Transcript Flora Hall - LearningSpace

LCSC06 Biological Sciences
Head & Neck 3:
Muscles of facial expression
H&N blood supply
Cranial nerves
Marianne Bos-Clark MCRSLT/HPC MSc
[email protected]
This session
• Muscles of facial expression and mastication
• Cranial nerves
• Blood supply
Muscles of the head and neck
• Aim:
describe origin, insertion, action and
innervation of the muscles of facial expression
and mastication.
Muscles of facial expression
•
•
•
•
Scalp
Mouth
Upper face: orbit and eyebrows
Neck
Muscles of facial expression 1
Scalp
Name
Origin
Insertion
Action
Epicranial aponeurosis
Skin superior to supra
orbital margin
•Raises eyebrows
Occipitofrontalis
Frontal belly
Surprise
Occipital belly
Occipital bone and
mastoid process of
temporal bone
Epicranial aponeurosis
Draws scalp
posteriorlly
Muscles of facial expression 2
Mouth
Origin
Insertion
Action
Obicularis oris
Muscle fibres
Skin at corner of
surrounding
mouth
opening of mouth
•Closes and protudes lips
•Compresses lips against
teeth
•Shapes lips during
speech
Zygomaticus
major
Zygomatic bone
Skin at angle of
mouth and
obicularis oris
•Draws angle of mouth
superiorlly and laterally as
in smiling
Zygomaticus
minor
Zygomatic bone
Upper lip
•Raises (elevates) upper
lip exposing maxillary
teeth
•Raises upper lip
Muscles of facial expression 3
Mouth
Muscle
Origin
Insertion
Action
Levator labii
superioris
Superior to
Skin at angle of
infraorbital foramen mouth and
of maxilla
obicularis oris
•Raises upper lip
Depressor labii
inferioris
Mandible
Skin of lower lip
•Depresses lower
lip
Depressor anguli
oris
Mandible
Angle of mouth
•Draws angle of
mouth laterally and
inferiorly: opening
mouth
Levator anguli oris
Inferior to
Skin of lower lip
infraorbital foramen
Draws angle of
mouth laterally and
superiorly
Muscles of facial expression 4
Mouth
Muscle
Origin
Insertion
Action
Buccinator
Alveolar process of
maxilla and
mandible
Obicularis oris
•Presses cheeks
against teeth
(whistling , blowing
& sucking). Draws
corners of mouth
laterally
•Mastication
Risorius
Facia over parotid
gland (saliva)
Skin at angle of
mouth
Draws angle of
mouth laterally as
in grimacing
Mentalis
Mandible
Skin of chin
Elevates and
protudes lower lip
and pulls skin of
chin up, as in
pouting
Muscles of facial expression 5
Orbit and eyebrow
Muscle
Origin
Insertion
Action
Orbicularis oculi
CN VII
Medial wall of orbit
Circular path
around orbit
Closes eye
Corrugator
supercilii
CN VII
Medial end of
superciliary arch of
frontal bone
Skin of eyebrow
Draws eyebrow
inferiorly and
wrinkles skin of
forhead vertically as
in frowning
Levator palpebrae
superioris
CN VII
Roof of orbit (lesser Skin of upper eyelid Elevates upper
wing of sphenoid
eyelid (opens eye)
bone)
Muscles of facial expression 6
Neck
Muscle
Origin
Insertion
Action
Platysma
CN VII
Facia over deltoid
and pectoralis
major muscles
Mandible, muscle
around angle of
mouth,
•Draws outer part
of lower lip
inferiorly (pouting)
•Depresses
mandible
Muscles of mastication 1
• Biting
• Chewing
• Manipulating
Cranial nerves: Mandibular division of CN V
(trigeminal)
Muscles of mastication 2
Muscle
Origin
Insertion
Action
TEMPORAL
TEMPORAL FOSSA
ANTERIOR BORDER OF
MANDIBLE
RAISES AND
RETRACTS
MANDIBLE
MASSETER
ZYGOMATIC ARCH
LATERAL SURFACE OF
ANGLE AND RAMUS OF
MANDIBLE
RAISES
MANDBLE
CLENCH TEETH
INTERNAL
PTERYGOID
XXX
RAMUS AND ANGLE OF
MANDIBLE
RAISES
MANDIBLE AND
PROTUDES JAW
EXTERNAL
PTERYGOID
SPHENOID BONE
MANDIBULAR CONDYLE
DEPRESSES
MANDIBLE AND
DRAWS
FORWARD AND
SIDEWAYS
BLOOD SUPPLY TO THE HEAD AND
NECK
Blood supply to the head
and neck
• Common carotid
arteries
• Vertebral arteries
COMMON CAROTID ARTERIES
Two branches in upper
neck
• INTERNAL CAROTID
ARTERIES
• EXTERNAL CAROTID
ARTERIES
Facial arteries
Branches from external
carotid arteries
Supplies skin of
• Chin
• Lips
• External nose
• Anterior parts of nasal
cavities
• Pharynx
Maxillary arteries
Supplies deep structures
of the face
Superficial temporal arteries
Supplies skin to temporal
region and scalp
VERTEBRAL ARTERIES
• Pass through foramen in cervical vertebrae for
part of course
• A branch of the subclavian arteries which also
supply the brain
Vertebral arteries
• Pass through foramen
in cervical vertebrae
• A branch of the
subclavian arteries
which supplies the brain
Circle of willis
• Joining area of several
arteries at the inferior
to the brain
VENOUS DRAINAGE
Drainage of the head and neck: JUGULAR VEINS
INTERNAL JUGULAR VEINS
• Large vessels formed at base of skull by veins
draining brain as they leave the cranial cavity
• Run alongside internal and common carotid
arteries and receive numerous tributaries
from other tissues and organs of the face and
neck as they pass down the neck
EXTERNAL JUGULAR VEINS
-smaller than internal
• Formed from tributary veins draining the
superficial face and scalp
• Tributaries from the deep and superficial
tissues of the face and scalp
The cranial nerves
I. Olfactory nerve
II. Optic nerve
III. Oculomotor nerve
IV. Trochlear nerve
V. Trigeminal nerve
VI. Abducens
VII. Facial nerve
VIII. Vestibulocochlear
nerve
IX. Glossopharyngeal
nerve
X. Vagus
XI. Accessory nerve
XII. Hypoglossal nerve
Cranial nerves 2
Cranial nerves 3
trigeminal nerve (CN V)
DIVISION
ACTION
IMPAIRED FUNCTION MAY
RESULT IN:
SENSORY :OPTHALMIC
Sensation to forehead and
scalp
DEFICITS IN SENSATION (touch,
pain, temp & proprioception):
forehead and scalp
SENSORY :MAXILLARY
Sensation to nose, temples, DEFICITS IN SENSATION: nose,
upper cheeks and lower
temples, upper cheeks, lower
eyelids
eyelids
SENSORY
:MANDIBULAR
Sensation to lower gum and DEFECITS IN SENSATION: mucosal
anterior 2/3 of tongue
membrane of lower gum & ant
2/3 of tongue
MOTOR FUNCTIONS
Innervates muscles of
mastication
Jaw deviation, weak
velopharyngeal closure ,
paralysis of masticators
Cranial nerves 4
facial nerve (CN VII)
ACTION OF NERVE
IMPAIRED FUNCTION MAY RESULT IN:
Sensory and motor functions:
•Controls muscles of facial
expression
•Taste-ant 2/3 of tongue
•Eye lubrication: lacrimal
gland
•Salivation (sub mandib and
subling glands)
•Excessive secretions from
submandibular and sub lingual
salivary glands
•Facial paralysis/flaccidity
asymmetry
•Hyperacusia
•Ptosis or eye drooping
Cranial nerves 6
Glossopharyngeal nerve (IX)
FUNCTION
ACTION OF NERVE
IMPAIRED FUNCTION MAY
RESULT IN:
SENSORY FUNCTION
•TASTE & SENSATION:
POSTERIOR 2/3 OF TONGUE
•CUTANEOUS PRESSURE
RECEPTORS ON PALATAL
ARCH, SOFT PALTATE, TONSILS
& EUSTACHIAN TUBE
•SOMATIC SENSATION OF
UPPER PHARYNX
•GAG: SENSORY ELEMENT
• LOSS OF SENSATION AND
TASTE TO POSTERIOR 2/3 OF
TONGUE
•DIMINISHED/ABSENT GAG
MOTOR FUNCTION
•VELOPHARYNGEAL CLOSURE
•UPPER PHARYNGEAL
CONSTRICTOR MUSCLES
•IMPAIRED VF CLOSURE
RESULTING IN NASAL ESCAPE
OF BOLUS
•IMPAIRED LARYNGEAL
ELEVATION
Cranial nerves 8
Vagus X
NERVE
FUNCTION
IMPAIRED FUNCTION MAY
RESULT IN…
SENSORY
•TASTE RECEPTORS IN
PHARYNX (UMAMI)
•VISCERAL SENSATION
•ISOLATED LEISIONS
UNCOMMON
MOTOR
•PHARYNGEAL REFLEXES(GAG:MOTOR RESPONSE)
•PHARYNGEAL
MOVEMENT: PHARYNGEAL
CONSTRICTOR MUSCLES
•LARYNGEAL FUNCTION
•UPPER OESOPHAGEAL
SPHINCTER FUNCTION
•PERISTALSIS/MOTILITY
•PARALYSIS OF SOFT
PALATE/PHARYNX AND
LARYNX
•INSPIRATORY STRIDOR
•ASPIRATION / CHOKING
•APHONIA
Cranial nerves 7
Hypoglossal nerve (CN XII)
NERVE
IMPAIRED FUNCTION MAY
RESULT IN…
SENSORY FUNCTION
NIL
NIL MOTOR FUNCTION
ONLY
MOTOR FUNCTION
TONGUE: INTRINSIC AND
EXTRINSIC MUSCLES
•FINE MOVEMENTS FOR
SPEECH
•BOLUS MANIPLUATION
•MIXING BOLUS WITH
SALIVA
•ANTERIOR-POSTERIOR
MOVEMENT OF BOLUS
•HYOID MOVEMENT
(SUPRA/INFRA HYOID
MUSCLES)
•DYSARTHRIA
•DIFFICULTY CONTROLLING
/MANIPULATING BOLUS
•
Practical: Self Study Task
Which muscles used?
Doubt
Vocalising
Sleep
Check out this website:
http://www.artnatomia.net/uk/artnatomyApplic
ation.html
and work out which facial muscles are used for:
Surprise; Crying; Smiling