalis
Risorius
Zygomaticus
major
Zygomaticus
minor
Levator labii
Attachment
Medial palpebral ligament and frontal bone,
frontal part of maxilla, medial palpebral
ligament to lateral palpebral raphe
Medial end of superciliary arch to skin of
medial half of eyebrow
Maxilla to aponeurosis across dorsum of nose
and alar cartilage of nose
Nasal bone and upper part of lateral nasal
cartilage to skin of lower forehead between
eyebrows
Maxilla to mobile part of nasal septum
Oblique line of mandible to skin at corner of
mouth, blending with orbicularis oris
Oblique line of mandible to lower lip at
midline, blending with muscle from opposite
side
Mandible to skin of chin
Fascia over masseter muscle to skin at corner
of mouth
Posterior part of lateral surface of zygomatic
bone to skin at corner of mouth
Anterior part of lateral surface of zygomatic
bone to upper lip just medial to corner of
mouth
Infra-orbital margin of maxilla to skin of upper
Function
Close eyelids gently (palpebral part)
and close eyelids forcefully (orbital
part)
Draws eyebrows medially and
downward
Compress nasal aperture
(transverse part) and draws
cartilage downward and laterally
opening the nostril (alar part)
Draws down medial angle of
eyebrows producing transverse
wrinkles over bridge of nose
Pulls nose inferiorly
Draws corner of mouth down and
laterally
Draws lower lip downward and
laterally
Raises and protrudes lower lip as it
wrinkles skin on chin
Retracts corner of mouth
Draws corner of mouth upward and
laterally
Draws upper lip upward
Raises upper lip, helps form
superioris
Lavator labii
superioris
alaeque nasi
Levator anguli
oris
Orbicularis oris
Buccinator
Anterior
auricular
Superior
auricular
Posterior
auricular
lateral half of upper lip
Frontal process of maxilla to alar cartilage of
nose and upper lip
nasolabial furrow
Raises upper lip and opens nostril
Maxilla below infra-orbital foramen to skin at
corner of mouth
From muscles in area; maxilla and mandible in
midline to ellipse around mouth
Posterior mandible and maxilla,
pterygomandibular raphe to blend with
orbicularis oris and into lips
Anterior temporal fascia into helix of ear
Raises corner of mouth, helps form
nasolabial furrow
Closes and protrudes lips
Epicranial aponeurosis to upper part of auricle
Elevates ear
Mastoid process to convexity of concha of ear
Draws ear upward and backward
Skin of eyebrows and lateral superior nuchal
Occipitofrontalis line and mastoid process to galea aponeurotica
Presses check against teeth,
compresses distended cheeks
Draws ear upward and forward
Wrinkles forehead and raises
eyebrows (frontal belly) Draws
scalp backward (occipital belly)
Major Arteries of the Face:
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Facial Artery: a branch of the external carotid artery, major artery supplying the face
o Passes posterior or through submandibular gland
o Curves around inferior border of the mandible, just anterior to the masseter: pulse point
o Branches include: inferior labial, superior labial, lateral nasal, and terminates as the
angular artery at the medial corner of the eye
o Supplies the upper and lower lip, lateral surface and dorsum of nose, and nasal septum
Transverse Facial Artery: a branch of the superficial temporal artery
o Arises within the parotid gland and crosses the face transversely, on the superficial
surface of the masseter muscle
o Supplies the area around the zygomatic arch
Maxillary Artery: a branch from the external carotid artery
o Branches include: infra-orbital, buccal, and mental arteries
o Supplies the lower eyelid, upper lip, and area between the two, the buccinator muscle,
and the chin
Ophthalmic Artery: a branch of the internal carotid artery
o Branches include: zygomaticofacial (from lacrimal branch), zygomaticotemporal (from
lacrimal branch), dorsal nasal (terminal), supra-orbital, and supratrochlear arteries
o Supplies the dorsum of the nose, the anterior scalp, and the area over the zygomatic
bone
Major Veins of the Face:
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Facial Vein: major vein draining the face
o Originates when the supratrochlear and supra-orbital veins join to form the angular vein
which becomes the facial vein as it proceeds inferiorly, nearing the facial artery
o The facial vein runs with the facial artery until it reaches the inferior border of the
mandible where it passes superficially to the submandibular gland to enter the internal
jugular vein
o Drains the eyelids, external nose, lips, cheek, and chin
Transverse Facial Vein: empties into the superficial temporal vein within the parotid gland
Intracranial Venous Connections: the facial vein connects with many other venous channels:
o Ophthalmic veins
o Veins passing into the infra-orbital foramen
o Veins passing into deeper regions of the face (deep facial vein, pterygoid plexus of veins)
 All of these venous channels have interconnections with the intracranial
cavernous sinus through emissary veins that connect the intracranial with
extracranial veins
 No valves in the veins of the face or head  blood can move in any direction
 The “danger area” (face/mouth/head) can allow infections to easily pass
through these venous channels all throughout the head, cranial cavity, and neck
Lymphatics of the Face: 3 groups of lymph nodes receive drainage from the face
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Submental Nodes: drain the medial lower lip and chin bilaterally
Submandibular Nodes: drain medial corner of the orbit, most of external nose, medial cheek,
upper lip, lateral part of lower lip
Pre-auricular and Parotid Nodes: drain most of the eyelids, a part of the external nose, and the
lateral part of the cheek
Innervation of the Face:
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The Trigeminal nerve [V] innervates facial structures derived from the first pharyngeal arch
o Cutaneous: ophthalmic [V1], maxillary [V2], and mandibular [V3] branches exit from the
cranial cavity to innervate all of the face except for a small area covering the angle and
lower border of the mandible ramus and parts of the ear ([V], [VII], and [X])
 Ophthalmic branch: exits skull through superior orbital fissure and enters orbit
where it branches into supra-orbital, supratrochlear, infratrochlear, lacrimal,
and external nasal nerves
 Maxillary branch: exits skull through foramen rotundum and branches into the
zygomaticotemporal, zygomaticofacial, and infra-orbital nerves
 Mandibular branch: exits skull through foramen ovale and branches into the
auriculotemporal, buccal, and mental nerves
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The Facial nerve [VII] innervates facial structures derived from the second pharyngeal arch
o Motor: exits skull through the internal acoustic meatus and gives off 7 branches (5 are
terminal), arrives inside the parotid gland and gives off two branches: temporofacial
(upper) and cervicofacial (lower) before giving off terminal branches
 Posterior auricular nerve: to the occipital belly of the occipitofrontalis and the
posterior auricular muscles
 Digastric branch: to the posterior belly of the digastric muscle and the
stylohyoid muscle
 Temporal branches: supply muscles in temple, forehead, and supra-orbital
region
 Zygomatic branches: supply muscles in infra-orbital area, lateral nasal area, and
the upper lip
 Buccal branches: supply muscles in cheek, upper lip, and corner of the mouth
 Marginal Mandibular branches: supply muscles of the lower lip and chin
 Cervical branches: supply the platysma
Parotid Gland:
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Largest of the 3 pairs of salivary glands
Anterior and below lower half of ear, superficial/posterior/deep to ramus of mandible, extend
down to lower border of mandible and up to zygomatic arch
Covers parts of SCM and masseter muscles
Innervated by the auriculotemporal nerve (branch of mandibular nerve [V3]) for sensory and
also receives secretomotor fibers (postganglionic parasympathetic) from the otic ganglion.
Preganglionic parasympathetic fibers from the otic ganglion come from [IX]
Parotid duct leaves anterior portion of parotid gland midway between zygomatic arch and
corner of mouth. It transversely crosses the medial border of the masseter, turns deeply into the
buccal fat pad, and pierces the buccinators muscle to open into the oral cavity near the 2nd
upper molars
The external carotid artery, transverse facial artery, retromandibular vein, auriculotemporal and
facial nerves pass through (or just deep):
o 5 branches of facial nerve emerge: temporal, zygomatic, buccal, marginal mandibular,
and cervical
o Retromandibular vein forms in the parotid gland when the maxillary and superficial
temporal veins unite
o External carotid artery gives off: posterior auricular branch and the maxillary and
superficial temporal (terminal branches)  which all supply the parotid gland
 Transverse facial artery branches from the superficial temporal artery
o Makes surgical removal difficult: 5 branches of facial nerve may be compromised along
with the vasculature running through and alongside the gland