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    GENERAL ANATOMY
    SECOND STAGE LEC.NO.3
    DR.MUKHALLED.AL-ASADY
    (ORAL & MAXILLOFACIAL SURGEON)
    B.D.S-C.A.B.M.F.S
    AL-MUTHNAA UNIVERSITY
    C0LLEGE OF DENTISTRY
    2024-2025
    HUMAN FACE-1
    ’’FACE’’

     The area bordered within the hairline,


    anterior border of the auricles, and the
    chin.
     Major contents: eyes, nose, mouth,
    muscles of facial expression, muscles of
    mastication, parotid gland, trigeminal
    nerve, and facial nerve.
     There is no deep fascia along the face.
    FACIAL LAYERS

     The entire face is similar to the scalp in being


    composed of five basic layers:
    (1)the skin,
    (2) the subcutaneous layer,
    (3) the musculoaponeurotic layer,
    (4) loose areolar tissue (ie, spaces and retaining
    ligaments), and
    (5) the fixed periosteum and deep fascia.
    FACIAL LAYERS

     The skin, superficial fascia, and SMAS form an


    anatomic structure similar to the scalp proper.

     The superficial muscular aponeurotic system


    (SMAS) is deep to the superficial fascia and
    provides a surgical plane for surgery of the
    face.
    SKIN OF THE FACE

     The skin of the face possesses numerous


    sweat and sebaceous glands.
     It is connected to the underlying bones by
    loose connective tissue, in which are
    embedded the muscles of facial
    expression.
     No deep fascia is present in the face.
    SUPERFICIAL MUSCULOAPONEUROTIC SYSTEM
    (SMAS)

     is the continuous layer, or sheet, of firm tissue


    that lies beneath the skin and runs from the collar
    bone to the forehead.
     Unlike the skin, which is a stretchy layer, the SMAS
    is a strong fibromuscular web; it is intricately
    connected to the skin, as well as the various
    muscles, tissues and fat pads in the face and
    neck.
     When the SMAS is surgically modified and lifted, it
    will also reposition the skin and make it look
    tighter, creating a more youthful appearance.
    Sensory Nerves of the Face

    GENERAL INFORMATION:
     Many motor and sensory nerves supply the
    face.
     All motor nerves are from the facial nerve and
    supply the muscles of facial expression.
     Sensory nerves of the face are derived:
     Mainly from the 3 divisions of the trigeminal
    nerve (V1, V2, V3).
     Small area by the branches of cervical plexus
    (C2&C3).
     The skin of the face is supplied by
    branches of the three divisions of the
    trigeminal nerve, except for the small
    area over the angle of the mandible
    and the parotid gland which is
    supplied by the great auricular nerve
    (C2 and 3).
     These nerves not only supply the skin of
    the face, but also supply proprioceptive
    fibers to the underlying muscles of facial
    expression.
     They are, in addition, the sensory nerve
    supply to the mouth, teeth, nasal
    cavities, and paranasal air sinuses.
    OPHTHALMIC NERVE (V1(
     The ophthalmic nerve supplies the skin of the
    forehead, the upper eyelid, the conjunctiva, and
    the side of the nose down to and including the tip.
    Five branches of the nerve pass to the skin:
     The lacrimal nerve supplies the skin and
    conjunctiva of the lateral part of the upper eyelid.
     The supraorbital nerve : It divides into branches
    that supply the skin and conjunctiva on the central
    part of the upper eyelid; it also supplies the skin of
    the forehead.
     The supratrochlear nerve: It divides into
    branches that supply the skin and conjunctiva
    on the medial part of the upper eyelid and the
    skin over the lower part of the forehead, close
    to the median plane.
     The infratrochlear nerve: It supplies the skin
    and conjunctiva on the medial part of the
    upper eyelid and the adjoining part of the side
    of the nose.
     The external nasal nerve leaves the
    nose by emerging between the nasal
    bone and the upper nasal cartilage.
     It supplies the skin on the side of the
    nose down as far as the tip.
    Maxillary Nerve (V2)
     The maxillary nerve supplies the skin
    on the posterior part of the side of the
    nose, the lower eyelid, the cheek, the
    upper lip, and the lateral side of the
    orbital opening.
     Three branches of the nerve pass to
    the skin.
     The infraorbital nerve is a direct continuation of
    the maxillary nerve. It enters the orbit and
    appears on the face through the infraorbital
    foramen.
     It immediately divides into numerous small
    branches, which radiate out from the foramen
    and supply the skin of the lower eyelid and
    cheek, the side of the nose, and the upper lip.
     The zygomaticofacial nerve passes onto the
    face through a small foramen on the lateral
    side of the Zygomatic bone. It supplies the skin
    over the prominence of the cheek.
     The zygomaticotemporal nerve emerges in the
    temporal fossa through a small foramen on the
    posterior surface of the zygomatic bone. It
    supplies the skin over the temple
    3.Mandibular Nerve (V3)
     The mandibular nerve supplies the skin
    of the lower lip, the lower part of the
    face, the temporal region, and part of the
    auricle.
     It then passes upward to the side of the
    scalp.
     Three branches of the nerve pass to the
    skin.
     The mental nerve emerges from the
    mental foramen of the mandible and
    supplies the skin of the lower lip and Chin.
     The buccal nerve emerges from beneath
    the anterior border of the masseter
    muscle and supplies the skin over a small
    area of the cheek.
     The auriculotemporal nerve ascends from
    the upper border of the parotid gland
    between the superficial temporal vessels
    and the auricle.
     It supplies the skin of the auricle, the
    external auditory meatus, the outer
    surface of the tympanic membrane, and
    the skin of the scalp above the auricle.
    Lymphatic Drainage of the Face (Introduction)
     The lymphatic system functions to drain tissue
    fluid, plasma proteins and other cellular debris
    back into the blood stream, and is also involved in
    immune defense.
     Once this collection of substances enters the
    lymphatic vessels, it is known as lymph.
     Lymph is subsequently filtered by lymph nodes and
    directed into the venous system.
     The lymphatic vessels of the head and neck can
    be divided into two major groups; superficial
    vessels and deep vessels.
     Superficial Vessels :
     drain lymph from the scalp, face and neck into the
    superficial ring of lymph nodes at the junction of the
    neck and head.
     Deep Vessels:
     The deep lymphatic vessels arise from the deep cervical
    lymph nodes. They converge to form the left and right
    jugular lymphatic trunks:
    • Left jugular lymphatic trunk – joins the thoracic duct
    at the root of the neck.
    • Right jugular lymphatic trunk empties into the right
    lymphatic duct at the root of the neck.
    Clinical Significance-1
     Sensory Innervation and Trigeminal
    Neuralgia
     The facial skin receives its sensory nerve
    supply from the three divisions of the
    trigeminal nerve.
     Remember that a small area of skin over
    the angle of the jaw is supplied by the
    great auricular nerve (C2 and 3).
    TRIGEMINAL NEURALGIA (TN OR TGN)

     is a chronic pain disorder that affects


    the trigeminal nerve.
     There are two main types: typical and atypical
    trigeminal neuralgia.
     The typical form results in episodes of severe,
    sudden, shock-like pain in one side of the face
    that lasts for seconds to a few minutes.
     Groups of these episodes can occur over a few
    hours.
     The atypical form results in a constant burning
    pain that is less severe.
     Episodes may be triggered by any touch to the
    face.
     Both forms may occur in the same person. It is
    one of the most painful conditions, and can
    result in depression.
    TRIGEMINAL NEURALGIA

     is a relatively common condition in which the


    patient experiences excruciating pain in the
    distribution of the mandibular or maxillary
    division, with the ophthalmic division usually
    escaping.
     A physician should be able to map out
    accurately on a patient’s face the distribution
    of each of the divisions of the trigeminal nerve.
    FACIAL SCAR

     Wrinkle lines of the face result from the


    repeated folding of the skin perpendicular
    to the long axis of the underlying
    contracting muscles, coupled with the
    loss of youthful skin elasticity.
     Surgical scars of the face are less
    conspicuous if they follow the wrinkle
    lines.
    FACE LIFT SURGERY

     clinically
    known as rhytidectomy, is
    a procedure used to reduce the
    appearance of facial wrinkles and
    other signs of aging, with the goal of
    improving the overall appearance of
    the face and jaw.

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