1. Dr. Lubna Nazli Associate Professor Anatomy
FACE AND SCALP
Dr. Lubna Nazli
Associate Professor Anatomy

2. Objectives Face: Boundaries Muscles Blood supply Nerve supply
Applied anatomy
Scalp:
Extent
Structure
Blood supply
Nerve supply
Applied anatomy

3. Facial muscles Platysma Epicranius (occipitofrontalis)
Frontal belly
Occipital belly
Galea aponeurotica
Orbicularis oculi
Buccinator
Orbicularis oris
Nasalis
Platysma

5. The skin of face is very thin and connected to the facial bones by loose connective tissue.
There is no deep fascia.
The facial muscles lie in this connective tissue.

6. Arteries of head Facial artery Branch of external carotid artery.
Loops around mandible (where it is palpable), at anterior border of masseter, to enter the face
Follows a tortuous course to medial angle of eye
Lies deep to most facial muscles

7. Superficial temporal artery
Terminal branch of external carotid artery.
Ascends in front of ear (where it is palpable) to supply temporal and anterior portion of scalp
Transverse facial artery runs above parotid duct to supply the cheek region

8. Maxillary artery Branch of external carotid .
Enters into infratemporal fossa medial to neck of mandible
Branches
Inferior alveolar a.
Middle meningeal a.
enters the skull through foramen spinosum
Supplies cranium and dura mater
Posterior superior alveolar a.

9. Veins of head Facial vein Begins at medial angle of eye (angular vein)
Runs downward and backward through the face, posterior to the facial artery
Below angle of mandible, joins anterior branch of retromandibular vein to form common facial vein, which drains into internal jugular vein
Connections with cavernous sinus through the ophthalmic vein.

10. Retromandibular vein
Formed by union of superficial temporal and maxillary veins
Divides into an anterior branch that unites with facial vein and a posterior branch that joins posterior auricular vein to become external jugular vein

11. “Dangerous area” －lies between root of nose and two angles of mouth; in this area the facial vein has no valves

12. Nerves of head
Facial nerve (Ⅶ) Leaves skull through internal acoustic meatus, facial canal and comes out through the stylomastoid foramen

13. Enters parotid gland and divides into its five terminal branches for muscles of facial expression
Temporal
Zygomatic
Buccal
Marginal mandibular
Cervical

14. Trigeminal nerve (Ⅴ) Ophthalmic nerve (V1) Maxillary nerve (V 2)
Mandibular nerve (V 3)
Supplies sensory innervation to the face.

15. SCALP Boundaries Anterior－supraorbital margin
Posterior－external occipital protuberance and superior nuchal line
Lateral－superior temporal line

16. Layers consists of five layers:
Skin
Superficial fascia
Galea aponeurotica and occipitofrontalis
Subaponeurotic space (loose connective tissue)
Pericranium
The superficial 3 layer are closely knit together, called scalp

17. The skin has the greatest concentration of hair and sebaceous glands
The superficial fascia is dense connective tissue that binds the skin strongly to the underlying galea aponeurotica
It is richly supplied by blood vessels.
Wounds of the scalp bleed profusely but heal well.

18. Galea aponeurotica
It is interposed between the frontalis and occipitalis portions of the occipitofrontalis muscle.
These muscles place the aponeurosis under tension so that deep transverse lacerations of the scalp gape widely .

19. Subaponeurotic space (loose connective tissue)
Extracranial hematoma, the result of bleeding in the subaponeurotic space, can extend over the cranium. lt can extend posteriorly, to the superior nuchal line; anteriorly, into the eyelids to produce the “black eye”; and laterally, to the temporal line.

20. Contains a rich network of deep arteries and veins
Contains a rich network of deep arteries and veins. Therefore, this layer has been called the “dangerous area”.
Infection may spread to the substance of the bones, to venous channels within the cranial cavity, or to the brain.

21. Pericranium
Fuses firmly with bone at the sutures and with the periosteum of the adjacent bone, thus limiting the sub periosteal space.

23. Nerve supply

24. APPLIED ANATOMY Facial lacerations Scalp injuries, infections, cysts.
Paralysis of facial muscles
Trigeminal neuralgia: sensory disorder
What is the lymphatic drainage of the face and scalp?